La riqueza de una experiencia en agua, saneamiento e higiene en establecimientos del primer nivel de atención (PNA)

La Organización Panamericana de la Salud / Organización Mundial de la Salud (OPS/OMS), en su compromiso por garantizar el cumplimiento de los Objetivos de Desarrollo Sostenible - #6 (Garantizar la disponibilidad y la gestión sostenible del agua y el saneamiento para todos) para 2030, tiene la firme voluntad de promover el fortalecimiento de las capacidades de los servicios de salud en la Región de las Américas. En 2018, el Secretario General de las Naciones Unidas hizo un llamamiento mundial para que se adopten medidas en favor del agua, el saneamiento y la higiene (WASH, por sus siglas en inglés) en todas las instalaciones de atención de la salud y, en la 72.ª Asamblea Mundial de la Salud, se adoptó una resolución para instar a los países (entre otros puntos clave) a establecer y aplicar, según cada contexto nacional, las normas mínimas sobre agua, saneamiento e higiene y sobre prevención y control de infecciones (PCI), en todas las instalaciones de atención de la salud.

Feasibility of increasing calcium content of drinking tap water following quality regulations to improve calcium intake at population level.

Background: Calcium intake is below recommendations in several parts of the world. Improving calcium intake has benefits not only for bone health but also helps to prevent pregnancy hypertension disorders. Calcium concentration of tap water is usually low The aim of the present study was to determine the maximum amount of calcium that can be added to tap water while complying with drinking water Argentine regulations. Methods: Tap water samples were collected from the Province of Buenos Aires (Argentina). Physicochemical properties and saturation index were measured. Different incremental concentrations of calcium chloride were added to the experimental aliquots. Results: Baseline water had a mean calcium concentration of 22.00 ± 2.54 mg/L, water hardness of 89.9 ± 6.4 mg/L CaCO 3, and a saturation index of -1.50 ± 0.11. After the addition of 0.4554 ± 0.0071 g of salt, water hard-ness reached 355.0 ± 7.1 mg/L CaCO 3, a calcium concentration of 140.50 ± 2.12 mg/L, and a saturation index -0.53 ± 0.02. Conclusions: This study shows that at laboratory level it is feasible to increase calcium concentration of drinking water by adding calcium chloride while complying with national standards. Calcium concentration of drinking tap water could be evaluated and minimum calcium concentration of tap water regulated so as to improve calcium intake in populations with low calcium intake.

Determinants of adoption of household water treatment in Haiti using two analysis methods: logistic regression and machine learning.

Household water treatment (HWT) is recommended when safe drinking water is limited. To understand determinants of HWT adoption, we conducted a cross-sectional survey with 650 households across different regions in Haiti. Data were collected on 71 demographic and psychosocial factors and 2 outcomes (self-reported and confirmed HWT use). Data were transformed into 169 possible determinants of adoption across nine categories. We assessed determinants using logistic regression and, as machine learning methods are increasingly used, random forest analyses. Overall, 376 (58%) respondents self-reported treating or purchasing water, and 123 (19%) respondents had residual chlorine in stored household water. Both logistic regression and machine learning analyses had high accuracy (area under the receiver operating characteristic curve (AUC): 0.77-0.82), and the strongest determinants in models were in the demographics and socioeconomics, risk belief, and WASH practice categories. Determinants that can be influenced inform HWT promotion in Haiti. It is recommended to increase access to HWT products, provide cash and education on water treatment to emergency-impacted populations, and focus future surveys on known determinants of adoption. We found both regression and machine learning methods need informed, thoughtful, and trained analysts to ensure meaningful results and discuss the benefits/drawbacks of analysis methods herein.

Water springs: an immeasurable resource for ensuring sustainability.

Water springs are manifestations of groundwater to the surface, forming and ensuring the supply and sustainability of streams, lakes, rivers, and dams. Therefore, its riparian forest is considered an area of permanent preservation, which aims to protect the water, as well as the spring, from consequences of disordered population growth, added to deficient basic sanitation systems, climate change, agricultural activities, inappropriate land uses, unplanned urbanization, and diffuse sources of pollution. In addition to compromising water quality, many of these factors affect the permanence of water upwelling at the source, compromising the formation and continuity of streams, lakes, and rivers. In this context, the objective of the present research was to carry out a bibliographic review on water springs, approaching adjacent themes to the main axis of the study that are fundamental for a deep understanding of their importance for the maintenance of water resources and ensuring biodiversity in the search for the sustainability of life for present and future generations. This research collaborates with the environmental view and shows that the function of a water sources is broader than its concepts can reveal.

Quality and access to water for human consumption: a look at the state of Amazonas, Brazil. / Qualidade e acesso à água para consumo humano: um olhar sobre o estado do Amazonas, Brasil.

Surveillance indicators of the quality of water for human consumption in the Amazon were analysed from 2016 to 2020 using 185,528 samples from 11 microregions. Of the samples analysed, 93.20% were from urban areas, 66.65% were from the public water supply system (WSS), 31.02% were from the Collective Alternative Solution-CAS, and 2.33% from the Individual Alternative Solution-IAS. There was an increase in the number of records by the WSS, with a downwards trend and fluctuations in records for the CAS and the IAS. The quality indicators of chemical and physical parameters for urban areas were higher than those for rural areas and traditional communities. Most of the samples presented pH values below the recommended level. In the quantification of microbiological parameters, a higher presence of total coliforms and E. coli was identified in samples from rural areas and in traditional communities. In conclusion, there were inadequacies in the chemical, physical and microbiological parameters as well as problems related to the supply, storage and surveillance of water distributed for human consumption. These findings indicate the need to build an agenda for public management to address water insecurity and its likely effects on food insecurity in the region.

Analisaram-se indicadores de vigilância da qualidade da água para consumo humano no Amazonas, de 2016 a 2020, utilizando 185.528 amostras provenientes de 11 microrregiões. Das amostras analisadas, 93,20% são da área urbana, 66,65% provinham do sistema público (SAA), 31,02% da Solução Alternativa Coletiva (SAC) e 2,33% da Solução de Alternativa Individual (SAI). Observou-se aumento do número de registros pelo SAA, com tendência de queda e oscilações de registros para a SAC e a SAI. Os indicadores de qualidade dos parâmetros químicos e físicos da área urbana foram superiores aos das áreas rurais e de comunidades tradicionais. A maior parte das amostras apresentou valores de pH abaixo do recomendado. Na quantificação dos parâmetros microbiológicos, identificou-se maior presença de coliformes totais e E.coli na área rural e em comunidades tradicionais. Em conclusão, verificaram-se inadequações nos parâmetros químicos, físicos e microbiológicos, assim como problemas relativos ao abastecimento, armazenamento e à vigilância da água distribuída para consumo humano. Tais achados indicam a necessidade de construir uma agenda, pela gestão pública, para o enfrentamento da insegurança hídrica e seus prováveis efeitos sobre a insegurança alimentar existente na região.

Comparison of Aedes aegypti arbovirus transmission thresholds in two communities with differing water supply infrastructure.

BACKGROUND: To assess whether the 'economic boom' in the tropical seaport city of Barranquilla improved tapped water supplies to socio-economically poor neighbourhoods resulting in: (1) their reduced use for domestic water-storage in large (> 1,000-litre) custom-made cement tanks which are their principal Aedes aegypti breeding sites and (2) their pupae/person index (PPI) values to below their established 0.5-1.5 PPI arbovirus transmission-threshold value, compared to matched neighbourhoods in the: (a) pre-economic boom (2004) period in Barranquilla and (b) economically-neglected seaport city of Buenaventura. METHODS: The simple, accurate and robust water surface sweep-net/calibration factor or total count methods were used to determine the total Ae. aegypti pupae numbers in greater or less than 20-litre water-holding container types located 'inside' or 'outside' these neighbourhood premises. The women residents also participated in questionnaire-based responses about their domestic water supplies, water-storage and maintenance and mosquito life stages and disease transmission knowledge, to subsequently plan appropriate resident education programmes. Microsoft Excel 8.0 with OpenEpi was used to determine the samples sizes and the statistical values. RESULTS: Tapped water supplies to the three poor Barranquilla neighbourhoods were dramatically increased from 2004 to 2023 resulting in their residents significantly reducing their: (a) large cement water-storage tanks from 1 per 6.9 (2004) to 1 per 31.2 (2020) premises (z = 10.5: p = 0) and (b) PPI values to 0.16, 0.19 and 0.53 (mean: 0.29: 95% CI ± 0.4) in each study neighbourhood. In contrast, tapped water supplies remained inadequate in the Buenaventura neighborhoods, thereby resulting in their continued use of many large (> 1,000-litre) water-storage containers (Barranquilla: 1 per 31.2 and Buenaventura: 1 per 1.5 premises: z = - 9.26: p = 0), with unacceptably high 0.81, 0.88 and 0.99 PPI values in each study neighbourhood (mean 0.89: 95% CI ± 0.12). CONCLUSIONS: Improved tapped water supplies resulted in reduced numbers of large custom-made stoneware water-containers, as are employed by poor residents throughout the world, as well as their Ae. aegypti PPI transmission threshold values which, together with appropriate residents' education programmes, are also urgently to reduce to prevent/reduce Ae. aegypti transmitted human diseases globally.

Indigenous people doing citizen science to assess water quality using the BMWP in rivers of an arid semi-arid biosphere reserve in Mexico.

Arid and semi-arid areas are among the most threatened ecosystems on the planet. The Tehuacán-Cuicatlán Biosphere Reserve (TCBR), in southeastern Mexico, is an arid and semi-arid area with high biological diversity and human settlements of eight ethnic groups. Two rivers drain the reserve, Río Grande (RG) and Río Salado (RS), which are not subject to water quality monitoring by government agencies; however, measures of water quality of these rivers are needed to focus conservation actions on this resource. This work aimed to test the effectiveness of participatory water quality monitoring with the participation of three actors: Reserve management leaders, local communities, and academics, to monitoring water quality in the rivers of the TCBR. Ninety-two residents were trained to carry out water quality biomonitoring using the Biological Monitoring Working Party (BMWP) index calibrated for the reserve. The BMWP uses macroinvertebrate families to display numerical and categorical water quality scores. Additionally, the Water Quality Index (WQI) was assessed and the Normalized Difference Vegetation Index (NDVI) of the riparian zones was estimated in each study site. The mean WQI scores were 69.24 for RS (no treatment necessary for most crops and necessary treatment for public water supply) and 75.16 for RG (minor purification for crops requiring high-quality water and necessary treatment for public water supply). The BMWP showed five water quality categories (Excellent, Very Good, Good, Fair, and Poor), showing higher water quality scores in the upper portion of the basins and capable of discriminating study sites with lower scores close to human settlements. At one study site, data from participatory monitoring impelled actions taken to address a pollution source and influenced policy focus, reaching the maximum level of participatory-based monitoring. This led to avoid the discharge of wastewater into the river to conserve and protect the water resource. WQI is closely related to BMWP; however, the latter was far more sensitive to detecting areas affected by domestic water discharges. The NDVI presented low values for the TCBR, being lower in RS (the driest area). Although the NDVI showed a weak relationship with BMWP values, areas with higher NDVI values generally achieved higher BMWP values. The results of this study highlight the high sensitivity of the BMWP to detect several water quality conditions in the rivers running through the TCBR when compared to WQI. In addition, the usefulness of biomonitoring using the BMWP index was evident, as well as the importance of the participation of local inhabitants contributing to the knowledge of water quality in biosphere reserves and carrying out timely measures that allow the rivers in these reserves to be maintained in good condition.

Sediment analysis and water quality assessment in the Pixquiac basin: drinking water supply of Xalapa city (Veracruz, Mexico).

Fluvial sediment analysis and water quality assessment are useful to identify anthropic and natural sources of pollution in rivers. Currently, there is a lack of information about water quality in the Pixquiac basin (Veracruz state, Mexico), and this scarcity of data prevents authorities to take adequate measures to protect water resources. The basin is a crucial territory for Xalapa, the capital city of Veracruz state, as it gets 39% of its drinkable water from it. This research analyzed 10 physicochemical parameters and 12 metal concentrations in various rivers and sources during two seasons. Dissolved metals presented average concentrations (µg/L): Al (456.25) > Fe (199.4) > Mn (16.86) > Ba (13.8) > Zn (7.6) > Cu (1.03) > Pb (0.27) > As (0.12) > Ni (0.118) (Cd, Cr and Hg undetectable). Metals in sediment recorded average concentrations (ppm): Fe (38575) > Al (38425) > Mn (460) > Ba (206.2) > Zn (65.1) > Cr (29.8) > Ni (20.9) > Cu (16.4) > Pb (4.8) > As (2.1) (Cd and Hg undetectable). During the rainy season, Water Quality Index (WAWQI) classified stations P17 and P18's water as "unsuitable for drinking" with values of 110.4 and 117.6. Enrichment factor (EF) recorded a "moderate enrichment" of Pb in sediment in P24. Pollution was mainly explained by wastewater discharges in rivers but also because of erosion and rainfall events. Statistical analysis presented strong relationships between trace and major metals which could explain a common natural origin for metals in water and sediment: rock lixiviation.

Consistency of information on the provision of water fluoridation in Brazil.

OBJECTIVE: This study aimed to assess the consistency of data regarding the provision of fluoridation in Brazilian municipalities with water supply systems. METHODS: Official data from the National Basic Sanitation Survey and the National Information System on Sanitation for 2017 were compared. RESULTS: Out of 5,570 municipalities in Brazil, 4,546 (81.6%) had water supply systems. The agreement between data sources was 84%, with a Kappa of 0.668, indicating substantial agreement. However, the estimates of fluoridation provision exhibited an average discrepancy of 8.1 percentage points, ranging from 1.2 points in the Central-West region to 21.4 points in the Northeast region. CONCLUSION: To address these inconsistencies, it is essential to enhance information sources, ensuring more reliable data for health, sanitation authorities, and society at large.

Reduction of Helicobacter pylori cells in rural water supply using slow sand filtration.

Helicobacter pylori is a microorganism that infects 60% of the population and is considered the main cause of atrophic gastritis, gastric and duodenal ulcers, and gastric cancer. Different emerging pathogens have been found in drinking water and their presence is considered to be an important public health problem. For this reason, it is necessary to carry out the validation of reliable technologies for this type of pathogens and evaluate their performance. This paper reports, for the first time, H. pylori reduction in a drinking water pilot plant of two slow sand filters (SSF). Inlet water was taken from a gravel filtration system of a rural water supply in Colombia and then inoculated with viable cells of H. pylori. By determining the Genomic Units (GU) through quantitative Polymerase Chain Reaction (qPCR), the concentration of GU/sample was measured. In the inlet water amplification for SSF1 and SSF2 were 5.13 × 102 ± 4.48 × 102 and 6.59 × 102 ± 7.32 × 102, respectively, while for the treated water they were 7.0 ± 5.6 and 2.05 × 101 ± 2.9 × 101 GU/sample for SSF1 and SSF2, respectively. The SSF pilot plant reached up to 3 log reduction units of H. pylori; therefore, since there is not an H. pylori contamination indicator and its periodic monitoring is financially complicated, the SSF could guarantee the drinking water quality necessity that exists in rural areas and small municipalities in developing countries, where infection rates and prevalence of this pathogen are high.

Confined within a sugarcane monoculture: A participatory assessment of water pollution and potential health risks in the community of El Tiple, Colombia.

Communities neighboring monoculture plantations are vulnerable to different forms of pollution associated with agro-industrial operations. Herein, we examine the case of El Tiple, a rural Afro descendant community embedded within one of the largest sugarcane plantations in the Americas. We implemented a participatory approach to assess water pollution, exposure via water ingestion, and non-carcinogenic health risks associated with the use of local water sources available to the community. We conducted household surveys to unveil demographic characteristics and family dynamics linked to water consumption. Additionally, we measured water quality parameters and assessed the concentration glyphosate, its major metabolite (aminomethylphosphonic acid) and metals and metalloids. Drinking water El Tiple households is sourced from three primary sources: the local aqueduct system, water delivery trucks, and private deep wells. Tests on water samples from both the local aqueduct and delivery trucks showed no traces of pesticides, metals, or metalloids surpassing regulatory limits set by Colombian or EPA standards. However, we found concentration of contaminants of primary concern, including mercury (up to 0.0052 ppm) and lead (up to 0.0375 ppm) that exceed the permissible regulatory thresholds in water from groundwater wells. Residents of the peripheric subdivisions of El Tiple are four times more reliant on well water extraction than residents of the central area of the town due to lack of access to public drinking water and sanitation infrastructure. Finally, adult women and school-age children have a higher health risk associated with exposure to local pollutants than adult men due to their constant presence in the town. We conclude that expanding the coverage of clean water and sanitation infrastructure to include all households of the community would be the most recommended measure to minimize exposure and risk via ingestion of water pollutants.

Diel and seasonal mixing patterns and water quality dynamics in a multipurpose tropical semiarid reservoir.

Eutrophication has become a recurrent concern in reservoirs worldwide. This problem is intensified in tropical semiarid regions, where the reservoirs have high seasonal and annual variability of water level and volume. Therefore, an extensive understanding of the diel variation of water quality key-parameters can help improve management of such reservoirs. This study focuses on Castanhão reservoir with the largest multipurpose dam in the Brazilian semiarid. Its main water uses are irrigation, fish farming, and human supply. The reservoir faced a decline in water quality due to a prolonged drought period. While previous research has predominantly emphasized the seasonal dynamics of thermal and chemical stratification, our investigation provides diel assessments of multiple water quality parameters, including nutrient concentrations and phytoplankton abundance. Our primary objective is to compare seasonal and diel variations in stratification and nutrient distribution within the reservoir. Key findings reveal a diel cycle of thermal stratification, primarily during dry season, driven by higher wind speeds. This is corroborated by a significant negative correlation between wind speed and the relative water column stability index. In contrast, during the rainy season, the reservoir experiences continuous thermal stratification due to inflowing water being warmer than the reservoir's water temperature. Notably, a significant negative correlation between total phosphorus and chlorophyll-a, along with a two-fold increase of this nutrient throughout the day during the rainy season, underscores the influence of the phytoplankton community dynamics on the diel nutrient variation. Chemical stratification of dissolved oxygen occurred during dry and rainy seasons, indicating that even during the dry season, where there is no significant inflow, the internal nutrient loading can also significantly impact the water quality of a reservoir. This study advances the understanding of diel water quality dynamics in tropical semiarid reservoirs, shedding light on both climatic and anthropogenic influences on water resources.

A multicriteria decision analysis for selecting rainwater harvesting systems in rural areas: a tool for developing countries.

Global water provision challenges have promoted decentralized water supply alternatives such as rainwater harvesting systems (RWHS). RWHS sustainability demands involve social, technical, and economic criteria in planning. Generally, in rural areas, water provision is more complex due to multiple uses of water, scattering of households, and low economies of scale. This research proposes a multicriteria tool for selecting RWHS in rural areas, considering social, technical, and economic criteria. The tool was developed by systematically identifying subcriteria and their hierarchization through the analytical hierarchy process (AHP), the technique for order of preference by similarity to ideal solution (TOPSIS), and a case study validation. Seven subcriteria were identified. The hierarchy of criteria was social (49.7%), technical (26.4%), and economic (23.9%). The tool involved: (i) users' consultation about the perceived ease of use and availability of water sources other than rainwater; (ii) system dimensioning to establish supply size, maintenance requirements, and required water quality; and (iii) costs and benefits estimation. Tool validation in a rural area included the evaluation of the alternatives proposed: (a) alternative 1: potable domestic uses (PD) and non-potable (NPD); (b) alternative 2: PD and NPD, irrigation of crops and chicken farming for self-consumption; and alternative 3: PD and NPD and chicken farming for profit sale. The sensitivity analysis showed the tool's consistency and robustness. Tool validation highlights the importance of integrating the three dimensions in selecting RWHS. The study provides a systematic methodology to assess and prioritize RWHS, appealing to policymakers, engineers, and practitioners facilitating water management and supply processes in rural areas.

Water, sanitation and hygiene insecurity predict abscess incidence among people who inject drugs in a binational US-Mexico metropolitan area: A longitudinal cohort study.

INTRODUCTION: People who inject drugs (PWID) are at high risk of developing injection-related infections, including abscesses. Access to water, sanitation, and hygiene (WASH) are key human rights and services; yet these services have been underexplored as predictors of abscesses among PWID. METHODS: Longitudinal analysis was employed among a cohort of PWID to determine if WASH insecurity (lack of access) was associated with abscess incidence in the Tijuana, Mexico and San Diego, United States metropolitan area during 24-months of follow-up survey data from 2020 to 2023. We calculated abscess prevalence at baseline and tracked the incidence of new abscesses among individuals without an abscess during the previous visit. Time dependent Cox regression modeling was employed with variance clustered by participant to characterize the relationship between WASH insecurity and abscess incidence. RESULTS: At baseline, hand hygiene insecurity, bathing insecurity in the previous six months and open defecation in the last week, were reported by 60 %, 54 % and 38 % of participants, respectively; 21 % reported an abscess in the last six months. The incidence of abscesses was 24.4 (95 %CI: 21.1-27.6) per 100 person-years. After adjusting for covariates, the hazard of developing an abscess remained significantly elevated among individuals using non-improved (with risk of contamination) water sources (e.g., surface water) for preparing drugs (adjusted HR [adjHR]: 1.49 [95 %CI: 1.01-2.21], experiencing bathing insecurity (adjHR: 1.59 [95 %CI: 1.12-2.24]) and open defecation (adjHR: 1.65 [95 %CI: 1.16-2.35]). CONCLUSIONS: PWID in the Tijuana-San Diego metropolitan area reported facing high rates of insecurity accessing WASH services. Abscess incidence was higher (four to nine times) than observed rate among PWID cohorts in other settings. Access to continuously available toilet facilities, bathing infrastructure, and safe water sources for preparing drugs for injection could prevent abscesses among PWID. Accessible WASH infrastructure should be ensured among PWID communities and promoted as a key component of harm reduction infrastructure.

Blue-green infrastructure in view of Integrated Urban Water Management: A novel assessment of an effectiveness index.

Addressing urban water management challenges requires a holistic view. Sustainable approaches such as blue-green infrastructure (BGI) provide several benefits, but assessing their effectiveness demands a systemic approach. Challenges are magnified in informal areas, leading to the combination of integrated urban water management (IUWM) with BGI as a proposed solution by this research. We employed the Urban Water Use (UWU) model to assess the effectiveness index (EI) of BGI measures in view of IUWM after stakeholder consultation. The procedure in this novel assessment includes expert meetings for scenario building and resident interviews to capture the community's vision. To assess the impact of IUWM on the effectiveness of BGI measures, we proposed a simulation with BGI only and then three simulations with improvements to the water and sewage systems. The results of the EI analysis reveal a substantial improvement in the effectiveness of BGI measures through IUWM combination. Moreover, we offer insights into developing strategies for UWU model application in informal settlements, transferrable to diverse urban areas. The findings hold relevance for policymakers and urban planners, aiding informed decisions in urban water management.

Water, sanitation, and hygiene access among people who inject drugs in Tijuana and San Diego in 2020-2021: a cross-sectional study.

BACKGROUND: Water, sanitation, and hygiene (WASH) access is critical to public health and human dignity. People who inject drugs (PWID) experience stigma and structural violence that may limit WASH access. Few studies have assessed WASH access, insecurity, and inequities among PWID. We describe WASH access, social and geographic inequalities, and factors associated with WASH insecurity among PWID in the Tijuana-San Diego metropolitan area. METHODS: In this cross-sectional binational study, we interviewed PWID (age 18+) in 2020-2021 about WASH access and insecurity. City of residence (Tijuana/San Diego) and housing status were considered as independent variables to describe key WASH access outcomes and to assess as factors associated with WASH insecurity outcomes. Measures of association between outcomes and independent variables were assessed using log modified-Poisson regression models adjusting for covariates. RESULTS: Of 586 PWID (202 Tijuana; 384 San Diego), 89% reported basic access to drinking water, 38% had basic hand hygiene, 28% basic sanitation, and 46% access to bathing, and 38% reported recent open defecation. Participants residing in Tijuana reported significantly higher insecurity in accessing basic drinking water (aRR: 1.68, 95%CI: 1.02-2.76), basic hygiene (aRR: 1.45, 95%CI: 1.28-1.64), and bathing (aRR: 1.21, 95%CI: 1.06-1.39) than those living in San Diego. Participants experiencing unsheltered homelessness experienced significantly higher insecurity in accessing basic drinking water (aRR: 2.03, 95%CI: 1.07-3.86), basic sanitation (aRR: 1.68, 95%CI: 1.48, 1.92), bathing (aRR: 1.84, 95%CI: 1.52-2.22), and improved water sources for cleaning wounds (aRR: 3.12, 95%CI: 1.55-6.29) and for preparing drugs (aRR: 2.58, 95%CI: 1.36-4.89) than participants living in permanent housing. CONCLUSION: WASH access among PWID in the Tijuana-San Diego metropolitan area was low by international standards and lower than the national averages in both countries. Homelessness was significantly associated with WASH insecurity in this population. Concentrated efforts are needed to guarantee continuously available WASH services for PWID-especially those who are unsheltered.

Water, Sanitation, and Hygiene Infrastructure and Resources in Schools in Belize during the COVID-19 Pandemic, 2021-2023.

Access to water, sanitation, and hygiene (WASH) resources in schools is critical for disease prevention and control, especially during public health emergencies. In Belize, systematic, national data on WASH in schools are needed to inform public health decisions and interventions. From December 2021 to January 2022, a national survey was sent electronically to government and government-aided primary and secondary schools in Belize (N = 308) to gather information on WASH services. From the survey, 12 pilot schools were selected based on the highest self-reported need for WASH resources to participate in additional evaluation and intervention, which included environmental nudges, supplemental supply provision, and hand hygiene education. To understand how the progression of the COVID-19 pandemic may have influenced hand hygiene, facility assessments to evaluate access to hand hygiene resources were conducted in person when most schools reopened for face-to-face learning during the pandemic (March 2022) and 15 months later (June 2023). Among the schools participating in the national survey (N = 221), 55% reported times when water was not available at the schools. Almost 9 in 10 schools (89%) had a functional handwashing station, and 47% reported always having soap for handwashing. Between baseline and follow-up at the 12 pilot schools, we observed decreases in the proportion of functional handwashing access points (-11%), functional handwashing access points accessible for individuals with disabilities (-17%) and small children (-29%), and functional alcohol-based hand rub dispensers (-13%). Despite the ongoing COVID-19 pandemic, we observed gaps in WASH resources in schools in Belize during the onsite assessments at the pilot schools. Schools should be encouraged and provided with WASH resources to maintain vigilance for disease control measures.

Climate change and land cover effects on water yield in a subtropical watershed spanning the yungas-chaco transition of Argentina.

The demand for mountain water resources is increasing, and their availability is threatened by climate change, emphasizing the urgency for effective protection and management. The upper Sali-Dulce watershed holds vital significance as it contributes the majority of the Sali-Dulce water resources, supporting a densely populated dry region in Northwestern Argentina, covering an area of 24,217 km2. However, the potential impact of climate change and land use/land cover change on water yield in this watershed remains uncertain. This study employs the InVEST Annual Water Yield model to analyze the average water yield in the watershed and evaluate its potential changes under future scenarios of climate and land use/land cover change. InVEST was calibrated using data from multiple river gauges located across the watershed, indicating satisfactory performance (R2 = 0.751, p-value = 0.0054). Precipitation and evapotranspiration were the most important variables explaining water yield in the area, followed by land use. Water yield showed a notable concentration in the montane area with 40% of the watershed accounting for 80% of the water yield, underscoring the importance of conserving natural land cover in this critical zone. Climate change scenarios project an increase in water yield ranging from 21 to 75%, while the effects of land cover change scenarios on water yield vary, with reforestation scenarios leading to reductions of up to 15% and expansions in non-irrigated agriculture resulting in increases of up to 40%. Additionally, water yield distribution may become more concentrated or dispersed, largely dependent on the type of land cover. The combined scenarios highlight the pivotal role of land cover in adapting to climate change. Our findings provide valuable insights for designing future studies and developing policies aimed at implementing effective adaptation strategies to climate change within the Salí-Dulce watershed.

Global relevance of Argentinean rainfed crops in a climatic variability context: A water footprint assessment in Buenos Aires province.

Argentina has a relevant international role as a producer of agricultural commodities. Buenos Aires is the province with the largest cultivated area of cereals and oilseeds of the country. Rainfed crops depend exclusively on green water, meaning a comparative advantage for Buenos Aires province. The green virtual water content in the crops produced in Buenos Aires has implications for water allocation at international level. A great amount of countries depends on the Argentinean rainfed agriculture. Therefore, it is important to understand the effects of climate variations on Argentinean crop production at local level and the role of rainfed crops in regional and international trade. We analysed the temporal and territorial variations of crops green water demand in a climatic variability context and their influence on the water footprint. The green water footprint of the main crops of Buenos Aires was assessed, including soybeans, maize, sunflower, wheat and barley, in different climatic conditions: for the period 2008-2018, which include a dry year, a humid year and an ordinary year. A dataset about the green water footprint at municipality level was provided, and the results were presented on maps for each crop and for the different climatic conditions. The relevance of green water of main crops in the world water-dependent supply chains was shown. This comprehensive green water footprint assessment provides a useful database for researchers, companies and policy makers in Argentina and beyond.