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Integrated health impact assessment of water supply and sanitation in communities of sustainable use forest reserves in the Amazon

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Author(s):
Carolina Bernardes
Total Authors: 1
Document type: Doctoral Thesis
Press: São Paulo.
Institution: Universidade de São Paulo (USP). Instituto de Eletrotécnica e Energia (IEE/BT)
Defense date:
Examining board members:
Wanda Maria Risso Günther; Ana Paula Fracalanza; Leandro Luiz Giatti; Marcelo Antunes Nolasco; Silvio Roberto Magalhães Orrico
Advisor: Wanda Maria Risso Günther
Abstract

In general , the relationship between environmental factors and health is systemic in nature , involving various fields of knowledge . One of the challenges of this issue involves integrated environmental health impact assessment approaches, which combine technical and operational, socio-economic and political dimensions, surpassing aproaches that consider only unicausualities of exposure and effect . The aim of this thesis was to evaluate , based on an integrated environmental health impact assessment , the health impact resulting from the implementation of water supply and sanitation interventions in populations of communities located in sustainable use forest reserves in the Middle Juruá river in state of Amazonas . The evaluation process was supported in methodological approach Integrated Environmental Health Impact Assessment (IEHIA) and used as the main conceptual framework a model for organizing indicators Driving Force - Pressure - Situation - Exposure - Effect - Action (DPSEEA) , applied in two well defined stages : i ) Before Stage : prior to the implementation of interventions in water supply and sanitation in the studied communities and ii ) After Stage : period of at least six months after implementaion and operation of the interventions . The results regarting the Effect component from the comparison between the two stages, which reflects directly the effect on health, , showed an average reduction of 65% in morbidity from diarrhea , 22 % of morbidity from intestinal parasites and an increased quality of life , represented by a mean reduction of 63 % of dissatisfaction with the community and 100% increase in the perception of the relationship between the increase in quality of life and sanitation. These results indicate that there were positive health impacts due to due the implemented interventions. The model DPSEEA used in this study brought information which enabeled the development of a broad and integrated analysis of the impacts of the variation in cenarios to express these positive health effects. Thus, it was possible to perform an integrated assessment of the impact of waster supply and sanitation interventions to reduce disease and increase the quality of life of the studied population. This evaluation process enabeled the cosistent detection, within the context of the study area, that in addition to the health effects , important aspects of the causal chain contributed in a integrated way to the expression of this effect . Regarding the DPSEEA model applied in the context of the thesis, we conclude that the assumptions used in its design allow adjustments to be made in accordance to the context for which the model is supposed to be used. This enables the validation and ajustment of the elements and indicators of the proposed model to allow its use in other Integrated Environmental Health Impact Assessment proposals which focus on health impacts of water supply and sanitation interventions. Thus, we reinforce that even with the local scale carcateristicas of our results, the evaluation process contributed to assist the planning of actions in the field of water supply and sanitation , enabling new models of interventions , redefining priorities and redirecting actions related to water supply and sanitation to increase health, reduce poverty, and ensure essential rights to citizens of rural areas of Brazil with equity. (AU)

FAPESP's process: 10/07638-2 - Assessment of the relationship between environmental sanitation and life quality at communities in Amazonian Conservation Units.
Grantee:Carolina Bernardes
Support Opportunities: Scholarships in Brazil - Doctorate