Combined effects of conditional cash transfer program and environmental health interventions on diarrhea and malnutrition morbidity in children less than five years of age in Brazil, 2006–2016

Abstract

Introduction Governmental measures aiming at social protection, with components of disease control, have potential positive impacts in the nutritional and health outcomes of the beneficiaries. The concomitant presence of these measures with environmental sanitation interventions may increase their positive effect. The context of simultaneous improvement of social protection and environmental sanitation is found in Brazil since 2007 and an assessment of the combined effects of both programs has not been performed so far. Objective To evaluate whether interaction effects between improvement of access to water, sanitation and solid waste collection with the Bolsa Família Program [PBF] were related to better responses in the reduction of morbidity due to diarrhea and malnutrition in children less than five years of age, acknowledging the positive results of these improved conditions and the PBF separately in coping with these diseases. Methods Descriptive and inferential analyses were performed through Generalized Linear Models of the Negative Binomial type of fixed effects, with and without addition of zeros. Interaction models were inserted in order to evaluate the outcomes when the two public policies of interest in the current study were present simultaneously in the municipalities. Results Interaction with negative effect when a concomitantly high municipal coverage of the Bolsa Família Program and adequate access to sanitation and solid waste collection were present. In contrast, regardless of municipal coverage by the PBF, the simultaneous presence of water and sanitation (0.028% / 0.019%); water and solid waste collection (0.033% / 0.014%); sanitation and solid waste collection (0.018% / 0.021%), all resulted in a positive effect, with a decrease in the average morbidity rates for both diseases. Conclusion Investments aimed at universalizing water, sanitation and solid waste collection services should be priorities, aiming at reducing the incidence of morbidity due to malnutrition and diarrhea and preventing deaths from these poverty-related diseases.

Effectiveness of cash-plus programmes on early childhood outcomes compared to cash transfers alone: A systematic review and meta-analysis in low- and middle-income countries

“…However, the goal of this review was to assess whether cash-plus programmes are more effective than cash alone rather than compared to no intervention. In addition to the cash-plus programmes included in this review, there are other combination interventions that may have an impact on children; examples include productivity and livelihood interventions that are targeted to households or adults, but have a benefit to improving child outcomes [ 60 ], or broader environmental health interventions such as water and sanitation management [ 61 ].…”

Doenças de Veiculação Hídrica: Uma análise do perfil a partir da literatura

“…Fatores ambientais e comportamentais, como a falta de acesso ou precário à água potável, prática de higiene, destinação inadequada de resíduos sólidos domésticos e não ser vacinado (para as doenças imunopreveníveis) podem contribuir no processo de adoecimento da população (Endris et al, 2019;Kadri et al, 2018;Mebrahtom, Worku & Gage, 2022;Mosisa et al, 2021;Omarova et al, 2018;Sekwadi et al, 2018;Stanwell-Smith, 2018). A saúde humana, animal e ambiental intimamente interrelacionadas, cuja transmissibilidade de doenças envolve sistemas complexos que incluem interações desta tríade epidemiológica (O'brien & Xagoraraki, 2019).É preciso considerar, ainda, o impacto das mudanças climáticas nas doenças de veiculação hídrica, tais como temperatura e volume de chuva, inundações e umidade podem intensificar o potencial epidêmico e aumentar áreas propícias para transmissão de doenças diarreicas, arbovirais e outras transmitidas pela água (Casanovas-Massana et al, 2018b;Kauppinen et al, 2019;Lequechane et al, 2020;Overgaard et al, 2021;Stanaway et al, 2019), a qual se constitui como um determinante social de saúde (Souza et al, 2021;Kadri et al, 2018;Lanrewaju et al, 2022;Mosisa et al, 2021), exigindo apoio técnico coordenado, mobilização de recursos e parcerias nos níveis local e global para superação dos desafios, sobretudo nos países subdesenvolvidos, devido a questões estruturais relacionadas aos sistemas de saúde e programas de saúde (Das et al, 2020).…”

“…Neste sentido, a contaminação da água entre a fonte e o ponto de uso aumentam não só o risco de contaminação da água, mas também a disponibilidade de habitats larvais de mosquitos (Souza et al, 2021;Endris et al, 2019;Overgaard et al, 2021;Rousis et al, 2022;Stanwell-Smith, 2018), tornando-se essencial a otimização dos processos de purificação, manutenção adequada dos sistemas de distribuição e abastecimento de água e esgoto para prevenir ou minimizar o risco de disseminação de protozoários parasitas (Ahmad et al, 2020;Omarova et al, 2018).…”

“…Os esforços e investimentos voltados para a universalização dos serviços de água, saneamento e coleta de resíduos sólidos devem ser prioridades governamentais, visando à redução da incidência de morbidade por desnutrição e diarreia e à prevenção de óbitos por essas doenças relacionadas à pobreza (Souza et al, 2021;Hasan et al, 2021). A adoção integrada de políticas de saneamento, educação e assistência à saúde que considerem as desigualdades regionais contribuirá para a melhoria das condições de saúde da população (Endris et al, 2019;Mebrahtom et al, 2022;Paiva & Souza, 2018;Sekwadi et al, 2018;Stanwell-Smith, 2018).…”

Analisis Aspek Makanan, Vektor, dan CTPS pada Kejadian Diare Balita di Wilayah ODF

“…Dalam penelitian ini, pengelolaan sampah yang baik meliputi tidak adanya sampah berserakan di rumah, terdapat tempat sampah tertutup, kuat, dan mudah dibersihkan, terdapat perlakuan aman seperti tidak membakar dan membuang sampah ke sungai, melakukan pengosongan sampah maksimal dua hari sekali untuk menghindari tempat berkembang biaknya vektor penyakit seperti lalat. Menurut (De Souza et al, 2021) kondisi sanitasi, akses air bersih, dan pengelolaan sampah yang memadai dianggap sebagai intervensi kesehatan masyarakat yang efektif dan berbiaya lebih murah untuk mengurangi kasus diare terutama di negara berkembang.…”