Globally, there are 2.5 billion people who do not have access to improved sanitation. One third of these people are living in India. Bad sanitation is both undignified and causes the spread of diseases like diarrhoea. It is a large challenge to handle the problematic situation with sanitation, especially in urban areas. Sustainable sanitary systems that are energy self-sufficient and do not require sewage system are needed. There are new techniques with this in mind that are under development. The aim of this thesis is to investigate the possibilities to implement a sustainable sanitary system in slum areas of Mumbai. The chosen area and existing sanitary techniques is investigated in the literature study. To understand the user requirements and their living situation, a field study is performed in slum areas of Mumbai. Interviews are held with experts from organisations working with the sanitary situation in the area to get a deeper understanding about their experiences. The sanitary situation today is not well functioning, a new way of solving the problem is needed and it has to happen soon. Through an analysis of the empirical findings, three different sanitary situations are presented. It is important that each area is investigated to identify what situation there is, before building new sanitary facilities. To achieve a more sustainable sanitation, one system for each of the three situations should be developed. Requirements for each of the situations are presented and they all have two things in common, the toilet is shared between a determined amount of people and the user has the responsibility for the maintenance. From a cross mapping between the investigated sanitary techniques and the requirements for the three situations, it is clarified what techniques that are suitable in which context. No one of the investigated techniques is a perfect match and further development is needed. One of the sanitary situations is taken further through concept development. The concepts are compared against the requirements to identify the best concept. The best concept with modifications is visualised to exemplify how it may be designed. In the comparison between the requirements and concepts, gaps in the design and issues for further development are identified. The core of this master thesis is to emphasise the importance of having a holistic approach concerning the sanitary situation. It is important that new techniques are being developed with a close connection to the users and the specific environment. By investing money in more sustainable systems, the situation for the slum residents in Mumbai can be improved and at the same time contribute to a more sustainable society.

Providing clean water remains a challenge in many African countries. Ethiopia, with the second largest population in Africa is also faced with this predicament. Efforts to improve supply have focused on abstracting groundwater. Although relatively cheaper to utilize, groundwater is prone to contamination, from improperly disposed of waste, particularly urban areas with no appropriate sanitation services. The city of Addis Ababa is faced with this difficult situation. Currently about 75 % of the population of Addis Ababa has access to sanitation in the form of pit latrines, while 0.6 % has access to sewerage services. The rest of the population is considered to have no access. This proliferation of pit latrines in the city has enhanced the risk of groundwater contamination. This research was initiated with the objective of assessing the temporal and spatial extent of contamination of groundwater due to human waste. It attempted to review the quality of water in deep wells and springs. The data analyzed indicates that the temporal and spatial extent of contamination has increased over the past few decades. Over abstraction of groundwater has also been observed. Whilst contaminant levels such as nitrates and chlorides in many wells are below maximum permissible values, few wells in the centre of the city have exhibited higher values. This steady temporal increase may soon make some wells unsuitable for human consumption. Efforts to reduce this risk will need to focus on sewerage services provision, review of existing environmental policy, public awareness drive and sustainable groundwater management. / D.Phil. (Environmental Science)

Orientador: Ricardo de Lima Isaac / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Civil, Arquitetura e Urbanismo / Made available in DSpace on 2018-08-19T03:27:02Z (GMT). No. of bitstreams: 1 HernandezMacedo_SoniaGyssela_M.pdf: 2422289 bytes, checksum: 5de40cb025e10f34037267c1b5159a3d (MD5) Previous issue date: 2011 / Resumo: Esta pesquisa teve como objetivo obter um panorama geral da situação das comunidades intencionais denominadas "ecovilas" do mundo, no que se refere ao saneamento, especificamente, dos sistemas de abastecimento de água e de esgotamento sanitário. Estabeleceuse um recorte no amplo universo de comunidades existentes, segundo os seguintes critérios: premissa de sustentabilidade ambiental em sua origem, espaço próprio e mais de uma família, decisões tomadas por consenso, práticas voltadas ao convívio humano e aprimoramento individual, preocupação com a produção local de alimentos e que tivessem sistemas próprios de abastecimento de água e esgotamento sanitário. Analisaram-se, uma a uma, as comunidades inseridas nas duas principais bases de comunidades intencionais disponíveis na Internet (i.e., Global Ecovillage Network -GEN e Intentional Communities Directory - ICD) . De um universo de 1.062 comunidades, apenas 170 (16%) atendiam aos quesitos pré-estabelecidos e foram convidadas a participar da pesquisa. Um questionário contendo 56 perguntas foi submetido, via correio eletrônico, para as 73 comunidades que sinalizaram positivamente, tendo retornado 51 respostas (30%). O primeiro objetivo foi de identificar e classificar as ecovilas quanto à localização geográfica e tamanho (número de moradores). A distribuição geográfica foi de 33 comunidades na América, 7 na Europa, 5 na Ásia e 6 na Oceania. Posteriormente, analisaram-se, em cinco grupos pré-estabelecidos (de 2 a 9, de 10 a 24, de 25 a 49, de 50 a 99 e com 100 ou mais moradores), os sistemas de saneamento quanto à tecnologia em si, ao processo de seleção da mesma e a alguns indicadores de sustentabilidade. Os sistemas de abastecimento de água são bastante simplificados, sendo que apenas 19 apresentam tratamento, destacando-se a filtração lenta. Dezessete comunidades captam de mananciais não protegidos e não fazem tratamento da água, com potencial risco à saúde. Nos sistemas de esgotamento sanitário predominam o tanque séptico (34 unidades), wetlands (18 unidades), privadas de compostagem (13 unidades) e tratamento no solo (11 unidades). A facilidade de acesso e de manipulação das técnicas e materiais permitiu que os membros das ecovilas pudessem participar ativamente da implantação, operação e manutenção dos seus sistemas. Observou-se que não existe nenhuma técnica inovadora. Quanto ao acesso à informação técnica e a implantação dos sistemas, 25 comunidades apontaram ter sido "fácil", outras 17 assinalaram ter sido "médio" e sete como "difícil". Comentários espontâneos dos representantes dessas comunidades denotaram a percepção de um distanciamento entre a sabedoria local e o conhecimento técnico-científico. Equívocos na concepção dos sistemas são relatados. O consumo de água per capita, em geral, condisse com o indicado na literatura. A elaboração conjunta de uma rede de pesquisa em saneamento com a colaboração de universidades representantes dos continentes e as redes de ecovilas já existentes é sugerida para criar uma ferramenta virtual de seleção de tecnologias de saneamento para ecovilas associada a um manual de saneamento / Abstract: Present work aimed to get a water supply and wastewater system panorama at intentional communities known as "ecovillages" around the world. Ecovillages were selected among the broad universe of existing communities, according to the following criteria: principle of environmental sustainability at creation, own property with more than one family, decision making by consensus, lifestyle focused on human sharing and individual improvement, concern with local food production and water supply and wastewater system owned by the community. One by one, the communities within the two main bases for intentional communities on the Internet (i.e., Global Ecovillage Network - GEN and Intentional Communities Directory - ICD) were analyzed. Just 170 (16.0%) out of 1,062 communities that met mentioned requirements were invited to take part. A survey containing 56 questions was sent via e-mail to 73 communities that agreed to make part of the research of which 51 (30%) completed it. The first objective was to identify and classify the ecovillage as to geographical location and size (by number of residents). Geographical distribution was 33 communities in America, 7 in Europe, 5 in Asia and 6 in Oceania. Systems were ranged and analyzed per five groups (i.e., 2-9, 10-24, 25- 49, 50-99, >99 residents), regarding adopted technology, technology selection process as well as some indicators of sustainability. Water supply systems are quite simplified. Only 19 of them include treatment, mostly slow sand filtration. Seventeen communities reported to take raw water from unprotected source without any treatment, meaning potential health risk. For wastewater system, occurrence obtained were septic tank (34), wetlands (18), composting toilets (13) and soil treatment (11). The ease of access and manipulation of materials and techniques allowed ecovillages residentes to work actively in the implementation, operation and maintenance of their own systems. There is no innovative technique being applied. Regarding access to technical information and construction of systems, 25 communities answered as "easy", another 17 reported "medium" and, finally, seven communities as "difficult." Free comments from community representatives denoted the perception of a gap between local knowledge and technical-scientific knowledge. Systems misconceptions were also reported. Water per capita consumption data fitted literature reference values. Development of a virtual tool for selection of technologies of water supply and wastewater systems for ecovillages associated with a sanitation handbook made cooperatively by regional representatives of those communities worldwide and an academic research network is suggested / Mestrado / Saneamento e Ambiente / Mestre em Engenharia Civil

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Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2016-03-07T11:27:08Z No. of bitstreams: 2 Dissertação - Poliana Nascimento Arruda - 2015.pdf: 2671904 bytes, checksum: 0ccd127461223a3858ff55187eeb2597 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2016-03-07T11:30:57Z (GMT) No. of bitstreams: 2 Dissertação - Poliana Nascimento Arruda - 2015.pdf: 2671904 bytes, checksum: 0ccd127461223a3858ff55187eeb2597 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2016-03-07T11:30:57Z (GMT). No. of bitstreams: 2 Dissertação - Poliana Nascimento Arruda - 2015.pdf: 2671904 bytes, checksum: 0ccd127461223a3858ff55187eeb2597 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2015-11-24 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The existence of basic sanitation, as well as its quality is essential to the composition of a healthy environment. Several factors influence the search for quality services as fair tariffs, satisfaction of users of services, the management and the management sanitary actions among other attributes that basic sanitation of the municipality must contain and influence in achieving satisfactory index under health, education, economy, etc. This study aimed conduct a survey the characteristics of the Water Supply Systems (SAA) and System Sewage (SES), covering the management of services, collection and control, user satisfaction and the quality of the water distributed, and as the contents of Acute Diarrhoeal Diseases (DDA) in 21 municipalities in the state of Goiás in the management of sanitation services are performed by public bodies, or by municipalities through local authorities, departments and offices. The characteristics of the systems were obtained through on-site visits with application forms for healthcare managers, as well as forms of satisfaction for consumers in the period 2012 to 2014. The water quality data and DDA incidence come from respectively the Ministry of Health programs, Environmental Health Surveillance related to Water Quality for Human Consumption (Vigiagua) and Acute Diarrhoeal Diseases Monitoring (MDDA) for the year 2014. It was observed that in ten municipalities systems are managed by local authorities, four by departments and offices and seven without specific organ. The absence of water treatment was found in seven counties, six without specific organ, explaining the relationship with the management. In sewage noticed a deficiency in the presence of black tanks fully in 57,1% of the municipalities. The satisfaction of the population is related to economic, cultural and political factors, the latter being the predominant on the situation of public water and sewage, wherein the way management influences the existence of better infrastructure conditions. In the 21 municipalities tariff revisions occur in different ways and there is not a specific regulatory entity, the collection was observed in 67% of these municipalities. It was observed that in 21 municipalities there is a greater need as investment in infrastructure and the Goiana Agency Regulation, the regulatory body of the 225 remaining municipalities in the state of Goiás, while not complying with the law in all its spheres, contributes effectively in quality the services offered. As for water quality, it was found that the municipalities that do not have treated water levels above 70% of samples outside the potability standard were found, not being a correlation between the incidence of DDA and this aspect. Compliance with the guidelines Vigiagua is unsatisfactory, particularly for fluoride parameter and turbidity. It needs to occur an interaction between environmental and health sectors for the data to be analyzed together in order to be practical preventive, educational and corrective actions. / A existência de saneamento básico, assim como sua qualidade é essencial para a composição de um ambiente salubre. Diversos fatores influenciam na busca por serviços de qualidade, como tarifas justas, a satisfação dos usuários dos serviços, a gestão e o gerenciamento das ações sanitárias entre outros atributos que o saneamento básico do município deve conter e que influenciam no alcance de índices satisfatórios no âmbito da saúde, educação, economia e etc. Esse estudo objetivou realizar um levantamento das características dos Sistemas de Abastecimento de Água (SAA) e Sistema de Esgotamento Sanitário (SES), abrangendo a gestão dos serviços, a cobrança e a regulação, a satisfação dos usuários e a qualidade da água distribuída, bem como os índices de Doenças Diarreicas Agudas (DDA) em 21 municípios do estado de Goiás em que a gestão dos serviços de saneamento são realizadas por entidades de direito público, ou seja, pela prefeituras por meio de autarquias, departamentos e secretarias. As características dos sistemas foram obtidas por meio de visitas in loco com aplicação de formulários para os gestores dos sistemas, além de formulários de satisfação para os consumidores no período de 2012 a 2014. Os dados da qualidade da água e da incidência de DDA são oriundos respectivamente dos programas do Ministério da Saúde, Vigilância Ambiental em Saúde relacionada à Qualidade da Água para Consumo Humano (Vigiagua) e Monitoramento de Doenças Diarreicas Agudas (MDDA) referentes ao ano de 2014. Observou-se que em dez municípios os sistemas são geridos por autarquias, quatro por departamentos e secretarias e sete não possuem órgão específico. A ausência de tratamento de água foi encontrada em sete municípios, sendo seis sem órgão específico, explicitando a relação com a gestão. No esgotamento sanitário notou-se uma deficiência com a presença de fossas negras integralmente em 57,1% dos municípios. A satisfação da população está relacionada a fatores econômicos, culturais e políticos, sendo esse último o preponderante para a situação dos serviços públicos de água e esgoto, sendo que a forma de gestão influencia na existência de melhores condições de infraestrutura. Nos 21 municípios as revisões tarifárias ocorrem de diferentes formas não havendo um ente regulador específico, sendo observada a cobrança em 67% desses municípios. Foi observado que nos 21 municípios há uma maior carência quanto aos investimentos em infraestrutura e que a Agência Goiana de Regulação, órgão regulador dos 225 municípios restantes do estado de Goiás, mesmo não cumprindo com a legislação em todas as suas esferas, contribui efetivamente na qualidade dos serviços oferecidos. Quanto a qualidade da água, foi verificado que nos municípios que não possuem água tratada índices acima de 70% de amostras fora do padrão de potabilidade foram encontradas, não sendo verificada correlação entre a incidência de DDA e esse quesito. O cumprimento das diretrizes do Vigiagua encontra-se insatisfatória, principalmente para o parâmetro flúor e turbidez. É necessário que ocorra uma interação entre os setores ambientais e de saúde para que os dados sejam analisados em conjunto no intuito de haver práticas de ações preventivas, educativas e corretivas.

The authors of this article conducted an analysis of the companies providing publicsanitation services. In particular, they focus on determining if these are legally entitled to market the treated waste water generated as a result of the provision of public services in charge. Additionally, in order to provide a complete analysis of the issue, the authors speak about the powers of the National Water Authority and his power to permit reuse of treated wastewater. / Los autores del presente artículo realizan un análisis sobre las empresas prestadoras de servicios públicos de saneamiento. En particular, se enfocan en determinar si es que estas se encuentran facultadas legalmente para comercializar el agua residual tratada que generan como consecuencia de la prestación de los servicios públicos a su cargo. Adicionalmente, a fin de brindar un análisis completo del tema, se toman en cuenta las facultades de la Autoridad Nacional del Agua para conceder autorizaciones de reúso del agua residual tratada.

The aim of this study was to assess the environmental sanitation conditions with regard to water, sanitation, waste management and personal hygiene of households of Dukem town in Ethiopia. A cross-sectional study design was used to conduct the research. A total of 391 households had participated in the study. Majority of households had access to improved source of drinking water. The mean per capita per day water consumption of the households was low. Two-thirds of households had improved toilet facilities. Availability of improved waste management was grossly inadequate. Two-thirds of households had washed hands after visiting toilet. Generally households had good domestic environmental sanitation conditions but it also emerged that the households were deprived from full range of access to the most essential environmental sanitation services. Therefore, the inadequate level of service to the study area could be seen as opportunity for further focused improvements towards universal access to improved environmental sanitation. / Health Studies / M.A. (Public Health)

Este trabalho investiga o efeito do saneamento sobre educação, ou seja, as consequências educacionais das crianças que apresentam estado de saúde debilitado por terem contraído Doenças Relacionadas ao Saneamento Ambiental Inadequado (DRSAI). Nesse sentido, condições de infraestrutura dos domicílios, expressas pela variável de acesso a saneamento básico, por impactar a saúde dos indivíduos, é mais um dos determinantes dos indicadores educacionais. A partir de dados municipais e distritais, o efeito do saneamento sobre educação foi obtido em duas etapas. Na primeira, utilizou-se dados por município do Censo Demográfico (IBGE), Censo Escolar (INEP), Sistema Nacional de Informações Sobre Saneamento (SNIS), entre outros, para anos 2000 e 2010, com o objetivo de avaliar o efeito do saneamento sobre educação. Na segunda etapa, verificou-se a hipótese que dá suporte ao efeito da etapa anterior: o efeito do saneamento sobre a saúde. Essa investigação foi realizada por meio de dados por distrito construídos a partir do Censo Demográfico do Universo por setor censitário (IBGE), Cadastro Nacional de Endereços para Fins Estatísticos (CNEFE, 2011), Diretório Nacional de Endereços (DNE, 2015) e Departamento de Informática do Sistema Único de Saúde (DATASUS, 2010). Ambas etapas fizeram uso de econometria espacial e não-espacial para estimação dos dois efeitos. Os resultados da primeira etapa indicam que o efeito do aumento de uma unidade percentual no acesso a saneamento está associado a um aumento de 0,11 pontos percentuais na taxa de frequência escolar, a uma queda de 0,31 pontos percentuais na taxa de distorção idade-série e a também uma queda de 0,12 pontos percentuais na taxa de abandono escolar. Os resultados da segunda etapa indicam que, em geral, o acesso aos serviços de saneamento inadequados causa impacto positivo na taxa de incidência de internações por DRSAI (por mil habitantes), a variável de saúde considerada nesse estudo. Para a população de todas as idades, o impacto total médio do aumento de 1% na parcela de domicílios servidos por água da chuva armazenada em cisterna ou caixa de cimento é 0,217 casos por mil habitantes. Quando se considera a porcentagem dos domicílios que tem banheiro conectado a uma fossa rudimentar, esse impacto é 0,035 casos por 1000 habitantes. Por outro lado, no que diz respeito à variável adequada de saneamento, o impacto total médio de 1% na porcentagem de domicílios particulares permanentes conectados à rede de distribuição de água e que, além disso, na quadra onde estão localizados é inexistente condições de esgoto a céu aberto é -0,166 casos por mil habitantes. A variável de maior impacto total médio refere-se à porcentagem de domicílios que não tem banheiro e, além disso, possuem presença de esgoto a céu aberto em suas condições de entorno. O aumento em uma unidade percentual nessa variável gera aumento de 3,281 na taxa de incidência de internações por DRSAI. Outro resultado desse estudo é que a população mais jovem é a mais atingida pelo acesso a condições inadequadas dos serviços de saneamento básico tanto em relação à saúde quanto à educação. Por fim, a recomendação de política pública apontou que, se fossem implementadas políticas de mitigação das condições inapropriadas de saneamento, iniciando por diminuir em um por cento a porcentagem de domicílios que não têm banheiro e estão expostos a condições de esgoto a céu aberto o setor público da saúde economizaria recursos num valor correspondente a 4,4% do gasto federal total investido por ano em saneamento. Dessa forma, essa política pode ser uma estratégia para acelerar as metas de universalização do acesso aos serviços de saneamento básico no Brasil. / This dissertation studies the effect of sanitation on education, in other words, the educational consequences for children whose health has been affected by Diseases Related to Inadequate Environmental Sanitation (DRIES). In this sense, infrastructure conditions of dwellings, expressed by the variable of access to basic sanitation, for impacting the health of individuals, is one of the determinants of educational indicators. The effect of sanitation on education was obtained in two steps, from municipality and district level data. At the first step, we applied data at municipality level, from the Population Census (IBGE), the School Census (INEP), the National Information System on Sanitation (SNIS), among others, for the years 2000 and 2010, with the goal of evaluating the effect of sanitation on education. At the second step, we analyzed the hypothesis that supports the effect of the previous step: the effect of sanitation on health. This analysis was conducted applying data at district level, which was constructed from the results from the universe of the Population Census (IBGE) by census tract, the National Register of Addresses for Statistical Purposes (CNEFE, 2011), the National Address Directory (DNE, 2015) and the Department of Informatics of the Unified Health System (DATASUS, 2010). Both steps made use of spatial and non-spatial econometrics techniques for estimating the two effects. The results of the first step indicate that the effect of one percentage increase in access to sanitation is associated with an increase of 0.11 percentage points in school attendance rate, a decrease of 0.31 percentage points in age-grade distortion rate, and also a decrease of 0.12 percentage points in the school dropout rate. The results of the second step indicate that, in general, access to inadequate sanitation services has a positive impact on the incidence of hospitalizations because of DRIES (per thousand inhabitants), the health variable considered in this study. For the population of all ages, the average total impact of a 1% increase in the share of dwellings served by rain water (stored in cisterns or cement tanks) is 0.217 cases per thousand inhabitants. Considering the percentage of dwellings with toilets connected to rudimentary cesspools, this impact is 0.035 cases per thousand inhabitants. On the other hand, with regard to the appropriate sanitation variable, the average total impact of 1% increase in the share of permanent dwellings connected to the water distribution network and whose block does not present open sewage conditions is -0.166 cases per thousand inhabitants. The variable with highest average total impact refers to the percentage of dwellings that have no toilet and, moreover, have the presence of open sewage in their surrounding conditions. The increase in a percentage unit in this variable generates an increase of 3.281 in the rate of incidence of hospitalizations because of DRIES. Another result of this study is that the younger population is the most affected by the poor conditions of access to basic sanitation services, both in terms of health on education. Finally, the public policy recommendations pointed out that, if the policies for mitigating inadequate sanitation conditions were implemented, starting with a one percentage decrease in the share of dwellings that do not have toilets and are exposed to open sewage, the health sector would save an amount corresponding to 4.4% of total federal spending invested annually in sanitation. Therefore, this policy can be a strategy to accelerate the targets for universal access to basic sanitation services in Brazil

INTRODUÇÃO: As doenças relacionadas ao saneamento ambiental inadequado (DRSAI) continuam presentes em áreas metropolitanas no Brasil. OBJETIVO: Analisar as hospitalizações por DRSAI na rede pública da região metropolitana de Porto Alegre (RMPA)/RS de 2010 a 2014. MÉTODOS: Análise das hospitalizações com diagnóstico principal dos códigos CID-10 correspondente às DRSAI a partir do Sistema de Informações Hospitalares SIH/SUS, disponíveis publicamente. RESULTADOS: Do total de 13.929 hospitalizações por DRSAI de residentes na RMPA, no período de 2010 a 2014, a maioria relaciona-se às doenças de transmissão feco-oral como diagnóstico principal. Dentre as internações, o maior número (20,4%) corresponde ao de crianças de 1 a 4 anos de idade (28,1 hospitalizações/10.000 hab./ano). As internações por 10.000hab./ano variam de 1,4 em Glorinha e Nova Santa Rita a 27,6, em Triunfo. A taxa de letalidade hospitalar pode ser avaliada como baixa, pois a cada 100 internações ocorrem 2,2 óbitos, mas se considerarmos que esse tipo de doença é evitável e que não deveria gerar internação temos um número expressivo. Dentre as causas de óbito segundo CID-10, as mais frequentes foram as doenças de transmissão feco-oral. A utilização de UTI atingiu 2,0% (284), cujo destaque foram as hospitalizações por leptospirose, com uso de UTI em 13,2%. O gasto total com as internações foi cerca de R$ 6,1 milhões. O valor médio de internação mais elevado foi no município de Viamão (R$ 626,82) e o mais baixo em Alvorada (R$ 258,36). Entre todos os municípios da RMPA, São Sebastião do Caí foi o município com maior percentual (100%) de internações dos próprios residentes no total de internações por DRSAI. CONCLUSÃO: Ainda hoje as DRSAI são um importante problema para saúde pública e, por meio de trabalhos como este, é possível mapear a situação para promoção de ações para seu devido enfrentamento e melhor alocação de recursos. / INTRODUCTION: Diseases Related to Inadequate Environmental Sanitation (DRSAI, in Portuguese) still represent a burden in metropolitan areas in Brazil. OBJECTIVE: To analyze the hospitalizations for DRSAI in the public health network of the Metropolitan Region of Porto Alegre (MRPA)/RS during 2010-2014. METHODS: Analysis of hospitalizations with primary diagnosis of ICD-10 codes corresponding at DRSAI of a national public hospitalization basis (SIH / SUS). RESULTS: We found 13,929 hospitalizations for DRSAI of the MRPA´s residents during 2010-2014, most related to feco-oral transmission diseases as first-listed diagnosis. The largest number (20.4%) among the admissions corresponded to children 1 to 4 years old (28.1 hospitalizations / 10,000 inh/year). The admissions (10.000 inh/year) ranged from 1.4 in Glorinha and Nova Santa Rita up to 27.6 in Triunfo. The hospital mortality rate was low, for each 100 admissions deaths occur in 2.2, but if we consider that this kind of disease is preventable and should not generate hospitalization, it may represent a significant number. Among death causes according to ICD-10, feco-oral transmission disease was the most frequent. Use of Intensive Care Unity (ICU) reached 284 hospitalizations (2.0%) and Leptospirosis with ICU use was the highest (13.2%). Total expenditure on hospital admissions was approximately R$ 6.1 million. The average hospital stay cost was higher in Viamão (R $ 626.82) and lowest in Alvorada (R$ 258.36). Among all municipalities of MRPA, Sao Sebastião do Cai had the highest percentage (100%) of admissions of residents own a total of hospitalizations for DRSAI. CONCLUSIONS: DRSAIs are still today a major problem for public health, and that through research like this, it´s possible to map the situation for promoting actions for their proper coping and better resource allocation.

Thesis (MPA.) -- University of Limpopo, 2017 / The World Health Organisation (WHO) and World Bank (WB) state that worldwide access to sanitation has improved with countries in the north having 100% access to sanitation. However, only 64% of the world's population has access to improved sanitation. Sub-Saharan Africa has a noticeable improvement with South Africa improving from 73% in 2010 to 74% in 2014. They further estimate that $260 billion is lost globally each year due to lack of adequate water supply and sanitation. Universal access to water and sanitation would result in an estimated $32 billion in economic benefits per year globally from reductions in health care costs and increased productivity from reduced illness. Sub-Saharan Africa loses an estimated 4.3% ($US694 billion) of its Gross Domestic Product (GDP) each year due to lack of adequate water supply and sanitation. Furthermore, the UNDP (2015) indicates that sanitation is one of the Millennium Development Goals (MDG), however many regions are performing poorly in attaining their declared sanitation targets. South African has not reached its target but it is maintaining its commitment to the provision of sanitation as a basic human right. However, it has left the responsibility to local government to work out how this should be done with no legislation. Currently there is no policy on sanitation and municipalities only develop by-laws that serve as guidelines in managing waste and providing the service. The available literature on this subject speaks very little about the knowledge and understanding that the communities have with regard to faecal sludge management and no study at all deals with the perceptions of people on this issue, particularly around Polokwane Municipality. It is for these reasons that the study was aimed at investigating the perceptions of Polokwane residents regarding alternative faecal sludge management. Methodologically the study used qualitative research approach where in face-to-face interviews and focus group interviews were conducted around Polokwane Municipality. Among the participants interviewed were Ward Councillors, Community Development Workers, Ward Committees and Traditional Authorities. These stakeholders were intentionally chosen as they are at the coalface of service delivery on a daily basis and they are part of the forums that interact with the Municipality on basic services and other related community matters. Data for this study were analysed using thematic data analysis approach. vi  The findings of this study suggest that the “concerned residents” under Polokwane Municipality see themselves being victims and vulnerable to controllable health threats. In addition, the study discovered that the majority of participants were aware of the delegated sewage maintenance duties on the Polokwane Municipality. This study findings further indicated that there is a growing concern among municipal authorities and communities‟ especially in Africa and South Africa in particular, to improve the inadequate faecal management. The objectives of the study were among others to determine the perceptions and awareness of the Polokwane Local Municipality residents regarding alternative faecal sludge management methods. Indeed, it has been discovered that some of the residents are aware of various management methods but expect authority to develop policies and improve the inadequate methods that are currently used in managing faecal sludge. The study among others discovered that this study should be used as a point of reference for municipal projects administration, i.e. for the development of Integrated Development Plan (IDP) on the water and sanitation and faecal sludge management in future. The Ministry of environmental health and management at Polokwane Local Municipality should organise solid and integrated awareness with the community to ensure a healthy environment for all. The study further realised that there is a need to equip most of residents in Polokwane Local Municipality with knowledge on how best man can improve environmental health, as well as how worse can a person destroy the environment. It should be an important task for the Polokwane Local Municipality to ensure that residents understand the faecal sludge management enterprise developments in the area to reduce the incompleteness of the perceptions among the residents. Various faecal sludge methods should be adopted and encouraged among the Polokwane Local Municipality residents in order to promote the preference for the sanitation methods. Key words: Sanitation, Faecal sludge, Faeces, Health hazards and Sub-Saharan Africa