Drinking water quality governance: A comparative case study of Brazil, Ecuador, and Malawi

Human health is greatly affected by inadequate access to sufficient and safe drinking water, especially in low and middle-income countries. Drinking water governance improvements may be one way to better drinking water quality. Over the past decade, many projects and international organizations have been dedicated to water governance; however, water governance in the drinking water sector is understudied and how to improve water governance remains unclear. We analyze drinking water governance challenges in three countries—Brazil, Ecuador, and Malawi—as perceived by government, service providers, and civil society organizations. A mixed methods approach was used: a clustering model was used for country selection and qualitative semi-structured interviews were used with direct observation in data collection. The clustering model integrated political, economic, social and environmental variables that impact water sector performance, to group countries. Brazil, Ecuador and Malawi were selected with the model so as to enhance the generalizability of the results. This comparative case study is important because similar challenges are identified in the drinking water sectors of each country; while, the countries represent diverse socio-economic and political contexts, and the selection process provides generalizability to our results. We find that access to safe water could be improved if certain water governance challenges were addressed: coordination and data sharing between ministries that deal with drinking water services; monitoring and enforcement of water quality laws; and sufficient technical capacity to improve administrative and technical management of water services at the local level. From an analysis of our field research, we also developed a conceptual framework that identifies policy levers that could be used to influence governance of drinking water quality on national and sub-national levels, and the relationships between these levers

Translating the Human Right to Water and Sanitation into Public Policy Reform

Abstract The development of a human right to water and sanitation under international law has created an imperative to implement human rights in water and sanitation policy. Through forty-three interviews with informants in international institutions, national governments, and non-governmental organizations, this research examines interpretations of this new human right in global governance, national policy, and local practice. Exploring obstacles to the implementation of rights-based water and sanitation policy, the authors analyze the limitations of translating international human rights into local water and sanitation practice, concluding that system operators, utilities, and management boards remain largely unaffected by the changing public policy landscape for human rights realization. To understand the relevance of human rights standards to water and sanitatio

General framework for a water quality knowledge and information network

2010 Spring.Includes bibliographic references (pages 87-94).Covers not scanned.Print version deaccessioned 2022.The increasing pressure on water resources worldwide, due to growing demand, scarcity, and pollution, are leading to a shift from top-down models of management to interdisciplinary approaches and participatory processes, highlighting the need for collaborative work. As a result, the evolution in regulations and management practices and the forging of new partnerships are creating the need for unprecedented amounts of data and knowledge exchange, adding to the complexity of managing information on water resources. Regarding water quality management in particular, the interdependency with the land and the environment and the uncertainty around sources of contamination and chemical interactions can add to the problem. Furthermore, information and knowledge are produced by many different water quality management entities, and efficient means to communicate them are an important part of the process. Technology has provided some excellent tools for sharing information in all branches of science, including water resources. The latest developments go beyond static formats, allowing for the creation of online communities that can provide the necessary tools for information and knowledge exchange. In this project, a search for the available technology for collaboration, methods of community filtering, and community-based review was performed and the possible implementation of these tools to create a general framework for a collaborative “Water Quality Knowledge and Information Network” was evaluated. The main goals of the network are to advance water quality education and knowledge; encourage distribution and access to data; provide networking opportunities; allow public perceptions and concerns to be collected; promote exchange of ideas; and, give general, open, and free access to information. A reference implementation was made available online and received positive feedback from the community, which also suggested some possible improvements

A general framework for a water quality knowledge and information network

The increasing pressure on water resources worldwide, due to growing demand, scarcity, and pollution, are leading to a shift from top-down models of management to interdisciplinary approaches and participatory processes, highlighting the need for collaborative work. As a result, the evolution in regulations and management practices and the forging of new partnerships are creating the need for unprecedented amounts of data and knowledge exchange, adding to the complexity of managing information on water resources. Regarding water quality management in particular, the interdependency with the land and the environment and the uncertainty around sources of contamination and chemical interactions can add to the problem. Furthermore, information and knowledge are produced by many different water quality management entities, and efficient means to communicate them are an important part of the process. Technology has provided some excellent tools for sharing information in all branches of science, including water resources. The latest developments go beyond static formats, allowing for the creation of online communities that can provide the necessary tools for information and knowledge exchange. In this project a search for the available technology for collaboration, methods of community filtering, and community-based review was performed and the possible implementation of these tools to create a general framework for a collaborative "Water Quality Knowledge and Information Network" was evaluated. The main goals of the network are to advance water quality education and knowledge; encourage distribution and access to data; provide networking opportunities; allow public perceptions and concerns to be collected; promote exchange of ideas; and, give general, open, and free access to information. A reference implementation was made available online and received positive feedback from the community, which also suggested some possible improvements

Características e atuação dos profissionais dos Núcleos Ampliados de Saúde da Família e Atenção Básica

OBJECTIVE To analyze the characteristics and performance of the teams of the Expanded Family Health and Basic Healthcare Centers (Nasf-AB) of Santa Catarina state. METHOD A multicenter study implementing mixed methods, a sample of 149 municipalities (50.5% of the state) and 359 professionals through applying a survey and collective interviews with five teams of 43 professionals. Quantitative data were analyzed using descriptive statistics, and qualitative data were subjected to thematic analysis. RESULTS There were 11 professions integrated to the Centers with a predominance of psychologists (27%), physiotherapists (18%) and nutritionists (18%). The professionals were mostly women (88%) aged between 30 and 39 years (50.4%), with their performance involving shared care, collective activities of their professional core, group activities and individual care to users. Professionals participate in the intermediation, regulation or evaluation of referrals from Primary Care to other points of the Network. The interviews revealed a set of actions of technical care and technical-pedagogical support and specialized actions. CONCLUSION Despite operational difficulties, the Expanded Family Healthcare Centers have been supporting Family Healthcare teams, strengthening Primary Care.OBJETIVO Analizar las características y la actuación de los equipos de los Núcleos Ampliados de Salud de la Familia y Atención Básica de Santa Catarina. MÉTODO Investigación multicéntrica, con métodos mixtos, muestra de 149 municipios (50,5% del Estado) y 359 profesionales, mediante aplicación de Survey y entrevistas colectivas con cinco equipos, 43 profesionales. Los datos cuantitativos fueron analizados por vía estadística descriptiva, y los cualitativos pasaron por análisis temático. RESULTADOS Se hallaron 11 profesiones integradas a los Núcleos, con predominio de psicólogos (27%), fisioterapeutas (18%) y nutriólogos (18%). Los profesionales son mayoritariamente mujeres (88%), cuya actuación involucra atención compartida, actividades colectivas de su núcleo profesional, actividades en grupos y atención individual a los usuarios. Los profesionales participan en la intermediación, regulación o evaluación de derivaciones de la Atención Primaria a los demás puntos de la Red. Las entrevistas desvelan un conjunto de acciones de apoyo técnico asistencial y técnico pedagógico y actuación especializada. CONCLUSIÓN Los Núcleos Ampliados, pese a las dificultades operativas, están actuando en el soporte a los equipos de Salud de la Familia, fortaleciendo la Atención Primaria.OBJETIVO Analisar as características e a atuação das equipes dos Núcleos Ampliados de Saúde da Família e Atenção Básica de Santa Catarina. MÉTODO Pesquisa multicêntrica, com métodos mistos, amostra de 149 municípios (50,5% do estado) e 359 profissionais, mediante aplicação de Survey e entrevistas coletivas com cinco equipes, 43 profissionais. Os dados quantitativos foram analisados via estatística descritiva, e os qualitativos passaram por análise temática. RESULTADOS Encontraram-se 11 profissões integradas aos Núcleos, com predomínio de psicólogos (27%), fisioterapeutas (18%) e nutricionistas (18%). Os profissionais são, majoritariamente, mulheres (88%) com idade entre 30 e 39 anos (50,4%), cuja atuação envolve atendimento compartilhado, atividades coletivas de seu núcleo profissional, atividades em grupos e atenção individual aos usuários. Os profissionais participam da intermediação, regulação ou avaliação de encaminhamentos da Atenção Primária para os demais pontos da Rede. As entrevistas revelam um conjunto de ações de apoio técnico-assistencial e técnico-pedagógico e atuação especializada. CONCLUSÃO Os Núcleos Ampliados, apesar das dificuldades operacionais, têm atuado no suporte às equipes de Saúde da Família, fortalecendo a Atenção Primária

PERFIL CLÍNICO DE PACIENTES PORTADORES DE SÍNDROME METABÓLICA DE UM PROJETO DE EXTENSÃO EM REABILITAÇÃO CARDIOVASCULAR E METABÓLICA

A Síndrome Metabólica (SM) é uma epidemia associada à alta morbi-mortalidade cardiovascular e ao elevado custo socioeconômico, o que a torna um problema de saúde pública em todo o mundo. Este trabalho consiste em um estudo observacional descritivo, com amostra consecutiva composta por pacientes com diagnóstico de SM participantes de um Projeto de Extensão em Reabilitação Cardiovascular e Metabólica (PERCVM) da Universidade Feevale, que teve como objetivo verificar o perfil clínico de pacientes portadores de SM. Para a coleta de dados, foi utilizada uma ficha de avaliação composta pelas variáveis: idade, sexo, distância percorrida no teste da caminhada de seis minutos, valores da pressão inspiratória máxima e da pressão expiratória máxima obtidas através de um manovacuômetro e frequência cardíaca máxima do teste ergométrico. A amostra foi composta por cinco pacientes, sendo quatro (80%) do sexo feminino. Todos os participantes apresentaram as características clínicas de SM, tendo como prevalência os critérios de obesidade central, hipertensão arterial sistêmica e níveis de HDL-colesterol baixo.Palavras-chave: Síndrome metabólica. Fatores de risco cardiovascular. Exercício

Drinking water quality governance: A comparative case study of Brazil, Ecuador, and Malawi

Human health is greatly affected by inadequate access to sufficient and safe drinking water, especially in low and middle-income countries. Drinking water governance improvements may be one way to better drinking water quality. Over the past decade, many projects and international organizations have been dedicated to water governance; however, water governance in the drinking water sector is understudied and how to improve water governance remains unclear. We analyze drinking water governance challenges in three countries—Brazil, Ecuador, and Malawi—as perceived by government, service providers, and civil society organizations. A mixed methods approach was used: a clustering model was used for country selection and qualitative semi-structured interviews were used with direct observation in data collection. The clustering model integrated political, economic, social and environmental variables that impact water sector performance, to group countries. Brazil, Ecuador and Malawi were selected with the model so as to enhance the generalizability of the results. This comparative case study is important because similar challenges are identified in the drinking water sectors of each country; while, the countries represent diverse socio-economic and political contexts, and the selection process provides generalizability to our results. We find that access to safe water could be improved if certain water governance challenges were addressed: coordination and data sharing between ministries that deal with drinking water services; monitoring and enforcement of water quality laws; and sufficient technical capacity to improve administrative and technical management of water services at the local level. From an analysis of our field research, we also developed a conceptual framework that identifies policy levers that could be used to influence governance of drinking water quality on national and sub-national levels, and the relationships between these levers