Aspectos demográficos, socioeconômicos e de doenças relacionadas à falta de condições sanitárias adequadas: estudo de caso realizado nos municípios mineiros dos Comitês da Bacia Hidrográfica dos Afluentes do Alto (SF1) e do Médio (SF9) São Francisco

This study seeks to identify and compare demographic, income, housing, human development, sanitary conditions, diseases related to sanitary conditions - diarrhea and dengue – indicators and institutional water supply and sanitation provision service models in the municipalities of the “Comitê da Bacia Hidrográfica dos Afluentes do Alto São Francisco (SF1)” and “Comitê da Bacia Hidrográfica dos Afluentes Mineiros do Médio São Francisco (SF9)”, located in Minas Gerais. For this, data obtained by the compatibility of information from the Instituto Brasileiro de Geografia e Estatística, Instituto Mineiro de Gestão das Águas, Ministério da Saúde e Programa das Nações Unidas para o Desenvolvimento, Instituto de Pesquisa Econômica Aplicada & Fundação João Pinheiro were used. To this end, seven dimensions were created and 13 study variables selected. The collected data were analyzed using univariate statistical methods, parametric (Student t test) and non-parametric (Mann Whitney U test), multivariate analysis (correspondence analysis) and multiple regression (logistic regression). Regarding diseases related to sanitary conditions, in the period between 2007 and 2016, time series analysis was performed. Thus, we found that the municipalities located in the more developed region (SF1) have a higher rate of urbanization and garbage collecting, better indicators of income, housing and human development, and lower rates of inadequate sanitation than the municipalities of SF9. Water supply rates for both groups were low and no statistically significant differences were found, confirming the prioritization of water supply services since the time the Plano Nacional de Saneamento. In relation to diseases related to sanitary conditions, we observed higher rates of hospitalization for dengue and diarrhea in the SF1 group, contrary to the expected result. However, lower hospitalizations in SF9 may be associated with poor hospital infrastructure and qualified professionals, difficulty accessing health services, cases where people do not go to hospitals and use home remedies and self-medication, or situations in which symptoms were treated on time and did not require hospitalization. With regard to provision service models, there was a greater presence of state companies in water supply and municipal direct management in sanitation in SF1, while in SF9 the state companies operate in the water supply and there is no provider collective sanitation. In general, in the first 10 years after the institution of Law 11.445/2007, there was a reduction in hospitalization rates due to diarrhea and dengue. However, there are still high rates of infectious diseases (which are related to inadequate sanitary conditions), and the Brazilian epidemiological profile is characterized by the persistence of high rates of diseases of poverty and by the increase of diseases of modernity. From the realization of this work, it was possible to visualize the importance of revitalizing the São Francisco before its transposition, since the sanitary framework presented to the SF1 and SF9 contribute to the degradation of the river.