ResumoO artigo objetiva oferecer uma visão histórica de fatores que induziram ou influenciaram as primeiras políticas públicas de saneamento e de recursos hídricos no Brasil. Um dos pressupostos adotados é o de que o desenvolvimento socioeconômico e político do país resultou não apenas de dinâmicas endógenas, mas também de estruturas globais de poder, desde os primórdios da empresa colonial. Para tanto, usa-se a linha teórica de intérpretes clássicos da história brasileira como Celso Furtado e Caio Prado Júnior e suas perspectivas sobre a posição periférica do país no sistema econômico global. O esforço analítico resultou na percepção de que a política de saneamento se desenvolveu em consonância com iniciativas e interesses europeus na área e de que, em diferente sentido, as políticas de recursos hídricos emergiram da necessidade de regular o uso da água, especialmente para privilegiar a geração de energia elétrica em um contexto de crise externa e de centralização administrativa.

Adequate environmental health services are critical for human rights, health, and development, especially in the context of forced displacement. There are more than 70 million forcibly displaced persons worldwide, most in protracted situations, having been displaced for more than two years. Some live in camps or informal settlements, but most live in urban areas. Environmental health services are important in the transition from emergency response to sustainable development in these settings, but evidence on environmental health in displaced populations is disparate and of variable quality. We conducted a systematic scoping review of environmental conditions, exposures, and outcomes in protracted displacement settings; obstacles to improvement in environmental health services; and recommendations made for improvement. We included 213 publications from peer-reviewed and grey literature databases. Data were extracted on environmental health topics including water, sanitation, hygiene, overcrowding, waste management, energy supply, vector control, menstrual hygiene, air quality, and food safety. Most studies present data from low- and lower-middle income countries. Northern Africa and Western Asia and Sub-Saharan Africa are the most-represented regions. There is substantial evidence on water, sanitation, and crowding, but few studies report findings on other environmental health topics. Water-related disease, parasites, and respiratory infections are frequently cited and studies report that services often fail to meet international standards for humanitarian response. The most frequent obstacles and recommendations are institutional, political, or implementation-related, but few studies provide concrete recommendations for improvement. Our review compiles and characterizes the research on environmental health in protracted displacement. We recommend including displaced populations in international environmental health policy and monitoring initiatives, and bridging from humanitarian response to sustainable development by preparing for long-term displacement from the early stages of a crisis.

The Human Rights to Water and Sanitation (HRWS), adopted as UN Resolutions since 2010, contemplates key elements that seek to ensure equal and non-discriminatory access to water and sanitation, including the elimination of gender inequalities. Working in populations with socio-environmental vulnerabilities, this study aims to assess gender division of labor in households of two rural communities in the North and Northeast Brazilian macroregions and identify why greater impacts occur on the lives of women when compared to men, resulting in human rights concerns. A qualitative analysis was carried out through semi-structured interviews and direct observation. The study showed that in the two rural Brazilian communities there is a clear labor division for water and sanitation access from a gender perspective. Men undertake more specialized work, sometimes requiring greater physical effort. As for women, they are assigned functions related to the domestic environment, including activities concerning water and sanitation. When facilities are inadequate, there is a disproportionate impact on women's health and quality of life, showing that the non-compliance with the human rights to water and sanitation often results in more harmful consequences for them.

In Brazil, about two million people living in rural semiarid regions were benefited with the construction of rainwater cement cisterns, as an initiative from the program “One Million Cisterns” (P1MC). Nevertheless, few epidemiological studies have been conducted to assess health risks or protection effects associated with consumption of this water source. The aim of this study was to evaluate whether access to rainwater harvesting cisterns is associated with the decrease in the occurrence of Giardia duodenalis infections in children, compared to other children living in households supplied by other water sources. A quasi-experimental study with two concurrent cohorts was developed in two rural municipalities of the semiarid region of Brazil. A sample of 664 children, aged between 4 months and 5 years old, was followed up, of which 332 had access to rainwater cisterns (cistern group) and 332 did not, having water supplied from alternative sources (comparison group). In a period of approximately one year (2010) intestinal parasites were investigated in feces three times. The prevalence of G. duodenalis in children from the cistern group ranged from 4.8 to 10.5%, while the prevalence in the comparison group ranged from 7.6 to 16.7%. Multivariate analysis (GEE) showed a higher risk of G. duodenalis infection in children who did not have access to rainwater cisterns, when compared to children who did (OR 1.72; 95% CI 1.14–2.59). The other variables associated with G. duodenalis infection were: number of rooms per house (OR 0.89; 95% CI 0.80–0.99); family income (OR0.48; 95% CI 0.26–0.88); birth order (OR 1.72; 95% CI 1.17–2.51); preterm children (OR 1.70; 95% CI 1.19–2.43); and improper hand hygiene prior to food preparation (OR 4.78; 95% CI 1.95–11.76). Ownership of a rainwater cistern is associated with a lower prevalence of G. duodenalis infection in children after adjustment for environmental and family-related factors. Nevertheless, the study suggests the necessity to complement physical interventions with actions related to personal and domestic hygiene to enable further reductions in parasite infections affecting mainly the underprivileged populations. Currently, rainwater harvesting cisterns built up through the “One Million Cisterns” Program, coordinated by the Brazilian Government, represents the most important public policy for water supply in the rural semiarid region of Brazil. Despite the extensive use of this water provision, few studies have been performed to assess the associated health impact. To assess such impact, this study investigated factors associated with the occurrence of Giardia duodenalis (protozoan closely related to the ingestion of contaminated water) in children aged between 4 months and five years old. Two distinct groups of children, one with access to rainwater cisterns (cistern group) and the other without cisterns, with water supplied from alternative sources, including rivers, springs or dams (comparison group) were followed up for approximately one year. It was observed that the risk occurrence of G. duodenalis prevalence was greater in children from the comparison group, when compared with those from the cistern group, indicating that the odds of infection by this parasite were 1.72 times greater for comparison group children. In conclusion, the study showed health benefits related to rainwater cisterns, but also identified that other complementary sanitation interventions are needed to minimize the risk of disease in populations with limited access to drinking water.