Peer-reviewed article
BASIC SANITATION AND PUBLIC HEALTH: A COMPARATIVE INTEGRATIVE REVIEW BETWEEN THE CAPIM DOURADO (TO) TERRITORY, STATE OF TOCANTINS, NORTHERN BRAZIL, AND THE SINGAPORE MODEL
Kamila Chaves Moura Sá Sá, César Martins Barbosa, Laura Picoreli Nicodemo, Andrea Bottoni, Alexandre Mansuê Ferreira Carneiro ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This mixed-methods study compares basic sanitation and public health in the Capim Dourado Territory in Tocantins, Brazil, with Singapore. It combines an integrative literature review with an analysis of secondary data from institutional sources. Water supply coverage is high in Tocantins, but sewage systems remain inadequate in smaller municipalities. Weaker sanitation infrastructure was associated with more acute diarrheal disease and hepatitis A. The authors conclude that Tocantins needs integrated planning, with sewage as the priority, and that Singapore's integrated governance and sustained financing offer a model. Children are not the main focus; they appear mainly through infant and fetal mortality.
Key points
- Water supply coverage in Tocantins is 90.1%, and 97.62% in the Capim Dourado Territory.
- Significant deficits in sanitary sewage systems persist in smaller municipalities.
- Limited sanitation infrastructure was associated with greater vulnerability to acute diarrheal diseases and hepatitis A.
- The literature indicates that Municipal Basic Sanitation Plans and intermunicipal consortia contribute to reducing infant and fetal mortality, more strongly in economically more developed municipalities.
- Singapore's integrated governance, long-term planning, urban monitoring technologies and sustained financing are presented as key conditions for universal access.
Limitations
The abstract does not give child-specific data, the number of studies reviewed, or the methods used to find the association between sanitation and disease. The Brazil-Singapore comparison relies on secondary data and cannot show cause and effect or whether Singapore's model would work in Tocantins.
Abstract
Basic sanitation is a structural determinant of public health, and its inadequacy is directly associated with the occurrence of waterborne diseases and the exacerbation of socio-environmental inequalities.This study analyzes and compares the relationship between basic sanitation conditions and public health indicators in the Capim Dourado Territory (TO), Brazil, and in Singapore, investigating how public policy instruments and urban governance models influence these outcomes.A mixed-methods approach was adopted, consisting of an integrative review of the scientific literature and a documentary analysis of secondary data from institutional sources-SNIS, ANA, SES-TO, IBGE, WHO, and PUB.The results indicate that Tocantins has high water supply coverage (90.1%), especially in the Capim Dourado Territory (97.62%), but significant deficits in sanitary sewage systems persist in smaller municipalities.An association was identified between limitations in sanitation infrastructure and greater vulnerability to acute diarrheal diseases and hepatitis A. The literature confirms that planning instruments-such as the Municipal Basic Sanitation Plans (PMSBs) and intermunicipal consortia-contribute to the reduction of infant and fetal mortality, with a more pronounced effect in economically more developed municipalities.A comparison with Singapore demonstrates that integrated governance, long-term planning, the use of urban monitoring technologies, and sustained financing are key conditions for achieving universal access to services.It is concluded that advancing sanitation in Tocantins requires integrated strategies, prioritizing sanitary sewage systems, strengthening the PMSBs, consolidating regionalization, and ensuring ongoing coordination between sanitation, health surveillance, and smart city governance.