The aim of this article is to measure the impact of basic sanitation services on the mortality rate of children under five years of age (U5MR) in the municipalities of the State of Alagoas, Brazil. A multivariate multiple linear regression model was applied for all 102 cities of Alagoas for data years 1991, 2000 and 2010. The research findings are evidence that access to basic sanitation services in the municipalities of the State of Alagoas, especially household sanitary sewage, is associated with a statistically significant reduction of U5MR, p < 0.01 . The estimates show that the 10% increase in access to household sanitary sewage is associated to a reduction of 5.7 deaths per 1000 born alive (BA). Based on a simulation of universal basic access sanitation services in the municipalities of the State of Alagoas, it is observed that only this public policy would be able to reduce child mortality by more than 94%. The end results of this study are important subsidies to guide basic sanitation policies not only in the State of Alagoas, Brazil, but also in developing regions all over the world, considering the evidences of social and environmental impact.
This study aims to evaluate the level of technical efficiency of companies that perform the integrated management of basic sanitation in Brazilian municipalities. A Multiple Data Envelopment Analysis (M-DEA) model was applied to estimate the performance of water supply and sewage services in 1628 municipalities covering more than 56% of the Brazilian population, identifying the factors that most influence the efficiency of the sector in the years 2008 and 2016. The M-DEA methodology is an extension of Data Envelopment Analysis (DEA) with multiple DEA executions considering all combinations of inputs and outputs to calculate efficiency scores. The methodology reduces possible biases in the selection of resources and products of the model, ability to support decision-making in favor of improvements in the sector′s efficiency based on national regulatory framework. The analyses show that the companies analyzed can increase their operating results and attendance coverage by more than 60%, given the current levels of infrastructure, human and financial resources in the sector. Based on the simulation of potential efficiency gains in Brazilian basic sanitation companies, the estimates show that the coverage of the population with access to sanitary sewage would go from the current 59.9% to 76.5%. The evidence found provides indications to subsidize sanitation management in the country at the micro-analytical level, enabling a better competitive position in the sector for the integrated management of basic sanitation and its universalization in Brazil.
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