[Impact of the Water for All Program (PAT) on childhood morbidity and mortality from diarrhea in the Bahia State, Brazil]

Abstract

This study aimed to evaluate the impact of the Water for All Program (PAT), launched in Bahia State, Brazil, with the objective of expanding coverage of the water supply and sanitation in areas with high vulnerability to waterborne diseases. A total of 224 municipalities (counties) with adequate vital statistics were selected. A controlled before-and-after study design was used, performing analyses with multivariate negative binomial regression with fixed effects, from 2005 to 2008. PAT coverage - as a continuous variable - was negatively associated (p < 0.01) with the under-five mortality rate. Municipalities with coverage ≥ 10% showed a reduction of 39% (p < 0.05) in mortality from diarrhea, under-five mortality of 14% (p < 0.01), and hospitalizations from diarrhea of 6% (p < 0.05) when compared to municipalities without PAT or with lower coverage, having adjusted for confounding. No effects were found on external causes of mortality, used as a control. When focused on highly vulnerable areas, water and sanitation programs can have an important impact in reducing health inequalities in the population.