Articulação entre vigilância da qualidade da água para consumo humano e vigilância epidemiológica : desafios e possibilidades para a integração de indicadores. Estudo em municípios de diferentes portes populacionais no Estado de Minas Gerais

Abstract

One of the main challenges of Brazilian’s drinking water surveillance program – Vigiagua - refers to the desired efficiency and effectiveness of actions, which are reached by its analysis and planning based on the epidemiological indicators. The proposed methodology of action research seeks to identify and assess the potential integration of drinking water surveillance and epidemiological surveillance to direct intersectoral action evolving sanitation and public health. The empirical work takes place in three different cities of Minas Gerais: Contagem, Nova Lima and Jaboticatubas, respectively large, medium and small sizes. It focuses on the articulation and evaluation of the data generated by surveillances and also how professionals perceive and enable social participation and intersectoral action, trying to understand and improve planning, implementation and evaluation of public policy reform at the municipal level. The first paper analyses practices established by the Ministry of Health for the identification and survey of the various types of water supply, for the compilation of geographic information systems, and for the allocation of responsibilities between organisations and sectors, taking as our data the statements made during interviews by Vigiagua professional staff in one large, one small and one intermediate sized municipality. The second and third ones provides an assessment on suitable instruments and strategies that aim to establish linkages between local epidemiologic and environmental health related to drinking water (Vigiagua), discussing potential challenges to its institutionalization. The fourth paper presents an assessment of a proposal that aimed to develop collaborative tools to promote joint planning and performance among the environmental monitoring department (Vigiagua) and Epidemiological Surveillance in these scenarios. The last chapter claims to explore critically the methodological approach of action research applied to the Environmental Monitoring Programme related to water quality for human consumption (Vigiagua). It was verified that the joint planning involving Vigiagua and Epidemiological Surveillance departments is not yet functional. Moreover the lack of interaction channels between departments and sectors and the incipient data sharing aggravates the situation. Instruments aiming at the integration were adopted to contribute to the development of work processes funded on interdisciplinarity.