BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

310 Patterns of Mortalityin Childhood
presence or absence of sanitary facilities.
These authors based their analysis on the
location of the water supply and toilet facility,
that is, inside or outside the house,
as has been done also in this Investigation.
They found the incidence of diarrheal disease
to be lowest when the dwelling had
water and a flush toilet inside the house.
In Chapter IX it was made clear that
mortality could not be reduced to low levels
without reduction of nutritional deficiency.
The data in this chapter indicate that provision
of water is another essential component
of a sound program leading to reduction
in death rates. As both factors, nutritional
deficiency and infection, are due
to unfavorable socioeconomic conditions,
their roles cannot be separated; infectious
agents from the environment attack the
most susceptible infants and children, those
weakened by nutritional deficiency. Thus
both the host and the agent are involved
in this complicated pattern of mortality and
both must be taken into account when plan-.
ning services to improve a population's
state of health.
WATER SUPPLIES
During the interviews in the homes of deceased
children, information was obtained
on the type of water supply available to
the family: water piped inside the house,
or piped water available outside or nearby
through a communal facility. One of the
goals laid down in the Charter of Punta del
Este (Organization of American States,
1961) was to supply potable water and
sewage disposal services to at least 70 per
cent of the urban and 50 per cent of the
rural population during the decade. At
the III Special Meeting of Ministers of
Health of the Americas, held in 1972
(PAHO, 1973), new goals were approved
for the decade of the 1970's: to provide
water service with house connections for 80
per cent of the urban population and water
for 50 per cent of the rural population; and
to install sewerage systems for 70 per cent of
the urban population and such systems or
other sanitary facilities for 50 per cent of
the rural population. The findings of the
Investigation can be viewed in relation to
these goals (which are for countries) so that
they may serve as a basis for future planning.
Table 182 presents the basic data in regard
to piped water available to families
of infants dying in the two age groups
(neonatal and postneonatal) in 22 areas of
14 projects (the California project is not
included as home interviews were not conducted).
Figure 155 shows (in the left
section) the percentages of households in
the first group (neonatal) served with
piped water. In nine cities more than 80
per cent of these households had piped water
available, namely:
Santiago
Medellin
Sherbrooke
Cali
Kingston-St.
96.2 Cartagena 89.9
95.1 San Juan (city) 87.9
94.6
92.9 Monterrey
83.0
Ribeirilo Pr~to
Andrew 91.5 (city) 812
In four of these cities the percentages
ranged from 81.2 to 89.9, and in the other
five they were above 90.
In the rural areas the percentages of
households with piped water were very
low, and they were low also in several of