Basic sanitation infrastructure and access to indigenous prenatal care in Northeastern Brazil
1
Faculty of Dentistry, University of Pernambuco, Recife, Brazil
2
Collective Health, Oswaldo Cruz Foundation (Fiocruz), Ministry of Health, Recife, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A1944
ABSTRACT
INTRODUCTION:
Access to basic sanitation remains marked by persistent inequalities. Among indigenous communities in Pernambuco, Northeastern Brazil, limited water resources combined with inadequate infrastructure pose ongoing challenges, particularly during pregnancy when continuity and quality of healthcare are essential for maternal and child protection.1-4 This study assessed investments in sanitation infrastructure between 2019-2022 and their relationship with access to indigenous prenatal care in the state, aiming to identify indigenous populations included in and excluded from public policies in this sector.
METHODS:
Secondary data were obtained from the Indigenous Health Care Information System (SIASI) on prenatal care and from the Planinfra database of the Brazilian Ministry of Health. Records of indigenous pregnant women followed between 2019-2022 were analysed, considering the place of care, pregnancy risk classification, municipality, and indigenous territory, in association with the presence of sanitation infrastructure projects contracted by the special indigenous health district of Pernambuco.
RESULTS:
Between 2019-2022, a total of 2275 indigenous pregnant women were followed, generating 15813 prenatal care records in the state of Pernambuco. Heterogeneity was observed in the distribution of prenatal care across indigenous territories, with higher concentrations in municipalities such as Pesqueira (448 women), Carnaubeira da Penha (408) and Jatoba (249). During the same period, the special indigenous health district of Pernambuco contracted 31 infrastructure projects, of which 14 were directly related to basic sanitation, primarily focused on water supply in the municipalities of Pesqueira, Buique, Águas Belas, Carnaubeira da Penha, Jatoba and Tacaratu. The distribution of sanitation projects did not consistently align with prenatal care demand, revealing structural inequalities in access to public policies.
CONCLUSIONS:
Gaps in sanitation infrastructure contribute to unequal access to prenatal care among indigenous territories in Pernambuco. Integrated policies that connect sanitation, primary healthcare, and culturally responsive prenatal services are needed to address these vulnerabilities.
Access to basic sanitation remains marked by persistent inequalities. Among indigenous communities in Pernambuco, Northeastern Brazil, limited water resources combined with inadequate infrastructure pose ongoing challenges, particularly during pregnancy when continuity and quality of healthcare are essential for maternal and child protection.1-4 This study assessed investments in sanitation infrastructure between 2019-2022 and their relationship with access to indigenous prenatal care in the state, aiming to identify indigenous populations included in and excluded from public policies in this sector.
METHODS:
Secondary data were obtained from the Indigenous Health Care Information System (SIASI) on prenatal care and from the Planinfra database of the Brazilian Ministry of Health. Records of indigenous pregnant women followed between 2019-2022 were analysed, considering the place of care, pregnancy risk classification, municipality, and indigenous territory, in association with the presence of sanitation infrastructure projects contracted by the special indigenous health district of Pernambuco.
RESULTS:
Between 2019-2022, a total of 2275 indigenous pregnant women were followed, generating 15813 prenatal care records in the state of Pernambuco. Heterogeneity was observed in the distribution of prenatal care across indigenous territories, with higher concentrations in municipalities such as Pesqueira (448 women), Carnaubeira da Penha (408) and Jatoba (249). During the same period, the special indigenous health district of Pernambuco contracted 31 infrastructure projects, of which 14 were directly related to basic sanitation, primarily focused on water supply in the municipalities of Pesqueira, Buique, Águas Belas, Carnaubeira da Penha, Jatoba and Tacaratu. The distribution of sanitation projects did not consistently align with prenatal care demand, revealing structural inequalities in access to public policies.
CONCLUSIONS:
Gaps in sanitation infrastructure contribute to unequal access to prenatal care among indigenous territories in Pernambuco. Integrated policies that connect sanitation, primary healthcare, and culturally responsive prenatal services are needed to address these vulnerabilities.
| eISSN: | 2654-1459 |
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