Inequalities in Access to Water, Sanitation, and Hygiene (Wash) in Semiarid Regions from a Human Rights and Sustainable Development Goals Perspective

Introduction: The Human Rights to Water and Sanitation (HRWS) were recognized by the United Nations in Resolution A/64/292 (2010), based on principles of equality and non-discrimination; participation and inclusion; accountability and answerability; progressive realization and the maximum use of available resources. Despite this recognition, 3.5 billion people still lack adequate sanitation and 2.2 billion do not have access to safe drinking water (UN, 2023), highlighting the gap between international norms and the lived reality, characterized by socio-spatial inequalities. Therefore, this study aimed to characterize and quantify inequalities in access to water, sanitation, and hygiene in the Intermediate Geographic Region of Montes Claros, located in the Semiarid Region of Minas Gerais, Brazil. The official delimitation of the Brazilian semiarid (2024) defined that the state of Minas Gerais comprises 217 municipalities within this territory, of which 81 belong to this intermediate region, the one with the highest number of municipalities in the semiarid. The methodology involved a literature review, document analysis, and examination of secondary data from the 2010 and 2022 Demographic Censuses. The analysis was guided by the concepts of adequacy and deficit as defined in the National Basic Sanitation Plan (Plansab). To measure geographical inequalities, the HEAT Plus (Health Equity Assessment Toolkit Plus) software was employed. The findings reveal inequalities both between regions and between urban and rural sectors, with rural areas being the most vulnerable. Monitoring these inequalities can inform public policies aligned with the HRWS and the principle of equality and non-discrimination, thereby contributing to the reduction of socio-spatial inequalities and to the promotion of universal access to water and sanitation.     Objective: This study aims to characterize and quantify inequalities in access to water, sanitation, and hygiene in the Intermediate Geographic Region of Montes Claros, situated in the Semiarid region of Minas Gerais, Brazil.     Theoretical Framework: The recognition of the Human Rights to Water and Sanitation took place in 2010 by the United Nations (UN). In 2015, the UN adopted Resolution A/RES/70/169, which acknowledged the distinct rights to water and to sanitation (Heller, 2022). The expansion of access to water, sanitation, and hygiene (WASH) is part of Goal 6 of the Sustainable Development Goals (SDGs) within the 2030 Agenda. Despite progress since 2000, significant geographical inequalities persist, hindering the universalization of access, particularly in historically marginalized communities (Deshpande et al., 2020).     Method: The methodology adopted in this research included a literature review, document analysis, and the examination of secondary data from the 2010 and 2022 Demographic Censuses and the National Sanitation Information System (SNIS, 2022). The analysis was guided by the concepts of adequacy and deficit as defined in the National Basic Sanitation Plan (Plansab). To assess geographical inequalities in access, the HEAT Plus software (Health Equity Assessment Toolkit Plus) was employed, a tool designed for equity analysis in health that has increasingly been applied to studies on WASH.     Results and Discussion: The findings revealed deficits in adequate access to WASH in the Semiarid Region and, more specifically, in the Intermediate Geographic Region of Montes Claros, as well as persistent geographical inequalities across the area. Between 2010 and 2022, there was a reduction in inequality rates regarding access to water in some municipalities; however, the Immediate Region of Pirapora maintained the highest levels of inequality. Regarding sanitation access, the expansion of coverage was accompanied by an increase in inequalities, particularly in the Immediate Regions of Pirapora and Salinas (in absolute values). Higher levels of inequalities and disparities in WASH were observed between urban and rural sectors, mainly concentrated in the Immediate Regions of Pirapora and Salinas.     Research Implications: The recognition of the HRWS and the 2030 Agenda, through the SDGs, imposes new challenges for assessing access conditions and developing public policies, particularly in contexts of socio-environmental vulnerability in the semiarid region. By highlighting the existing geographical inequalities in the Intermediate Geographic Region of Montes Claros, this study contributes to strengthening continuous monitoring strategies aligned with the principles of equality and non-discrimination. Furthermore, it provides evidence to support the formulation of more inclusive and territorially sensitive public policies capable of guiding interventions aimed at reducing inequalities and promoting equity.     Originality/Value: This study contributes by outlining an overview of coverage and inequalities in access to WASH in the Intermediate Geographic Region of Montes Claros, which encompasses the largest number of municipalities in the Semiarid area of Minas Gerais. By highlighting persistent vulnerabilities and territorial disparities among the immediate regions of this locality, the study provides evidence to support the design of more inclusive and territorially oriented public policies, thereby strengthening the debate on the HRWS and the possibilities for their implementation in territories historically marked by exclusion.