A community education strategy to promote participation in dengue prevention in Cuba

作者:Sanchez Lizet; Perez Dennis; Alfonso Lazara; Castro Marta; Sanchez Luis Manuel; Van der Stuyft Patrick; Kouri Gustavo
来源:Pan American Journal of Public Health, 2008, 24(1): 61-69.
DOI:10.1590/S1020-49892008000700008

摘要

Objectives. To document the process and analyze the results of implementing a strategy aimed at increasing community participation in the fight against the dengue mosquito vector.
Methods. From May 2002 to May 2004, an intervention was implemented to advance social action against dengue in three districts of the municipality of Playa, La Habana, Cuba. A learning group and community working groups (CWG) were organized in each location. A community education model was followed that combines putting the plan of action into practice, with sessions to reflect and learn from the results, and then reworking of the actions for subsequent stages. Diagnostic tools were developed for communities, preventative actions, communication, surveillance, and evaluation. Changes in participation were identified by applying the content analysis technique to the documents and through interviews with key informants.
Results. The community work advanced at a pace relative to the abilities and interests of each community with different areas of focus: healthy community, environmental risk, and entomological risk. Positive changes in the concept of participation were obtained, according to the five areas evaluated: leadership, needs assessment, organization, management, and mobilization of resources. At the end of two years of intervention, the rate of Aedes aegypti larvae and pupae deposits found per 100 households had declined 79% and cases of dengue were not detected in any of the districts.
Conclusions. This strategy reduced mosquito vector infestation levels by increasing community participation in decision-making and strengthening the competencies of the medical teams and CWGs so that they lead participative processes in the community and raised confidence in their ability to achieve change with the appropriate resources and intersectoral support.