Table 4 Control and prevention of dengue (TDR/IDRC funded)
Conceptualization, research and praxis | Accomplishments and challenges | |
|---|---|---|
Bio-security | We are examining the presence/reproduction of unhealthy modes of living and unhealthy agricultural spaces in the context of an unhealthy metabolism between unsafe agricultural production and its ecological conditions. Emphasis is on understanding how social processes affect vector transmission in the socio-ecological context of an agro-industrial region as well as the associated exposure and vulnerability of marginalized populations amid an increasing and uneven prevalence of dengue. We anticipate that with increased attention to the engagement of the affected communities’ there will be a direct involvement in processes to decrease their vulnerabilities and to monitor negative impacts. | We have successfully demonstrated the INSOC (Social Insertion) index as a more sensitive measurement tool for analyzing social gradients of vulnerability. As well, a computerized system (SAT-Dengue) for rapid notification to increase the efficiency and effectiveness of health system performance has been introduced – with the intention of building this as part of an intersectoral integrated system for monitoring additional elements to be addressed in control and prevention actions. The effectiveness, albeit limited, of community prevention and control activities has been documented, setting the stage for a more comprehensive analysis of options for intervention that can provide stronger prospects for reducing exposure to dengue. |
- Health justice | ||
Sustainability | Consideration of broader processes of land use, chemical application and food production is being considered in relation to the sustainability of conditions for healthy modes and living contexts. | Recognizing the limitations of what can be achieved through adaptive local community actions, attention to broader contextual processes has been introduced in reviewing study results, including opportunities for strengthening environmental regulations, municipal infrastructure and its economic feasibility and the interactions with broader patterns of agro-industrial development that have transformed the local ecology. |
- Ecological justice | ||
Solidarity | Emphasis in the study has been on the role of community engagement (through the participation of health promoters and neighbourhood school activities) in achieving prevention and control of dengue by restricting conditions for the virus-carrying vector to multiply | Patterns of networks that are involved in dengue prevention and control have been analyzed to highlight need and opportunities for sustainably building effective community engagement, countering vertical paternalistic approaches such as that which was introduced by a “top-down” bio-larviciding program that was concurrently initiated by the Ministry of Health during the study period. |
- Social justice | ||
- Agency | ||
Sovereignty | Effects on local communities of interactions with government and other institutions including has been carefully monitored, through direct involvement of local community organizations. | Greater accountability for further dengue activity by authorities is being emphasized; as are opportunities for communities to build on their increased involvement in this study to take on additional health priorities that they have identified in their health committees. |
- Epistemological justice | ||
- Interculturality | ||
- Respect for local expertise |