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Achieving sustainability of community-based dengue control in Santiago de Cuba

Author

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  • Toledo Romani, Maria E.
  • Vanlerberghe, Veerle
  • Perez, Dennis
  • Lefevre, Pierre
  • Ceballos, Enrique
  • Bandera, Digna
  • Baly Gil, Alberto
  • Van der Stuyft, Patrick

Abstract

Achieving sustainability is one of the major current challenges in disease control programmes. In 2001-2002, a community-based dengue control intervention was developed in three health zones of Santiago de Cuba. New structures (heterogeneous community working groups and provincial/municipal coordination groups inserted in the vertical programme) were formed and constituted a key element to achieve social mobilization. In three control zones, routine programme activities were intensified. We evaluated the sustainability of the intervention strategy over a period of 2 years after the withdrawal of external support. Data on maintenance of effects, level of institutionalization and continuity of activities through capacity building were collected via documental review, direct observation, questionnaires, key informant and group interviews and routine entomological surveys. The intervention effects, evaluated through larval indices and behavioural change indicators, were maintained during the 2 years of follow-up. In the intervention area, 87.5% of the water storage containers remained well covered in 2004 and 90.5% of the families continued to correctly use a larvicide, against 21.5% and 63.5%, respectively in the control area. The house indices further declined from 0.35% in 2002 to 0.17% in 2004 in the intervention area, while in the control area they increased from 0.52% to 2.25%. Institutionalization of the intervention, assessed in terms of degrees of intensiveness (passage, routine, niche saturation), was reaching saturation by the end of the study. Key elements of the intervention had lost their separate identity and became part of the control programme's regular activities. The host organization adapted its structures and procedures accordingly. Continuous capacity building in the community led to participatory planning, implementation and evaluation of the Aedes control activities. It is concluded that, in contrast to intensified routine control activities, a community-based intervention approach promises to be sustainable.

Suggested Citation

  • Toledo Romani, Maria E. & Vanlerberghe, Veerle & Perez, Dennis & Lefevre, Pierre & Ceballos, Enrique & Bandera, Digna & Baly Gil, Alberto & Van der Stuyft, Patrick, 2007. "Achieving sustainability of community-based dengue control in Santiago de Cuba," Social Science & Medicine, Elsevier, vol. 64(4), pages 976-988, February.
    • Handle: RePEc:eee:socmed:v:64:y:2007:i:4:p:976-988
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    References listed on IDEAS

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    1. Pluye, Pierre & Potvin, Louise & Denis, Jean-Louis, 2004. "Making public health programs last: conceptualizing sustainability," Evaluation and Program Planning, Elsevier, vol. 27(2), pages 121-133, May.
    2. Bossert, Thomas J., 1990. "Can they get along without us? Sustainability of donor-supported health projects in Central America and Africa," Social Science & Medicine, Elsevier, vol. 30(9), pages 1015-1023, January.
    3. Pluye, Pierre & Potvin, Louise & Denis, Jean-Louis & Pelletier, Jocelyne & Mannoni, Chantal, 2005. "Program sustainability begins with the first events," Evaluation and Program Planning, Elsevier, vol. 28(2), pages 123-137, May.
    4. Pluye, Pierre & Potvin, Louise & Denis, Jean-Louis, 2004. "Corrigendum to `Making public health programs last: conceptualizing sustainability' [Evaluation and Program Planning 27 (2004) 121-133]," Evaluation and Program Planning, Elsevier, vol. 27(4), pages 453-453, November.
    5. Roberto Suarez, M. & Maria Fernanda Olarte, S. & Ana, M.F.A. & Catalina González, U., 2005. "Is what I have just a cold or is it dengue? Addressing the gap between the politics of dengue control and daily life in Villavicencio-Colombia," Social Science & Medicine, Elsevier, vol. 61(2), pages 495-502, July.
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    1. Madon, Shirin & Malecela, Mwele Ntuli & Mashoto, Kijakazi & Donohue, Rose & Mubyazi, Godfrey & Michael, Edwin, 2018. "The role of community participation for sustainable integrated neglected tropical diseases and water, sanitation and hygiene intervention programs: A pilot project in Tanzania," Social Science & Medicine, Elsevier, vol. 202(C), pages 28-37.
    2. Sebastian Ion Ceptureanu & Eduard Gabriel Ceptureanu & Cristian Eugen Luchian & Iuliana Luchian, 2018. "Community Based Programs Sustainability. A Multidimensional Analysis of Sustainability Factors," Sustainability, MDPI, vol. 10(3), pages 1-15, March.
    3. Pérez, Dennis & Lefèvre, Pierre & Castro, Marta & Toledo, María Eugenia & Zamora, Gilberto & Bonet, Mariano & Van der Stuyft, Patrick, 2013. "Diffusion of community empowerment strategies for Aedes aegypti control in Cuba: A muddling through experience," Social Science & Medicine, Elsevier, vol. 84(C), pages 44-52.
    4. Marta Castro & Lizet Sánchez & Dennis Pérez & Carlos Sebrango & Ziv Shkedy & Patrick Van der Stuyft, 2013. "The Relationship between Economic Status, Knowledge on Dengue, Risk Perceptions and Practices," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-6, December.
    5. Montgomery, Catherine M. & Munguambe, Khátia & Pool, Robert, 2010. "Group-based citizenship in the acceptance of indoor residual spraying (IRS) for malaria control in Mozambique," Social Science & Medicine, Elsevier, vol. 70(10), pages 1648-1655, May.

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