Operation of government policies for the prevention and control of dengue: The cases of Arauca and Armenia

Abstract

Dengue is a growing public health problem in urban areas, given that its transmission is associated with the environment, as well as with the behaviour of individuals and communities. The model proposed by Ecohealth to study this problem includes the operation of government policies. To describe the operation of policies to prevent and control dengue in two Colombian cities. A qualitative study was conducted. Data was collected through interviews with officials who worked in the health and education sectors. The contents were processed with the Ethnograph software, using the proposals of the bottom-up model of implementation as analytical categories. A lack of coordination was identified between department and municipal offices, with few developments of the protocol for dengue and severe dengue in terms of community participation, communication strategies and studies of inhabitants´ knowledge, attitudes and practices. The integrated management strategy was limited by the instability of human resources, limited intra-institutional and cross-sectorial coordination and little emphasis on promotion interventions, both at the individual and population levels. Coordination between the departament and the municipality needs to be strengthened in the city of Arauca. Both here and in Armenia administration of human resources and interinstitutional coordination should be improved. Promotion of preventative measures should be strengthened to impact on the determinants of dengue.