Community participation (CP) has been defined “as a process whereby individuals, families and communities are involved in the planning and conduct of local vector control activities so as to ensure that the programme meets the local needs and priorities of the people who live in the community, and promotes community’s self-reliance in respect to development.” In short, CP entails the creation of opportunities that enable all members of the community and extended society to actively contribute to, influence the development of, and share equitably in the fruits of accrued benefits. Objectives of community participation in dengue prevention and control:
- To extend the coverage of the programmer to the whole community by creating community awareness. This however often requires intensive inputs.
- To make the programmer more efficient and cost-effective, with greater coordination of resources, activities and efforts pooled by the community.
- To make the programmer more effective through joint community efforts to set goals, objectives and strategies for action.
- To promote equity through sharing of responsibility, and through solidarity in serving those in greatest need and at greatest risk.
- To promote self-reliance among community members and increase their sense of control over their own health and destiny.
How to invoke community participation
- By showing concern: Community and government organizers should reflect the true concern for human suffering, i.e. morbidity and mortality due to dengue in the country, economic losses to the families and the country, and how the benefits of the programmer fit into the people’s needs and expectations.
- Initiating dialogue: Community organizers and opinion leaders or other key personnel in the power structure of the community, namely women’s groups, youth groups and civic organizations, should be identified. Dialogue should be undertaken through personal contacts, group discussions and film show. Interaction should generate mutual understanding, trust and confidence, enthusiasm and motivation. The interaction should not be a one-time affair, but should be a continuing dialogue to achieve sustainability.
- Creating community ownership: Organizers should use community ideas and participation to initiate the programmer, community leaders to assist the programmer, and community resources to fund the programmer. Mosquito control, abatement agency and community partnerships should be strong, but limited to providing technical guidance and expertise.
- Health education (HE): Health education should not be based on telling people the do’s and don’ts through a vertical, top-down communication process. Instead, health education should be based on formative research to identify what is important to the community and should be implemented at three levels, i.e. the community level, systems level and political level.
Community level: People should not only be provided with knowledge and skills on vector control, but education materials should empower them with the knowledge that allows them to make positive health choices and gives them the ability to act individually and collectively.
Systems level: To enable people to mobilize local actions and societal forces beyond a single community, i.e. health, development and social services.
Political level: Mechanisms must be made available to allow people to articulate their health priorities to political authorities. This will facilitate placing vector control high on the priority agenda and effectively lobby for policies and actions.
Defining community actions: For sustaining DF/DHF prevention and control programmes, the following community actions are essential:
- At the individual level, encourage each household to adopt routine health measures that will help in the control of DF and DHF, including source reduction and implementation of proper personal protection measures.
- At the community level, organize “clean-up” campaigns two or more times a year to control the larval habitats of the vectors in public and private areas of the community. Some key factors for the success of such campaigns include extensive publicity via mass media, posters and pamphlets, proper planning, pre-campaign evaluation of foci, execution in the community as promised, and follow-up evaluations. Participation by municipal sanitation services should be promoted.
- Where community-wide participation is difficult to arrange for geographical, occupational or demographic reasons, participation can be arranged through voluntary associations and organizations. The people in these organizations may interact daily in work or institutional settings, or come together for special purposes, i.e. religious activities, civic clubs, women’s groups and schools.
- Emphasize school-based programmes targeting children and parents to eliminate vector breeding at home and at school.
- Challenge and encourage the private sector to participate in the beautification and sanitary improvement of the community as sponsors, emphasizing source reduction of dengue vectors.
- Combine community participation in DHF prevention and control with other priorities of community development. Where municipal services (such as refuse collection, wastewater disposal, provision of potable water, etc.) are either lacking or inadequate, the community and their partners can be mobilized to improve such services, and at the same time reduce the larval habitats of Aedes vectors as part of an overall effort at community development.
- Combine dengue vector control with the control of all species of disease-bearing and nuisance mosquitoes as well as other vermin, to ensure greater benefits for the community and consequently greater participation in neighborhood campaigns.
- Arrange novel incentives for those who participate in community programmes for dengue control. For example, a nationwide competition can be promoted to identify the cleanest communities or those with the lowest larval indices within an urban area.