Consolidation and up-scaling of the shared management model for the prevention of Chagas disease in Bolivia

The objective of the Ayuda en Acción project is to implement a model to fight Chagas disease in the Bolivian populations located in the municipalities of Sucre, Villa Huacaya, Villa Vaca Guzmán, Saipina and Comarapa. The project aims to reinforce the participative social network, the communal network of entomological surveillance, the implementation of an educational program, and the promotion of areas of analysis and reflection through the exchange of experience.

CONTEXT
Bolivia, and particularly the previously mentioned municipalities, has a high incidence of Chagas due to various factors that encourage the development of the vector that transmits it: precarious living conditions, a dispersed population, and limited capacity for the health services to carry out epidemiological surveillance, diagnosis and treatment. To all these factors must be added the lack of knowledge on the part of the population with respect to prevention of the disease.

The municipalities of Sucre, Villa Huacaya, Villa Vaca Guzmán, Saipina and Comarapa are composed of a multi-ethnic and pluri-cultural population (Guaraní, Quechua and Mestizo) who are primarily employed in agricultural activities.

PROJECT
The specific objective of the project is to reinforce the local capacity of the public health services and the civil society organizations to decrease the risk of the population in the intervention zone contracting Chagas. Ayuda en Acción has divided the project into three types of activities:  

In a first phase the activities are focused on the implementation of an anti-chagas model in the districts of reference. To do so, a study will be carried out which will serve as baseline and allow for the determination of the prevalence of Chagas; from this point, an IEC strategy will be developed oriented to the institutionalization of the prevention campaigns, In a parallel manner, local healthcare personnel will be given capacity-building in the detection and diagnosis of Chagas and reference laboratories will be equipped. Finally, vector information stands will be set up and the personnel in charge of them trained.   

In the second phase, Ayuda en Acción will carry out different activities in order to consolidate its anti-chagas model providing support for the updating of the family registers in order to determine their epidemiological situation.
Finally, activities will be held focused on reinforcing local capacities in the early detection, diagnosis, follow-up and treatment of congenital Chagas. To achieve this, an information system will be developed and healthcare personnel trained in its management, a reference center will be equipped, and the implementation of domestic hygienic practice encouraged for the prevention of Chagas.

BENEFICIARIES
The direct beneficiaries of the project will be a total of 25,736. Of these, 12,369 are women and 6,434 aged less than five years. The population is composed of people of Guaraní, Quechua and Mestizo origin who are highly vulnerable and exposed to the disease.