Community Action in the prevention and control of Chagas disease, Totogalpa - Madriz, Nicaragua

The project is part of the Family and Community Health Model (MOSAFC), in the vector-borne disease control strategy, it will strengthen community entomological surveillance, epidemiological surveillance and basic sanitation, combining two methodologies for behavioral changes

CONTEXT

In 2018, Nicaragua occupies the 124th position out of 193 countries according to the Human Development Index (HDI = 0.658), it is still the second poorest country in Latin America after Haiti, the Department of Madriz is classified in high poverty 42.4%, Totogalpa is the second municipality with the most communities in extreme poverty, a determining factor for the prevalence of Chagas disease. In Totogalpa, the houses have the ecological conditions for the proliferation of the vector: Houses are made of adobe (predisposes to cracks where the transmitting bedbug can live), tile roof or plant material nests, on the other hand, lack of general sanitation in the homes of each community which facilitates the habitat for the vector. Of those affected in 2018, 75% are women and of those recruited 55 are pregnant women.

PROJECT

The project is part of the Family and Community Health Model (MOSAFC), in the vector-borne disease control strategy, it will strengthen Community Entomological Surveillance, Epidemiological Surveillance, Basic sanitation, combining two methodologies for behavioral changes;

In the implementation of the project activities, three linked components will be carried out:

1). Strengthening the Capacity of Health personnel and Community Health Agents for the Entomological and Epidemiological Surveillance System

2.) Community empowerment for disease prevention

3.) Information - Education - Communication (IEC)

Objectives of the Project

General Objective: "Contribute to the improvement of the living conditions of the families of 20 communities by reducing the prevalence of Chagas disease and Vector control in the Municipality of Totogalpa, Madriz"

Specific objective 1. To establish a Community Entomological Surveillance program based on the determination of infestation rates in homes for the development of a basic family sanitation plan for housing.

Specific objective 2. Strengthen Capacities in community Health agents, MINSA technicians in the prevention and control of Chagas disease, and Health education in beneficiary families.

Expected results and activities by results

RE1.Entomological Surveillance and Vector control program strengthened, including basic sanitation in 20 Communities

A1. Triatomine capture and delivery to the health unit for analysis of taxonomic identification

A2, Determine housing infestation rates by Community every 6 months after the baseline.

A3. Institutional entomological survey (MINSA) one a year

A4. Stratification of communities at the end of the semester according to triatomine capture

A5. Vector Control with an environmental physical approach (promotion of  housing improvement and rehabilitation)

RE2. Capacity Building in 80 community health agents for epidemiological surveillance and implementation of the Combi Plan in the prevention and control of Chagas

A1. Training for 80 Health Brigadiers on the population dynamics of vectors, prevention and control of vectors, entomological surveillance, epidemiology of the disease, uptake and reference.

A2. Training of Health personnel (40) on the program standards and strengthening epidemiological surveillance.

A3. Managing family knowledge for behavior change through FECSA and COMBI Plan for prevention and control.

A4. Acquisition and referral of acute and chronic patients to health units

RE3. Implemented an IEC Campaign for health promotion and education that contributes to behavioral changes in the families of the 20 communities

A1. Radio bullets for public awareness

A2. Distribution of brochure (Trifoliar), posters, educational booklet for families

A3. Knowledge fairs and community festivals in two sectors of concentrated communities to raise awareness of basic sanitation.

BENEFICIARIES

The direct beneficiaries are 80% of the children, adolescents, women and men aged 20-49 from the 20 communities (3,128 people, 935 families, 1,087 women, 1,297 children and adolescents), who also benefit directly the brigade members and leaders of the Family community and life cabinets (80), and the health personnel of the entire municipality (40).

The indirect beneficiaries belong to the remaining communities and to the urban area of Totogalpa (10,000).