Experiences, barriers and facilitators to the implementation of interventions for controlling Aedes aegypti in Latin America and the Caribbean: a qualitative study

TAPIA-LÓPEZ, ELENA; BARDACH, ARIEL; CIAPPONI, AGUSTÍN; ALCARAZ, ANDREA; GARCÍA-PERDOMO, HERNEY ANDRÉS; RUVINSKY, SILVINA; BELIZÁN, MARÍA

CADERNOS DE SAúDE PúBLICA

CADERNOS SAUDE PUBLICA

Año: 2019 vol. 35

0102-311X

This study sought to describe experiences, barriers and facilitators to the implementation of interventions for controlling Aedes aegypti in Latin America and the Caribbean. A qualitative approach with semi-structured in-depth interviews with program implementation experts (19 participants in nine countries) was carried out. We used a software to codify the data and created matrices to compare them. Based on our findings, we developed a graphic representation of the theoretical dimensions that encompass the barriers and facilitators to the implementation of interventions. At the global level, the natural and built environment contributed to the mosquito?s reproduction. In the health system, the lack of priority given to the problem and the scarcity of material and human resources are the most important obstacles. Sectors other than health must take responsibility for actions directed at improving social determinants of health. There are transversal barriers related to governance, lack of coordination between central and local levels, lack of continuity in terms of interventions and technical groups. The community faces problems such as lack of information, poverty or resistance to recommendations. Public opinion can have a positive or negative impact, indirectly influencing political decisions. This study proposes a framework of analytical dimensions based on our findings; describes factors that influence policy implementation, which can guide future actions from an integrated perspective.