Contextual barriers and facilitators for the prevention of dengue in affected human settlement in Lima-Peru: a qualitative study
METHODS: Semi-structured interviews with residents, community leaders and health workers were conducted in order to explore their perceptions from a socio-ecological approach, based on the health belief model.
RESULTS: For each of the six shantytowns, two residents, one community leader and one health professional were selected to participate in the study. Total of 24 individuals interviewed. The main barriers identified were lack of continuous access to piped water resulting in the necessity of storing water. Also, the inadequate household practices favoring vector breeding conditions and exposure to vectors (for example, the custom of wearing light summer clothes that do not protect from mosquito bites) were identified among the barriers, as well as, a scarce participation in the community dengue control activities and the prioritization of other type of problems. Among the facilitators mentioned were the activities developed by the community health workers such as educational conferences to the community, distribution of larvicide and outdoor space spraying. The identification of conditions for vector breeding, location of breeding places and the acknowledgement of community participation in control activities were also stated as facilitators as well as an adequate knowledge of the consequences of the disease.
CONCLUSIONS: The barriers and facilitators for dengue prevention identified in this study represent potential action scenarios for designing control interventions in poor developed urban settings of Lima.