Centro Internacional de Entrenamiento e Investigaciones Médicas, CIDEIM, Cali, Colombia.
Universidad Icesi, Cali, Colombia.
Infect Dis Poverty. 2020 Apr 14;9(1):25. doi: 10.1186/s40249-020-00639-w.
Improved access to health care and quality of services require integrated efforts and innovations, including community empowerment and participation in transformation processes. Chagas disease is a neglected tropical disease that is generally controlled by insecticide spraying. To achieve community empowerment in a health program, actions for social innovations may include: community-based research, interdisciplinary and intersectoral participation, community perception of direct benefits and participation in health or environmental improvements. The aim of this study was to describe and analyze the processes by which an interdisciplinary team, in collaboration with communities of Comapa, Guatemala, developed an effective solution to address the risk for Chagas disease.
A qualitative study involving interviews semi-structured and direct observation was conducted using a case study approach to describe and understand the community-based research and intervention process developed by researchers from the Laboratory of Applied Entomology and Parasitology of the Universidad de San Carlos of Guatemala (Laboratorio de Entomologia y Parasitologia Aplicada). Nine interviews were conducted with the investigators, innovators, members of the community in which the intervention had been implemented. NVivo software (version 12) was used for the emergent coding and analysis of the interviews.
Processes of social transformation were evident within households, and the communities that transcended the mere improvement of walls and floors. New social dynamics that favored the household economy and conditions of hygiene and home care that positively impacted the health of the community. We describe how the integration of criteria of social innovation into a home improvement strategy for Chagas disease control, can generate processes of transformation in health by considering sociocultural conditions, encouraging dialogue between public health approaches and traditional practices. We identify and discuss processes for Social Innovations in Health and identify their potential in improving community health in Latin America.
When social innovation criteria are included in a health control initiative, the community-based research and the interdisciplinary and intersectoral participation facilitate the implementation of the control strategy, the perceived benefits by the community and its empowerment to sustain and share the strategy. The case study provided understanding of the intersectoral and interdisciplinary dynamics in particular contexts, and documented the relevance of innovation criteria in health processes.
改善医疗保健服务的可及性和服务质量需要综合努力和创新，包括社区赋权和参与转型过程。恰加斯病是一种被忽视的热带病，通常通过喷洒杀虫剂来控制。要在卫生计划中实现社区赋权，可以采取以下社会创新行动：以社区为基础的研究、跨学科和跨部门参与、社区对直接利益的感知以及对改善健康或环境的参与。本研究旨在描述和分析一个跨学科团队与危地马拉科马帕社区合作，开发有效解决恰加斯病风险的过程。
采用案例研究方法，进行了一项涉及半结构化访谈和直接观察的定性研究，以描述和理解危地马拉圣卡洛斯大学应用昆虫学和寄生虫学实验室（Laboratorio de Entomologia y Parasitologia Aplicada）的研究人员开展的社区为基础的研究和干预过程。对 9 名调查员、创新者和实施干预措施的社区成员进行了访谈。使用 NVivo 软件（版本 12）对访谈进行了新兴编码和分析。
家庭内部出现了社会转型过程，社区超越了仅仅改善墙壁和地板的阶段。新的社会动态有利于家庭经济，改善了家庭卫生和护理条件，对社区健康产生了积极影响。我们描述了如何将社会创新标准纳入控制恰加斯病的家庭改善策略中，可以通过考虑社会文化条件、促进公共卫生方法与传统实践之间的对话，在健康方面产生变革过程。我们确定并讨论了健康领域的社会创新过程，并探讨了它们在改善拉丁美洲社区健康方面的潜力。
当社会创新标准被纳入卫生控制倡议时，基于社区的研究以及跨学科和跨部门的参与促进了控制策略的实施、社区的感知收益以及社区的赋权，使其能够维持和分享该策略。案例研究提供了对特定背景下的跨部门和跨学科动态的理解，并记录了创新标准在卫生进程中的相关性。
