Community participation in the control of Aedes aegypti:: opinions of the population in one section of Havana, Cuba

Objective. To analyze opinions on community participation held by residents of one section of the city of Havana, Cuba, in order to identify key criteria to use in preparing a participatory strategy for controlling the Aedes aegypti mosquito. Methods. The study was conducted from September to October 1999 in Playa, one of the 15 municipios (districts) that make up the city of Havana, Cuba. In the first phase of the study, interviews were carried out with key informants, including health brigade members and sanitation activists, who had lived in Playa for more than five years. The key informants were selected randomly from the nine health areas that the Playa municipio has. Qualitative content analysis was used to identify terms, common expressions, and key concepts related to community participation in the area. In the study's second phase a questionnaire using a Likert scale was prepared for application with a population sample from Playa. Based on the answers from the respondents, a point score with a confidence interval was calculated for each of the 30 statements on the questionnaire. The point scores for those statements were used to identify the population's most relevant criteria, that is, the statements producing the strongest agreement and the ones producing the strongest disagreement. Results. In the first phase, from the interviews with key informants, the three most important variables to explore were identified as: (1) community participation in environmental cleanup, (2) the role and image of community leaders and of community organizations, and (3) community participation, in a general sense, in solving any problem in the community. In the second phase, the population survey indicated that the members of the community recognized the usefulness of community participation in solving local problems, especially for controlling A. aegypti. Among the statements on the questionnaire that had the highest levels of agreement were ones dealing with the value of working together as a team, the knowledge that local authorities had of community problems, and recognition of the obligation that citizens have to take part in developing the community. The statements that had the lowest level of agreement had to do with the need to reward-with more than just words of thanks-residents who regularly serve the community and with the view that the majority of community leaders were more concerned with their personal well-being than with the problems of the community. Conclusions. The opinions on community participation identified among the population in Playa served as the basis for designing new strategies for controlling A. aegypti. The methodology utilized in this study could be used to plan local participatory processes, both in Cuba and in other countries, and could be applied to other problems whose solution requires community participation.