Laporkan Masalah

COMMUNITY ENGAGEMENT STRATEGIES AND ITS INFLUENCE IN SUSTAINABILITY OF LARVAL ERADICATION IN AN URBAN AREA OF HANOI CITY, VIETNAM

Nguyen Tien Thang, Riris Andono Ahmad; Ari Probandari

2017 | Tesis | S2 Ilmu Kesehatan Masyarakat

Background: Dengue is a globally growing public health threat. Dengue situation in Hanoi city of Vietnam, a tropical country in Asia-Pacific region is re-emerging, focusing on inner districts. Previous studies showed that the effectiveness of dengue prevention and control program in Hanoi is limited due to lack of community engagement of local government authorities; health sector and community themselves. Objectives: General objective was to assess the current status of community engagement in larval eradication in dengue prevention and control program in the urban area of the capital city of Vietnam. Specific objectives were: (1) To explore the contextual factors and positive drivers on implementation of community engagement strategies in larval eradication in an urban district of Hanoi city (2) To assess the level of community engagement in larval eradication activity in an urban district of Hanoi city; Setting and Methods: The research was conducted at Lang Thuong, Khuong Thuong, Tho Quan and Kim Lien wards in Dong Da district in Hanoi city chosen by purposive sampling method based on the newest dengue incidence from Hanoi Preventive Medicine Center. This qualitative study used community-based participatory action research. Data collection process was implemented from April to June 2017. Qualitative data was collected and utilized in various subjects. All discussions were recorded and transcribed verbatim in the MS. Word. Data was analyzed by coding and then categorizing them using content analysis approach. Secondary data from the dengue prevention and control program's reports and observation on two clean-up campaigns were employed to have comprehensive supplement evidences. Result In the study sites, there were 7 contextual factors affecting the interaction between relevant stakeholders on implementation of community engagement strategies in larval extermination in the urban area of Hanoi city were identified including (1) acceptance of dengue control's barriers, (2) lack of interest and dependent attitude on health sector local People's Committee, (3) lack of enthusiasm of mass organizations and community leaders, (4) overload and lack of communication skills from health sector, (5) low awareness and readiness from community, (6) lack of detailed policy guidelines and low enforcement of related policy, (7) limited budget. However, political commitment and close partnership of stakeholders, especially the leadership of WPC, shared responsibility of vertical health sector, diversity of local mass organizations' network and individual motivation to protect family health emphasizing on women's role were amongst the structural and individual drivers to improve the community engagement in dengue control. Three top-down community engagement strategies consisting of leadership, communication and training and mobilizing the participation through clean-up campaigns were adopted for dengue control program at the research sites. As a result, the level of community engagement strategies in this urban setting was considered as Inform, the lowest level according to the spectrum of public participation. Conclusion and recommendations The barriers outweighed the drivers in facilitating the interaction between relevant stakeholders in larval extermination in the urban area of Hanoi city. It led to the low level of implementation of community engagement strategies in the study sites. Increasing the budget from government is an important proposal to implement the dengue control program smoothly. Meanwhile, establishing communication programs emphasizing the involvement of women and resource mobilization were recommended to improve the awareness and participation of stakeholders, especially the community in the current resource-limited context of Vietnam. And other model should be experimented to reduce the overburden of health staffs whereas they need to be trained on communication skills to easily convince the community. Further studies should be carried out in various settings to explore more on novel communication methods and policy enforcement to improve the community engagement from the very first stages mixed by top-down and bottom-up approach.

Background: Dengue is a globally growing public health threat. Dengue situation in Hanoi city of Vietnam, a tropical country in Asia-Pacific region is re-emerging, focusing on inner districts. Previous studies showed that the effectiveness of dengue prevention and control program in Hanoi is limited due to lack of community engagement of local government authorities; health sector and community themselves. Objectives: General objective was to assess the current status of community engagement in larval eradication in dengue prevention and control program in the urban area of the capital city of Vietnam. Specific objectives were: (1) To explore the contextual factors and positive drivers on implementation of community engagement strategies in larval eradication in an urban district of Hanoi city (2) To assess the level of community engagement in larval eradication activity in an urban district of Hanoi city; Setting and Methods: The research was conducted at Lang Thuong, Khuong Thuong, Tho Quan and Kim Lien wards in Dong Da district in Hanoi city chosen by purposive sampling method based on the newest dengue incidence from Hanoi Preventive Medicine Center. This qualitative study used community-based participatory action research. Data collection process was implemented from April to June 2017. Qualitative data was collected and utilized in various subjects. All discussions were recorded and transcribed verbatim in the MS. Word. Data was analyzed by coding and then categorizing them using content analysis approach. Secondary data from the dengue prevention and control program's reports and observation on two clean-up campaigns were employed to have comprehensive supplement evidences. Result In the study sites, there were 7 contextual factors affecting the interaction between relevant stakeholders on implementation of community engagement strategies in larval extermination in the urban area of Hanoi city were identified including (1) acceptance of dengue control's barriers, (2) lack of interest and dependent attitude on health sector local People's Committee, (3) lack of enthusiasm of mass organizations and community leaders, (4) overload and lack of communication skills from health sector, (5) low awareness and readiness from community, (6) lack of detailed policy guidelines and low enforcement of related policy, (7) limited budget. However, political commitment and close partnership of stakeholders, especially the leadership of WPC, shared responsibility of vertical health sector, diversity of local mass organizations' network and individual motivation to protect family health emphasizing on women's role were amongst the structural and individual drivers to improve the community engagement in dengue control. Three top-down community engagement strategies consisting of leadership, communication and training and mobilizing the participation through clean-up campaigns were adopted for dengue control program at the research sites. As a result, the level of community engagement strategies in this urban setting was considered as Inform, the lowest level according to the spectrum of public participation. Conclusion and recommendations The barriers outweighed the drivers in facilitating the interaction between relevant stakeholders in larval extermination in the urban area of Hanoi city. It led to the low level of implementation of community engagement strategies in the study sites. Increasing the budget from government is an important proposal to implement the dengue control program smoothly. Meanwhile, establishing communication programs emphasizing the involvement of women and resource mobilization were recommended to improve the awareness and participation of stakeholders, especially the community in the current resource-limited context of Vietnam. And other model should be experimented to reduce the overburden of health staffs whereas they need to be trained on communication skills to easily convince the community. Further studies should be carried out in various settings to explore more on novel communication methods and policy enforcement to improve the community engagement from the very first stages mixed by top-down and bottom-up approach.

Kata Kunci : dengue fever, community engagement, larval eradication, Hanoi

  1. S2-2017-391500-abstract.pdf  
  2. S2-2017-391500-bibliography.pdf  
  3. S2-2017-391500-tableofcontent.pdf  
  4. S2-2017-391500-title.pdf