A regional strategy based on community interventions

Foto: Save the Children

A REGIONAL STRATEGY BASED ON COMMUNITY INTERVENTIONS Zika in Latin America and the Caribbean

REGIONAL RESPONSE Reports from the Pan-American Health Organization (PAHO) record almost 200.000 cases of suspected and over 35.000 confirmed cases of Zika in Latin America and the Caribbean.

Cases of congenital birth defects related to Zika keep increasing. This shows a clear alert and demands an immediate call to action.

LOCAL SOLUTIONS HAITI

The main objective of Save the Children´s regional response to the Zika virus was to prevent neonatal microcephaly and ensure the appropriate protection and care for children that are born with congenital birth defects due to the virus.

HONDURAS

COLOMBIA

EL SALVADOR

HOW DID WE DO IT? NICARAGUA

Strengthening the ability of individuals and communities to prevent Zika through education and community mobilization for vector control and self-care.

Increasing access to personal protection and vector control materials for both communities and organizations in charge of public health in each country.

WHERE DID WE ACT? We worked in five countries: Colombia, Haiti, Honduras, Nicaragua and El Salvador.

Raising awareness on the use of contraceptives (including emergency contraceptives) to reduce the number of unwanted pregnancies in women of reproductive age and prevent the sexual transmission of the virus.

Our regional office in Panama also offered technical support to independent projects in Bolivia and the Dominican Republic.

Strengthening the commitment of decision makers and communities through advocacy and communication campaigns.

BOLIVIA COMMUNITY MOBILIZATION AND ADVOCACY SAVE LIVES During the last two decades, Bolivia has closely experienced the impact of mosquito-borne diseases like Dengue, Chikungunya and now Zika. Although these diseases tend to focus in tropical areas of the country, prevention work at a national level is essential for saving lives. This entails careful work at municipal and community level, and coordinated advocacy with partners.

Our efforts in Bolivia used community mobilization and the promotion of education opportunities for children at risk as starting points. We do so through teachers and leaders in the community’s Education Units and local health authorities.

Photo: Save the Children

This intervention was made possible thanks to the support of UNICEF, in coordination with the Ministry of Health, the Departmental Health Service (SEDES) and the Education Units in each municipality, who facilitated collaboration with teachers and children at risk.

Together, we developed training, clean-up sessions and information conferences in seven municipalities of the Beni department. We also helped them in ensuring intervention continuity through political advocacy for the approval of laws related to health, sanitation and vector control.

Through this intervention boys, girls, adolescents, teachers, public and private sector workers in seven different municipalities are now better informed, aware and prepared to prevent Zika.

WHAT DID WE ACHIEVE? Over 27 thousand children and adolescents and over a thousand teachers were trained in Zika prevention strategies.

Over 200 thousand people were reached through mass communication campaigns on prevention.

Awareness sessions and joint collaborations with over 400 civil servants.

The presentation of draft bills on Zika, Dengue and Chikungunya prevention for five municipalities in collaboration with our partners.

The inclusion of advocacy actions in this intervention facilitated the allocation of financial and technical resources for Zika prevention at municipal level.With dedicated resources, these can be scaled up to cover even more people.

COLOMBIA

EL SALVADOR

BUILDING STRATEGIC ALLIANCES FOR ZIKA PREVENTION

PREVENTING ZIKA FROM WITHIN COMMUNITIES IN EL SALVADOR

In Colombia, we responded to Zika by working closely with municipal authorities in Cúcuta and Montería, and consulting academic institutions dedicated to the study of tropical diseases. Our efforts reached tens of thousands of people at risk in the region with essential information on prevention, and sanitation and protection equipment. Our intervention includes:

In June of 2016, the first birth with congenital nervous system defects related to the disease was reported. And the trend is rising.

Hygiene and sanitation campaigns for vector control together with people from each community.

Photo: Save the Children

Awareness raising sessions on the virus and its neurological consequences with experts from the University of Rosario, the National Health Institute and Atlanta’s Center for Disease Control and Prevention (CDC).

Hygiene and sanitation campaigns focused on vector control. These campaigns are led by people form each community.

Collaboration with more than 100 community civil protection commissions to develop joint action response plans.

More than 70 schools are now active partners in the creation of school brigades for Zika prevention.

ZIKA-FREE SCHOOLS IN COLOMBIA ‘Zika-free Schools’ is a strategy from the Health Secretariat in Cúcuta, developed in public schools located in sectors with high Zika rates. Save the Children Colombia collaborated with the Secretariat through technical support and funds for the purchase of biogent traps, which facilitate the capture of female mosquitoes.

The traps attract moquitos within a range of 200 meters and, using an inverted fan, effectively impede their exit.This tramps are inspected every eight days and the mosquitos harvested are then studied by tropical disease experts, supporting the improvement of the overall response of the health system in the country.

Our work in El Salvador had a strong community focus and is based on simple prevention techniques for school children. We also delivered important protection materials and assisted community cleaning campaigns to eliminate mosquito breeding sites, reaching tens of thousands of people. Some key examples of what we achieved include: More than 100 mosquito control campaigns together with people of over 85 communities.

Distribution of items for prevention and personal protection, such as mosquito nets, educational products and prophylactics.

Development of school-based projects through the Zika Marathon and the use of mosquito traps.

Photo: Save the Children

Our intervention covers three affected departments: Ahuachapán, La Paz and Sonsonate. In each department we work within municipalities at risk, together with communities local governments and partners.

BOYS AND GIRLS LEADING PREVENTION EFFORTS

Biogents AG

The strategy also included training students, who supervised vector control in their schools and homes.

The prevention efforts with our girls and boys were not just trainings. We also made them participants of inclusion activities that went beyond the schools and reach our whole community. In this health and Zika prevention fair, students from the San José El Naranjo community learned and shared along with their parents, representatives from the Ministry of Health, Ministry of Education, Community Development Associations and Save the Children.

There was music, parades, dance performances and a costume contest using recycled materials... because the less trash there is, the less mosquito breeding grounds exist!

Photo: Save the Children

HAITI A CASE FOR COMMUNITY EMPOWERMENT FOR ZIKA PREVENTION

HONDURAS SUCCESSFUL COMMUNITY STRUCTURES: OUR BEST CHANNEL FOR CHANGE INTIBUCÁ

The increase in cases of nervous malformations from congenital Zika virus syndrome in newborns in Haiti is raising serious concerns within health authorities in the country. The trend is expected to increase as rains hit the country through this year’s hurricane season. The impact of Hurricane Andrew, for example, called for critical and swift action.

Our Zika response plan in Haiti was based in community empowerment through focused education, protection and mobilization activities. To ensure our messages took root -and thus increase our impact- we built on our previous work in these areas and the trust people place on us.

ARTIBONITE

WEST

PUBLIC FESTIVALS: A PERFECT OPPORTUNITY FOR COMMUNITY EDUCATION Photo: LoopHaiti

We have supported the creation of more than 20 school brigades for boys and girls to carry out prevention activities.... ...and also worked with their teachers, who supported the children.

VALLE

We implemented this project in three key departments: Francisco Morazán, Intibucá and Valle, all highly affected by Zika.

Our project took advantage of the efforts built upon decades of struggling against these transmissible diseases: prepared community structures ready to act and replicate the local know-how. We worked together with water boards, health committees, cooperation networks and youth associations active in the communities, which communicated our messages through: Implementation of over sixty vector control campaigns, with members of the selected communities.

Capacity building and mobilization of community organizations such as the health committees, violence prevention networks and communal medicine funds.

Development of Zika prevention projects in schools, training students for vector control in their homes.

HOW DO WE DO IT? WORKING TOGETHER WITH PEOPLE AT RISK Together with the Ministry of health, we have reached more than 4.000 people who attended the Dessalines Public Festival with key prevention messages and protective equipment.

The Honduran territory is especially vulnerable to mosquito-borne diseases, like we see every year with Dengue, and recently with Chikungunya and now Zika.

Just in 2016, over twenty births with Zikarelated congenital birth defects have been registered, and over 100 cases of GuillánBarré also related to the disease have been reported.

FRANCISCO MORAZÁN

Women Groups

More than four thousand people participated in the Festival of St. Claire, patron of the Dessalines commune in Artibonite. We took advantage of the all-around celebration to complement the food, music and dance with educational materials and one-on-one sessions focused on mosquito control at home and the importance of improving reproductive and sexual health practices.

Water Boards and Health Committes

Schools Municipal Governments

Active Community Structures Social Support Networks

Regional and local authorities Health Secretary

NICARAGUA

DOMINICAN REPUBLIC

THE COMMUNITY: OUR STARTING POINT FOR PREVENTING ZIKA

MAKING THE MOST OF OUR ACTIVE COMMUNITY HEALTH PROJECTS

Government institutions and communities in Nicaragua actively participate in Zika prevention campaigns at national level.

We take advantage of this high level of organization as an opportunity to increase the reach of community mobilization and education, as well as sanitation actions developed by the brigadistas of the Ministry of Health.

During the last decades, the Dominican Republic has suffered various epidemics of mosquito-borne diseases.

National authorities keep constant vigilance on the outbreak of possible Dengue, Zika and Chikungunya epidemics. However, even if sometimes the trend seems to take positive turns, with Zika only one out of every five people presents symptoms. Within this reality, Zika prevention saves lives.

DAJABÓN

We strived to expand the scope of our community health projects financed through alliances with the corporate sector in the country. Some of the integration approaches we use included:

This strategy was particularly effective thanks to the nature of this health brigades, which include experts in vector control, community leaders and community members from each affected area.

SAN JU ÁN SAN PEDRO DE MACORÍS

We implemented Zika interventions in three provinces: Dajabón, San Juan and San Pedro de Macorís.

Emphasizing Zika prevention in all our house visits on health Photo: Save the Children

Including sexual and reproductive health in our training sessions on tropical diseases.

Collaborating with provincial health offices for the delivery of water treatment and management materials.

TEAMWORK: THE IMPORTANCE OF THE HEALTH BRIGADES The Health Brigades are teams composed of vector control inspectors from the Ministry of Health, five community promoters and an average of five community leaders.

This team makes visits, home by home, for the process of education, raising awareness and destroying breeding grounds in the communities and neighborhoods intervened.

The brigadistas mobilize from home to home, raising awareness and educating the population so the health promoters can enter their homes to perform sanitation activities and raise community awareness on Zika risks and prevention techniques.

Boys and girls are always the most affected by mosquito-borne diseases, which is why I take precautions not to leave any open water containers that may serve as breeding ground. I keep every water barrel in my house well covered.

Cindy Rugama, 31.

Nicaraguan mother after a visit from the Health Brigades.

CORPORATE ALLIANCES TO IMPROVE THE LIFES OF VULNERABLE PEOPLE The efforts of Save the Children Dominican Republic are wide, both in programs as in coverage. That is why the development of alliances with agents from the private sector that seek to give back to their communities as responsible companies, is essential to ensure the resources we need. At this moment, we are making the most out of agreements we have signed with Coca-Cola, GSK and Empresa Generadora de Eletricidad Haina (EGE Haina).

Photo: Save the Children Dominican Republic

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