Community participation in Aedes aegypti control: a sociological perspective on five years of research in the health area ‘‘26 de Julio’’, Havana, Cuba

Summary Objective: Effective dengue prevention and Aedes aegypti control is a priority for the Cuban health authorities. To enhance effectiveness, strategies oriented towards a more active involvement of communities in control activities are being tested. This paper presents a sociological perspective on a pilot project conducted in the health area ‘‘26 de Julio’’ (La Havana) in 1999–2004. Methods: Instrumental case study based on an exhaustive content analysis of project documents and on observations of a sociologist. Results: The context and the pilot project are systematically described and an analysis of the evolution of the underlying concept of community participation is provided. The pilot experience was a dynamic process influenced by self‐reflection of the research team, feedback from research partners and changes in the epidemiological context (provoked by two dengue outbreaks during the study period). Community participation evolved from being just one component in Aedes aegypti control directed by the health staff into a learning and empowering process for the people. This change in the concept of participation was reflected in different aspects of the pilot project such as the learning and evaluation processes. Conclusion: Empirical evidence from 5 years of research in the particular context of Cuba showed that moves towards community‐based Aedes aegypti control are feasible. However, in order to be successful, community‐based dengue prevention should be a social learning process, implying a transfer of power and responsibilities to local people. Actions undertaken must be oriented towards creating local capabilities, strengthening existing structures and organizations and promoting group work for learning participation from participation itself. Objectif La prévention effective de la dengue et le contrôle de l’Aedes aegypti sont une priorité pour les autorités cubaines de la santé. Afin d'augmenter l'efficacité, des stratégies dirigées vers une participation plus active des communautés dans les activités de contrôle ont été examinées. Cet article présente une perspective sociologique sur un projet pilote menée dans la zone de santé‘26 de Julio’à La Havane en 1999–2004. Méthodes Étude de cas instrumentale basée sur une analyse exhaustive du contenu des documents du projet et sur les observations sociologiques. Résultats Le contexte et le projet pilote sont systématiquement décrits et une analyse de l’évolution du concept fondamental de