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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Pérez, Dennis Lefèvre, Pierre Castro, Marta Toledo, María Eugenia Zamora, Gilberto Bonet, Mariano Van der Stuyft, Patrick |
| Spatial Coverage | Cuba |
| Description | Country affiliation: Cuba Author Affiliation: Pérez D ( Epidemiology Division, Tropical Medicine Institute Pedro Kouri, Autopista Novia del Mediodía, Km. 6 ½, La Lisa. P.O. Box 601, Marianao 13, Havana City, Cuba. dennis1905@yahoo.com) |
| Abstract | Effective participatory strategies in dengue control have been developed and assessed as small-scale efforts. The challenge is to scale-up and institutionalize these strategies within dengue control programs. We describe and critically analyze the diffusion process of an effective empowerment strategy within the Cuban Aedes aegypti control program, focusing on decision-making at the national level, to identify ways forward to institutionalize such strategies in Cuba and elsewhere. From 2005 to 2009, we carried out a process-oriented case study. We used participant observation, in-depth interviews with key informants involved in the diffusion process and document analysis. In a first phase, the data analysis was inductive. In a second phase, to enhance robustness of the analysis, emerging categories were contrasted with Rogers' five-stage conceptual model of the innovation-decision process, which was eventually used as the analytical framework. The diffusion of the empowerment strategy was a continuous and dynamic process. Adoption was a result of the perceived potential match between the innovative empowerment strategy and the performance gap of the Ae. aegypti control program. During implementation, the strategy was partially modified by top level Ae. aegypti control program decision-makers to accommodate program characteristics. However, structure, practices and organizational culture of the control program did not change significantly. Thus rejection occurred. It was mainly due to insufficient dissemination of know-how and underlying principles of the strategy by innovation developers, but also to resistance to change. The innovation-diffusion process has produced mitigated results to date, and the control program is still struggling to find ways to move forward. Improving the innovation strategy by providing the necessary knowledge about the innovation and addressing control program organizational changes is crucial for successful diffusion of empowerment strategies. Issues highlighted in this particular experience might be relevant in the innovation-diffusion process of other complex innovations within health systems. |
| File Format | HTM / HTML |
| ISSN | 02779536 |
| e-ISSN | 18735347 |
| Journal | Social Science & Medicine |
| Volume Number | 84 |
| Language | English |
| Publisher | Elsevier |
| Publisher Date | 2013-05-01 |
| Publisher Place | Great Britain (UK) |
| Access Restriction | Open |
| Subject Keyword | Discipline Medicine Aedes Decision Making, Organizational Diffusion Of Innovation Mosquito Control Organization & Administration Animals Cuba Power (psychology) Program Evaluation Qualitative Research Research Support, Non-u.s. Gov't |
| Content Type | Text |
| Resource Type | Article |
| Subject | Medicine Health (social science) History and Philosophy of Science |
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