Managua Household Visits

A brigadista explains how to look for larvae and pupae in water barrels to a community member.

Household visits are a central component of Camino Verde. Through them, we establish a dialogue between brigadistas and members of a household based on evidence from their own neighbourhoods. The purpose of the visits is to look for options about “what to do” regarding Aedes aegypti breeding sites, based on resources available to the household, and without resorting to prescribed or preconceived solutions. Options arise from dialogue, monitoring water containers, a detailed understanding of the mosquito’s life cycle and the neighbourhood’s experience, including the expenses incurred by households to take care of dengue fever patients or to avoid any inconvenience brought on by the mosquito. These are not entomological inspection visits.

Initially, we visited households that participated in the baseline survey (about 130 per neighbourhood), but we later included other households in the same sector or cluster. The tendency was to extend this practice and include entire neighbourhoods.

Usually, a household was visited weekly by one or two brigadistas, although the frequency depends mostly on the household’s entomological status. Each brigadista was assigned a determined sector or block, so that each household was almost always visited by the same people.

The philosophy behind household dialogue visits implies, above all, respect for privacy; but it also implies respect for each household’s diversity and self-determination. The moment when we knock on the door, followed by a greeting and an invitation to enter, is a milestone for the growth of the brigades, since it implies trust, free and informed consent to “let us in,” and a confidentiality agreement whereby we will not make public anything that is considered private by the household. The facilitators’ testimonies show this strongly and clearly.

Once they have been allowed into a home, brigadistas and members of the household look through water containers together and talk about new experiences or changes observed since the last visit; these are dialogues in which nobody’s knowledge is superior to anyone else’s. We do not pretend to “change behaviours or habits,” which implies the superiority of whoever defines them; we respect decisions that we ourselves might consider as “wrong.” We ask people to consider the  results and be open to further dialogue. Briefly put, we seek a horizontal conversation backed by evidence.

Usually, the dialogue visits are not limited to the topic of Aedes aegypti control or dengue prevention. The horizontal element of the communication opens the door for households to bring up other problems and needs beyond dengue; this ranges from problems within the community at large to issues of special concern to the individual household.