Camino Verde in Nicaragua

Young SEPA brigadistas discuss neighbourhood entomological and serological evidence with a community member at her door.

In Managua, the Camino Verde process began with a pilot stage between 2004 and 2007, when 10 neighbourhoods started down this path towards dengue prevention. In 2010, the process was taken up again in 30 neighbourhoods that participated in a community-based cluster randomised controlled trial, in coordination with the Nicaraguan Ministry of Health and with support from CIET, the University of California, Berkeley and the Sustainable Sciences Institute.

The process was based on CIET’s SEPA methodology and was implemented through the following stages: baseline measurement (August 2010 and January 2011); household discussions about the results with local facilitators and local brigadistas; focus groups with community leaders; integrating, equipping and organising the volunteer brigades’ in each neighborhood; house-to-house visits; school visits; collective actions in neighbourhoods carried out by the brigades, such as educational fairs, training and community celebrations; decentralisation and accountability; and peer-to-peer monitoring. The order in which these stages unfolded varied depending on the circumstances and rhythms of each neighbourhood.

This process sought to generate a higher sense of agency in households and neighbourhood leadership (perceiving that “I can do it,” or “we can do it ourselves”) and increase communication among neighbours, organisations and local schoolchildren, with the aim of reducing dependence on chemicals (temephos, insecticides) and increasing the communities’ autonomy in dengue control and prevention. We expected this participative intervention to lead to diminished levels of pupa and larva infestations and less risk of dengue virus infection. Beyond this specific end, we sought to generate better health conditions in the neighbourhoods, strengthen local leadership and foster the communities’ capacities in other areas.

The SEPA dialogue revolves around each neighbourhood’s evidence and experience. This brings about diverse interpretations of the evidence, reflection on what is already being done and a search for alternative actions and ways of carrying them out. At all times, we seek to ensure that decisions develop through consensus and that they reflect the use of neighbourhood evidence and resources. Some examples of evidence include:

  • larvas or pupas found in households;
  • immunological status of children regarding the dengue virus, determined through saliva sample analyses;
  • reported household expenses related to mosquito protection and the economic cost to treat the illness, expressed in terms of both money spent directly as well as in lost workdays;
  • results from baseline survey on knowledge, attitude, subjective norms, intentions and other elements of the CASCADA model.

The following chart synthesises the different stages of the Camino Verde process as it was implemented in Managua:

The SEPA Road to Develop Camino Verde in Managua

Nicaragua 2010-2013 (updated 12 March 2012)