Barriers to Engaging Communities in a Dengue Vector Control Program: An Implementation Research in an Urban Area in Hanoi City, Vietnam

Abstract

The dengue situation in the urban setting of Hanoi city, Vietnam, is emerging, focusing on inner districts. Previous studies showed that a dengue vector control program in Hanoi was not effective because of the lack of adequate engagement of the local government authorities, health sector, and community. This implementation research aimed to explore barriers to implementing community engagement in a dengue vector control program in an urban district of Hanoi city. Ten in-depth interviews and 14 focus group discussions were conducted at Lang Thuong, Khuong Thuong, Tho Quan, and Kim Lien wards in Dong Da district, Hanoi city. Data collection was implemented from April to June 2017. All discussions were recorded and transcribed verbatim. Data were analyzed using the content analysis approach. Secondary data from the dengue vector control program reports were used to support the qualitative evidence. We found that the barriers to implementing effective community engagement were as follows: 1) lack of interest and an attitude of dependency on action from the health sector of local people's committee, 2) lack of enthusiasm of mass organizations and community leaders, 3) overburdened workloads and lack of communication skills from health sector, 4) low awareness and readiness from community, 5) lack of detailed policy guidelines and low enforcement of related policy, and 6) limited budget. Recommended actions should be made to improve the community engagement in the current resourcelimited context of Vietnam by both top-down and bottom-up approaches.

A Mixed-Methods Approach to Understanding Knowledge of Mosquito-Borne Infections and Barriers for Protection in Hanoi, Vietnam

“…In addition, most participants blamed their neighbors or health authorities for improper management of breeding sites rather than taking responsibility for it. Similar attitudes were described in a study conducted in Hanoi in 2017, where most people would rely exclusively on health authorities for implementing vector control [31].…”

Evaluating and Strengthening the Health System of Curaҫao to Improve its Performance for Future Outbreaks of Infectious Diseases.

“…-Perform insecticide resistance and entomological research (e.g., to determine the house index container index, breteau index, and pupal index) to guide vector control strategies. Similar results were found in other studies that also researched challenges in vector control in the eld of malaria (23,24) and dengue (25).…”

“…-Evaluate the motivation, job satisfaction, and abilities of the workforce of the health system. Similar results were found in other studies that also researched challenges in vector control in the eld of malaria (23,24) and dengue (25).…”

Urban transmission of mosquito-borne flaviviruses – a review of the risk for humans in Vietnam

“…In conclusion, DENV transmission is frequently presented also in urban areas of Vietnam. Therefore, public health interventions are needed to investigate the circulation of this dangerous flavivirus since the current dengue vector control program is working inefficiently [83].…”

“…In Vietnam, the practice of storing water in tanks or containers at home is common, enabling Aedes mosquitos, the main vector of DENV and ZIKV, to expand quickly [110]. In addition, the impact of climate change and urbanization plus the lack of awareness among urban inhabitants on the importance of removing the breeding grounds of mosquitoes have lead to a significant increase of the vector density [33,83]. In addition to encouraging people to use personal protective measures to avoid mosquito bites, new effective strategies for vector control need to be built globally [118] because the current program has its limitations and is difficult to achieve [119].…”