Abstract
Adaptive management and ecohealth frameworks were developed for malaria elimination in Amerindian riparian communities of Venezuela. These frameworks were developed as a strategy to capture, organize, and communicate connections among key factors related to local malaria complex systems. Important causal relationships between social, economic, and environmental stressors which are determinant of malaria were identified at different levels and assumptions that guide interventions are offered, based on available scientific knowledge and input from stakeholders. Drawing on our experience of action research committed to the health of Amerindian populations and conservation of areas with biodiversity value, the authors provide lessons to strengthen the practice of an ecohealth approach. First, conservation targets were considered as a way to achieve sustainable human well-being rather than as a consequence of well-being. Second, the effectiveness and sustainability of technical solutions generally proposed for malaria control depend largely on individual knowledge, attitudes, and practices. Hence, it is necessary to look at the real opportunities of choices that Amerindian people have for attaining a life without malaria, and therefore pay attention to local capabilities, needs, and freedom to choose. The ecohealth approach can benefit from the capability approach, and we explain why.
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Acknowledgments
This study was supported by an award from the Canadian International Development Research Centre Grant No 103696-006 and the Fondo Nacional de Ciencia, Tecnología e Innovación in Venezuela (Project Misión Ciencias No. 200800777) to ACOANA. The authors extend their heartfelt thank and appreciation to KUYUJANI Amerindian organization of the Caura River, the Ye’kwana and Sanema peoples, its communities stakeholder and local health team; to Dr. Angela Martínez and the Malaria Program team of Instituto de Salud Pública and Demarcación Sanitaria in Bolivar State; to Dr. José Cárdenas, Dr. Alfredo Brito, and the CENASAI team in Bolivar State; to the Instituto de Altos Estudios de Salud Pública “Dr. Arnoldo Gabaldón” and the field working team Víctor Sánchez, Yarys Estrada, Jorge Moreno, William Anaya, and Hernán Guzmán; to Roberto Bazzani, Dominique F. Charron, Arlyne Beeche, and the IDRC-Ecohealth team; and to Dr. Luis Gonzalo Morales in the Postgrado of Ecology Universidad Central de Venezuela and ACOANA administrative team in Caracas, all of whom contributed significantly in the development of this study. This article was drafted and revised during a scientific writing workshop organized by the Communicable Diseases Research Program, Communicable Diseases and Health Analysis Department, and Pan American Health Organization to support the dissemination of TDR-funded research carried out from an eco-bio-social approach. The authors thank Zaida E Yadon for organizing the workshop, Ms Karen Shashok for editorial guidance, and Ricardo E Gürtler for helpful comments on prior versions of the manuscript.
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Bevilacqua, M., Rubio-Palis, Y., Medina, D.A. et al. Malaria Control in Amerindian Communities of Venezuela. EcoHealth 12, 253–266 (2015). https://doi.org/10.1007/s10393-015-1026-3
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DOI: https://doi.org/10.1007/s10393-015-1026-3