Two sections presented the results. The first analysis examines the 2020–2023 logbooks in accordance with the five sequential phases of the RPOC-ECOHEALTH strategy, assessing activities and practices and consolidating findings at the city level. The second section analyzes focus group interviews, describing the achievements, challenges, and opportunities for improvement perceived by SSDESC staff and community leaders.
The community comprises organized community groups (senior citizen groups, community leaders, community mothers’ associations, members of Community Action Boards, youth police, among others). The research team reached agreements on the availability of spaces, schedules, and support from leaders in areas with increased security risk. It was the strategy used to build neighborhood databases and foster collaborative community engagement.
The researchers identified 207 prior experiences relevant to the community, including (
Between 2020 and 2023, 87 workshops were conducted, involving a total of 1,593 participants. In 2020, 7 communes and 33 workshops, attracting 581 participants. In 2021, 8 communes and 20 workshops drew a total of 234 people. In 2022, 7 communes and 17 workshops, with 361 attendees. In 2023, 14 communes and 17 workshops, with 417 participants. Overall, the period demonstrates territorial expansion, doubling the initial coverage from 7 to 14 communes, and shows stabilization in the number of workshops over the last two years, with a slight increase in participation in 2023 compared to 2022.
In the logbooks, the researchers found that these two activities help the SSDESC understand community dynamics and build trust relationships for deploying the strategy. The workshops were held in various locations, including community dining halls, sports centers, courts, parks, community centers, and the homes of community leaders.
The researchers disseminated the messages by combining educational content with creative activities, such as posters, songs, plays, poems, stories, and other methods, facilitating learning and knowledge acquisition. To comprehend the process of collective construction and empowerment, an analysis was conducted on the distribution of messages developed by the community. From the examination of 151 messages, four main categories were derived:
The messages reflected a collaborative approach and concrete actions, with phrases such as “
The focus was on information about
The messages highlight the role of public institutions in implementing innovative methods, such as the use of guppy fish for biological vector control, stating,
The importance of educating people about the early signs of dengue fever, such as fever, muscle aches, eye pain, and skin rashes, was emphasized. Messages in this section emphasize the importance of seeking medical care early when symptoms appear:
Analysis of community messages on dengue prevention and control over the years shows an emphasis on preventive actions, especially the elimination of breeding sites and the adoption of preventive practices. However, messages addressing vector identification, institutional support, and symptom recognition remain limited, revealing both progress and gaps in the communication strategy (
Percentage of community messages on dengue prevention and control by year.
| Type of action | 2020 | 2021 | 2022 | 2023 | Total | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | n | % | n | % | |
| Prevention | 20 | 80% | 36 | 71% | 22 | 63% | 24 | 60% | ||
| Vector Recognition | 3 | 12% | 11 | 22% | 7 | 20% | 13 | 33% | ||
| Institutional Recognition | 2 | 8% | 3 | 6% | 4 | 11% | – | – | ||
| Symptom Identification | – | – | 1 | 2% | 2 | 6% | 3 | 8% | ||
The bold values means the total of messages.
Spatial distribution of community messages by communes in Cali, 2020–2023.
The findings showed that communes 13 and 6 had the highest numbers of messages (20–23 and 15–20, respectively), partly because they were the only communes that were intervened every year and are highly vulnerable to vector-borne diseases. Communes such as 4, 14, 15, 21, and 18 showed an intermediate participation, while the remaining areas, such as 2, 5, 7, and 20, registered low intensity. Likewise, communes 9,17,19 and 22 (represented in gray) do not display visible coverage, indicating a limited presence of institutional and community leaders in these areas.
Management by community leaders, as multipliers of knowledge and disseminators of the strategy, as well as their participation in comprehensive public health campaigns, enabled the development of practices for preventing and controlling VBDs. The logbooks identified two types of practices: preventive practices, which are proactive interventions aimed at reducing the likelihood of vector emergence and proliferation; and corrective practices, which are reactive measures taken in response to vector presence or active outbreaks.
Between 2020 and 2023, 187 practices were recorded: 128 preventive (68%) and 59 corrective (32%). Preventive practices predominated in all years, although their relative weight decreased year after year, in parallel with an increase in corrective practices. The annual number of interventions grew from 23 (2020) to 62 (2023), with the highest number of actions occurring in 2023 (
Preventive and corrective actions per year.
| Type of action | 2020 | 2021 | 2022 | 2023 | Total | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | n | % | n | % | |
| Preventive | 20 | 87% | 48 | 86% | 26 | 57% | 34 | 55% | ||
| Corrective | 3 | 13% | 8 | 14% | 20 | 43% | 28 | 45% | ||
| – | – | – | – | |||||||
The bold values means the total of actions.
In terms of the distribution of the number of practices in Cali, some communes had 30 practices (commune 13), while others had only between 1 and 4 (communes 3, 8, 10, and 20) (
Community leaders’ practices by commune in Cali, 2020–2023.
Preventive practices centered on inspection, education, and recommendations aimed at communities to eliminate potential breeding sites before they become a serious risk. These practices included:
- Cleaning tanks, flower vases, pet water bowls, and drains.
- Applying larvicides to water containers that are currently larvae-free.
- Community education on best practices.
In the corrective measures, the research team intervened in positive breeding sites with larvae present in different developmental stages:
- Elimination of detected breeding sites.
- Use of larvicides in positive containers (main product VectoBac® - produced in Libertyville, Illinois, USA).
- Targeted interventions in chronic locations such as landfills or sources with high accumulation of water and larvae.
After reviewing the data by commune and the focus of the activities, communes 6, 7, and 15 predominantly employ preventive practices, recognizing community empowerment through efforts to eliminate potential breeding sites. On the other hand, communes such as 13, 16, and 20 primarily exhibit corrective practices, indicating a significant prevalence of active breeding sites and the need for interventions to mitigate these risks. The research team identified chronic areas in communes 14 and 18, especially recurring dumpsites, which require constant attention due to their persistent nature and potential as breeding grounds for the vector.
Once the workshops were completed, during phase 4, the EHT conducted: (
Between 2020 and 2023, the EHT administered 3,755 satisfaction surveys with nine Likert-type questions to community participants to evaluate workshops led by the SSDESC. The surveys inquired about the achievement of objectives, timelines, resolution of concerns, materials used, and other factors. Most responses were in the “Very Satisfied” and “Satisfied” categories, with no responses in the lower satisfaction categories.
During this phase, the community received certification for its efforts after completing 40 hours of training. From 2020 to 2023, a total of 1,365 certificates were awarded (2020: 142, 2021: 299, 2022: 538, 2023: 386), demonstrating a sustained increase in participant retention within the program. These certificates enable the recognition of a significant number of Cali citizens who possess knowledge of VBDs.
For the analysis of phase five, the research team was unable to produce a city-wide consolidated report due to differences in the level of detail and the lack of standardization in the annual logbooks, revealing heterogeneity in how implementation was recorded. Some logbooks recorded the number of activities per neighborhood and organization, while others described the thematic approaches, and still others included only photographic evidence, making comparison impossible.
The researchers present the main findings of the focus groups conducted with community leaders (
Among the achievements, the guide demonstrated a high level of appropriation. The intervention is supported by a situated pedagogical adaptation that promotes understanding of content, consolidates the Environment and Health Team’s sustained trajectory (averaging 7 years of work), and showcases the team’s ability to adapt to diverse contexts. It also highlights effective coordination between community and institutional actors that enhances local governance, along with the community’s autonomous mobilization in deploying the learned practices.
The Environment and Health Team’s initial approach to the communities was perceived as a collaborative and respectful process, prioritizing assertive and effective communication with local leaders.
“Well, there are many organizations that go to the neighborhoods and do not care [about what is going on there]. It is just, as they say, a photo for Face [Facebook] (…), but here we are, a group of workers who love and care about our community (…) The Secretariat does not do this; that is why we have liked it”. (CL).
Furthermore, the community positively values the information provided on Dengue and its practical application, exceeding their expectations by receiving in-depth and detailed information.
“We didn’t expect to learn how to prevent it from our homes (…). They taught us things we didn’t really know, like how to identify larvae in clear water” (CL).
“I really enjoyed the first workshop because you learn from the beginning, and it encourages you to keep coming back and to invite more friends to learn too” (CL).
Furthermore, the teaching methods used in the workshops were highly valued, as participants were the protagonists in various activities, fostering a dialogue of knowledge.
“They took us to the health center, set everything up [teaching materials], and explained how to use them in the workshop. It was a really nice experience.” (CL).
On the other hand, the challenges perceived by the Environment and Health Team and community actors correspond to difficulties in accessing certain territories, which affect the safety and integrity of the team; long working hours, including nights and weekends; and the timely hiring of the team for the deployment of activities.
“ (…) the intervention was difficult; even entering the territory [El Vergel neighborhood] was complicated! (…) even for the team’s movement (…) There, you never know; you’re walking and suddenly bullets start flying. So, we were accompanied by the leaders throughout the entire process; we made the journey with them (…). Even as leaders, they couldn’t get through (…), but we persisted, we persisted, and we developed the module.” (EHT).
Among the opportunities for improvement to strengthen the strategy, the approach with populations considered by the participants as resistant to change (men and young people) stands out:
“The most resistant population is the male population; men tend not to pay much attention to these things.”(CL).
To this end, proposals exist to include activities that directly involve men, such as those related to community roles or interests, including maintaining public spaces or workshops for fathers. Likewise, integrating dengue prevention into schools was seen as an opportunity to change attitudes from an early age.
Another recommendation from community leaders was to ensure ongoing and regular activities; they suggested maintaining a consistent presence of the Team and continuing to motivate and train participants.
“Let the program continue (…), hold more frequent workshops. That way, we could inform more people.” (LC).
Intersectoral work in the field is also crucial, involving relevant and timely actions such as fumigation in areas with high concentrations of the vector, garbage collection, and the cleaning of rainwater channels.
“In Valle Grande [Commune 21], we have the reservoir right next to us (…). That is an immense tank, more than 15 meters deep (…). They drained it; there is a hole, but there is standing water [rainwater], so it has been a maximum concentration of mosquitoes.” (CL).
Participants recommend issuing identification cards to certified individuals; this would enable them to be visible in their communities and maintain ongoing leadership in their territories, while focusing on preventing the spread of contagion.
Finally, the results demonstrate the comprehensive and complex commitment of the RPOC-ECOHEALTH implementation by the Health Authority, which aims to create a city vision with an Eco-healthy focus, encompassing prevention and intervention in vector management and reducing the burden of disease.