Vivek Kumar, Navya Vyas, Myron Anthony Godinho, S. Elstin Anbu Raj · 5 authors
Abstract Background Vector-borne diseases (VBD) pose significant threats to global public health. Despite the adoption of Integrated Vector Management (IVM) in India to address this issue, its implementation encounters several obstacles that undermine its effectiveness. This review systematically examines implementation challenges and highlights key areas for improving VBD reduction in India. Methods We conducted a systematic review and meta-synthesis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Studies conducted during 2016–2025 were included in this review, as the first IVM guidelines were introduced in India in 2016. PubMed, Scopus, Embase, and Web of Science databases were included in the search. The Consolidated Framework for Implementation Research (CFIR) was used as a lens to synthesise the evidence. Methodological quality of the included studies was assessed using an appraisal tool based on the study design. Results Across the 55 studies included, 35 implementation challenges affecting IVM were identified. The most frequently reported barriers included low preventive practices and risk perception (29.1%, n = 16), insecticide resistance (25.5%, n = 14), deficits in community engagement (21.8%, n = 12), and gaps in physical and information technology infrastructure (21.8%, n = 12). System-level challenges related to health workforce capacity, inter-sectoral coordination, financing, and governance were common. Individual-level barriers included knowledge gaps, misconceptions, and limited motivation among communities, as well as training and competency gaps among implementers. Process-related challenges were prominent and included coverage and fidelity gaps, weak engagement, issues with surveillance data quality, and inadequate planning and monitoring. Conclusion IVM implementation in India reflects interconnected multi-level barriers, particularly within the outer, process and inner domains. Strengthening decentralized, real-time surveillance system with a formal feedback mechanism, alongside institutionalizing community co-design approaches, represents a key approach through theory-informed, context-sensitive implementation strategies to improve implementation fidelity and program effectiveness and accelerate towards Sustainable Development Goal (SDG) 3. Registration This review protocol was developed and registered in the Open Science Framework (OSF). Registration https://doi.org/10.17605/OSF.IO/JTCWD
This article describes the trajectory of the city of Rio de Janeiro in facing public health emergencies between 2021 and 2024, based on three axes of action proposed by the World Health Organization (WHO): preparedness, surveillance, and response. Innovation in timely data analysis from non-conventional information sources has enabled an early detection of events, promoting reorientation in health surveillance practices. The construction of a strong institutional identity, as well as the coordination of response actions in Emergency Operations Centers, contributed to the consolidation of a culture of rapid response and networking. The integration of primary health care (PHC) and surveillance networks guaranteed a continuity of care and coordinated risk management, highlighting the importance of a decentralized health system that seeks intersectorality in responding to emergencies. The advances observed in combating the COVID-19 and dengue epidemics during this period in the city were driven by adequate investments in structure and human resources, emphasizing the importance of continuous financing and strategic planning aimed at this model of care.
Abstract This article describes the trajectory of the city of Rio de Janeiro in facing public health emergencies between 2021 and 2024, based on three axes of action proposed by the World Health Organization (WHO): preparedness, surveillance, and response. Innovation in timely data analysis from non-conventional information sources has enabled an early detection of events, promoting reorientation in health surveillance practices. The construction of a strong institutional identity, as well as the coordination of response actions in Emergency Operations Centers, contributed to the consolidation of a culture of rapid response and networking. The integration of primary health care (PHC) and surveillance networks guaranteed a continuity of care and coordinated risk management, highlighting the importance of a decentralized health system that seeks intersectorality in responding to emergencies. The advances observed in combating the COVID-19 and dengue epidemics during this period in the city were driven by adequate investments in structure and human resources, emphasizing the importance of continuous financing and strategic planning aimed at this model of care.
Henk van den Berg, Raman Velayudhan, Rajpal S. Yadav
Interventions to control the vectors of human diseases, notably malaria, leishmaniasis and dengue, have relied mainly on the action of chemical insecticides. However, concerns have been raised regarding the management of insecticides in vector-borne disease-endemic countries. Our study aimed to analyze how vector control insecticides are managed in selected countries to extract lessons learned. A qualitative analysis of the situation of vector control insecticides management was conducted in six countries. Multi-stakeholder meetings and key informer interviews were conducted on aspects covering the pesticide lifecycle. Findings were compared and synthesized to extract lessons learned. Centrally executed guidelines and standards on the management of insecticides offered direction and control in most malaria programs, but were largely lacking from decentralized dengue programs, where practices of procurement, application, safety, storage, and disposal were variable between districts. Decentralized programs were better at facilitating participation of stakeholders and local communities and securing financing from local budgets. However, little coordination existed between malaria, visceral leishmaniasis and dengue programs within countries. Entomological capacity was concentrated in malaria programs at central level, while dengue and visceral leishmaniasis programs were missing out on expertise. Monitoring systems for insecticide resistance in malaria vectors were rarely used for dengue or visceral leishmaniasis vectors. Strategies for insecticide resistance management, where present, did not extend across programs or sectors in most countries. Dengue programs in most countries continued to rely on space spraying which, considering the realities on the ground, call for revision of international guidelines. Vector control programs in the selected countries were confronted with critical shortcomings in the procurement, application, safety measures, storage, and disposal of vector control insecticides, with implications for the efficiency, effectiveness, and safety of vector control. Further international support is needed to assist countries in situation analysis, action planning and development of national guidelines on vector control insecticide management.