Recognizing territorial vulnerabilities to Zika virus: a participatory health education model

Abstract

INTRODUCTION: Considering that the engagement of the population in the control of arboviruses should not be restricted to care to avoid domestic foci of the Aedes aegypti, health education initiatives must approach the social health determinants in the territories. OBJETIVE: To describe a proposal for a pedagogical model aimed at community participation in recognizing vulnerabilities to the Zika virus and the main results of its application. METHODS: Based on Paulo Freire’s critical-problematizing pedagogy and within the framework of vulnerability and human rights, a workshop model was developed and applied in participatory research to train community health workers to diagnose local vulnerabilities to the Zika virus in a community of Rio de Janeiro, Brazil. Four 20-hour workshops were held in weekly meetings with 38 participants. It included activities involving territory mapping, experiences with the virus, and identifying community spaces vulnerable to the proliferation of mosquitos. RESULTS: The proposed pedagogical model identified territorial spaces vulnerable to the proliferation of mosquitoes that do not depend only on the will or behavior of its residents. These aspects are conditioned to social contexts that express the tense relationship between residents, the State, and drug traffickers with a vital power relationship in the territory. CONCLUSIONS: By transcending the traditional vertical health education model, the proposed participatory method was sensitive and timely to capture the participants’ deep knowledge of the territory of residence, not only to identify mosquito foci but, above all, understanding multiple vulnerability determinations.