Argentina

From Indigenous households in the Gran Chaco region to national policy in Argentina: Knowledge translation for Chagas disease prevention

This collaboration between Canadian experts in knowledge translation (KT) and global health and Argentinean experts on Chagas disease among indigenous people in Argentina’s Chaco region will use KT to promote the use of research findings by indigenous organizations and the indigenous population, personnel in the health system, and national level stakeholders in Argentina’s National Chagas Program.

Research in 2008 to 2009 by Llovet and Dinardi addressed social factors in reinfestation of previously treated homes and peri-domiciles by Triatoma infestans (the insect vector that transmits the Chagas parasite) in Pampa del Indio, a community in Argentina’s Gran Chaco region. The project, “An ecosystem perspective of the process of re-infestation by Triatoma infestans in rural communities of the Gran Chaco eco-region,” was part of IDRC’s 2006 initiative on Ecosystem Approaches to Human Health (and led to collaboration between the partners who are now proposing the research here).

The study found inequitable differences in the health status and access to resources of the Toba indigenous population, who have a higher rate of Chagas than the non indigenous population in the region but less access to Chagasrelated resources and care. In the context of a long-term goal of promoting improvements in Chagas disease rates and access to services by indigenous people, this project will describe key social processes as well as employ multi-sector KT activities to foster local-level household improvements in vector control knowledge and behaviours, and promote improvements in Argentina’s National Chagas Plan and related Program. These grassroots to national level KT activities are based in partnerships with indigenous people and organizations, and will serve policy needs for greater and appropriate inclusion of seriously affected indigenous groups in the National Chagas Plan.

The project’s KT plan has four emphases:

1. identification and synthesis of salient elements of the evidence on Chagas disease and its prevention, emphasizing findings from the Argentinean partners’ previous research;
2. presentation and discussion of that knowledge in condensed, understandable formats that suit the needs of local knowledge users and reflect health literacy principles;
3. collaboration with representatives of the Toba ethnic group, facilitated by use of PhotoVoice andSocial Marketing in the KT methodology, to facilitate awareness, interest, and a consensus process to inform development of a local Action Plan and recommendations for the National Chagas Program/Plan regarding disease prevention in indigenous communities; and
4. presentation and revision of products from the above steps to stakeholders at the local level (e.g., the Che´eguera Association, indigenous nurses, and other personnel in the health system) and to policymakers and staff for use at the national level (e.g., for the National Chagas Program and National Chagas Plan).

Outcomes will include accomplishment of KT processes and the production of KT products (e.g., Chagas related photographs taken by community members for reports and local educational materials; a local Action Plan; a Policy Brief). The intended impact is the explicit, appropriate attention to indigenous peoples’ needs in Argentina’s National Chagas Program and Plan, leading in the long term to improvements in Chagas rates and access to care by indigenous people and others in need. The project will also produce peer-reviewed publications and enhance research program partnerships and productivity of the Canadian and Argentinean scholars who are addressing Chagas disease.