Democracy to Combat Vector-Borne Diseases on a Local Level

Political Science professor studies how civil engagement in Brazil helps abate mosquitos and improve local health care services

Long before the Zika virus made headlines in South Florida this summer, it  had morphed into a public health emergency in Brazil and was declared a global health emergency by the World Health Organization in February.

Michael Touchton, assistant professor, Political Science

According to Michael Touchton, assistant professor in the College of Arts and Science’s Political Science Department, Brazil reported 200,000 cases of Zika in the first half of 2016, which equates to 36 cases per municipality in the country.

Touchton is not an epidemiologist, but a political scienctist whose research on Zika and other vector-borne diseases focuses on citizen engagement in local health care policymaking to improve services and medical outcomes in Brazil and other Latin American countries. 

At a recent event hosted by the University of Miami Institute for the Americas, Touchton discussed his research and addressed how a “thicker” version of democracy, including frequent, direct citizen engagement to improve local governance, helps to combat vector-borne diseases like Zika and dengue.

“Brazil designed policy reforms to bring local citizens into the democratic process who monitor and evaluate health care services and delivery in their municipalities, and this happened across the country,” said Touchton. “In my research, I show that there are big improvements in health care performance and service delivery when you bring regular people into oversite roles where they conduct neighborhood meetings to discuss how health care services are working—or not working—in their neighborhoods.”

Health care funding comes directly from Brazil’s federal government and is implemented at the local level, which according to Touchton, causes a wide gap in the quality of health care across many municipalities. Touchton says this is evident in wealthier areas of Brazil where health care policy is implemented effectively, yet there is a gap in health care services within the poorer areas, rural and urban alike.

“I’ve looked at data regarding local Zika contraction in Brazil, and local citizens are more engaged where environmental policy management councils exist,” he says. “These councils help direct mosquito abatement efforts, which include giving out education pamphlets, dumping out standing water, informing neighbors about installing screens, and even providing funds from the government for neighbors to put up the screens.

Touchton says the next step in his research is to return to Brazil in the summer of 2017 and gather a comprehensive dataset on dengue and Zika in the country and eventually other countries—Mexico, Colombia, Puerto Rico, and the Dominican Republic—and incorporate the data into his existing research on the effectiveness of the local government councils and how they help prevent vector-borne disease transmission.

“The preliminary results of my research surrounding these councils give me a reason to be optimistic that citizen engagement can work, and that this idea can be extended to other cities in the Americas that are at risk of major Zika outbreaks, like Miami,” Touchton said.

Touchton’s previous research shows how citizen engagement in local health care policymaking improves service delivery and medical outcomes such as infant mortality. His latest research will be published this winter in the one of the top journals in political science, the American Political Science Review.

For more information about Touchton’s research, view his faculty page.  

 

November 29, 2016