A framework for decision-making in integrated vector management to prevent disease.

Integrated vector management (IVM) aims to extend the basis of disease control by involving other sectors and local communities in control action. It is vital that decisions on IVM are made locally for two reasons: first, the epidemiology of disease can vary at a small spatial scale, suggesting the need for precise targeting and second, a number of disease determinants relate to the actions and conditions of local communities, suggesting the need for their increased participation. This requires a shift from centrally managed, sector-specific operations to the facilitation of multi-partner programmes at the district and local level. We propose a methodology for involving local partners outside the health sector in describing and mapping the local determinants and conditions of disease, analysing control options, and consolidating a joint strategy of control. Thus determinants that often lie outside the domain of the health sector are tackled.