Malaria Control in Amerindian Communities of Venezuela : Strengthening Ecohealth Practice Throughout Conservation Science and Capability Approach.

Adaptive management and ecohealth frameworks were developed for malaria elimination in Amerindian riparian communities of Venezuela. These frameworks were developed as a strategy to capture, organize, and communicate connections among key factors related to local malaria complex systems. Important causal relationships between social, economic, and environmental stressors which are determinant of malaria were identified at different levels and assumptions that guide interventions are offered, based on available scientific knowledge and input from stakeholders. Drawing on our experience of action research committed to the health of Amerindian populations and conservation of areas with biodiversity value, the authors provide lessons to strengthen the practice of an ecohealth approach. First, conservation targets were considered as a way to achieve sustainable human well-being rather than as a consequence of well-being. Second, the effectiveness and sustainability of technical solutions generally proposed for malaria control depend largely on individual knowledge, attitudes, and practices. Hence, it is necessary to look at the real opportunities of choices that Amerindian people have for attaining a life without malaria, and therefore pay attention to local capabilities, needs, and freedom to choose. The ecohealth approach can benefit from the capability approach, and we explain why.