Chagas Disease Control Initiatives such as the Southern Cone Initiative and the Central American Initiative achieved reduction in the transmission of the disease via effective vector control. The Southern Cone Initiative triggered the launch of other regional initiatives such as the Central American, Andean and Amazon initiatives. The Central American Initiative made progress in the elimination of an imported triatomine (Rhodnius prolixus) and the control of a widespread native species (Triatoma dimidiata), while facing constraints such as a fragmented vector control program under a decentralized health system. International aid agencies and NGOs played an important role in Central America, in bridging between fragmented organizational resources. Decentralization of the health system limits the vertical vector control operation, and T. dimidiata-control needs sustainable surveillance and a control system to cover a large geographic area efficiently with stratification, quality control, community mobilization, and information management. Stakeholders such as the National Chagas Program, the local health system, and local government must share responsibilities to continue comprehensive vector control. Also, the private sector such as insecticide companies could be involved to explore alternative methods of spraying which complement the weakened institutional-led spraying, such as market- and incentive-driven spraying (purchase of insecticides and spraying by residents).
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