Gestión adaptativa con Scrumban para el control comunitario de la malaria en la Amazonía boliviana: Estudio piloto mixto en seis municipios endémicos
Palabras clave:
Malaria, Accesibilidad a los servicios de salud, Participación comunitaria, Ciencia de la implementación
Resumen
La malaria es un desafío de salud pública en la Amazonía boliviana, donde el aislamiento territorial, la infraestructura sanitaria limitada, la movilidad de la población y las desigualdades sociales dificultan el diagnóstico oportuno y el uso sostenido de medidas preventivas. Este estudio analizó la factibilidad operativa y la aceptación comunitaria de una estrategia Scrumban en seis municipios priorizados. Se aplicó un diseño piloto mixto y convergente, con una encuesta estratificada a 600 participantes, información epidemiológica municipal e insumos cualitativos de actores comunitarios. La intervención organizó acciones mediante un backlog territorializado, sprints de cuatro a seis semanas, un tablero Kanban, revisiones y retrospectivas comunitarias. Los resultados mostraron diferencias significativas entre municipios en el retraso diagnóstico y en el uso regular de mosquiteros. Tras la intervención, el retraso promedio disminuyó de 4,67 a 3,20 días y el uso regular de mosquiteros aumentó del 79,0% al 85,0%. La aceptación comunitaria fue alta, con respuestas favorables superiores al 80%. El modelo multivariado evidenció que el territorio y el conocimiento comunitario se asociaron con un retraso en el diagnóstico basal. Los hallazgos sugieren que Scrumban puede traducir barreras territoriales y evidencia epidemiológica en decisiones operativas de ciclo corto. Por su carácter piloto y la ausencia de un grupo de comparación, los resultados deben interpretarse como evidencia inicial de mejora operativa.
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Walters, T., & Insch, A. (2018). How community event narratives contribute to place branding. Journal of Place Management and Development, 11(1), 130–144. https://doi.org/10.1108/JPMD-09-2017-0089
Zachariah, R., Rust, S., Thekkur, P., Khogali, M., Kumar, A. M., Davtyan, K., Diro, E., Satyanarayana, S., Denisiuk, O., Griensven, J. van, Hermans, V., Berger, S. D., Saw, S., Reid, A., Aseffa, A., Harries, A. D., & Reeder, J. C. (2020). Quality, Equity and Utility of Observational Studies during 10 Years of Implementing the Structured Operational Research and Training Initiative in 72 Countries. Tropical Medicine and Infectious Disease, 5(4), 167. https://doi.org/10.3390/tropicalmed5040167
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Creswell, J. (2018). Research Design. Qualitative, Quantitative, and Mixed Method Approaches.
Desai, M., Tardif-Douglin, M., Miller, I., Blitzer, S., Gardner, D. L., Thompson, T., Edmondson, L. P., & Levine, D. M. (2024). Implementation of Agile in healthcare: methodology for a multisite home hospital accelerator. BMJ Open Quality, 13(2). https://doi.org/10.1136/BMJOQ-2024-002764
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Ferreira, M. U., & Castro, M. C. (2016). Challenges for malaria elimination in Brazil. Malaria Journal. https://doi.org/10.1186/s12936-016-1335-1
Garberi, J. C., Estryk, G., Chiara, R., Callisperis, P., Loza, P., Scigliano, L., Casevecchie, S. A., Garberi, J. E., Villarte, E., Acevedo, M., Castro, M., Quiroz, G. C., Huarachi, A., Martinez, L., Langer, L., Prieto-Valiente, L., Liester, M., Franco-Paredes, C., & Kory, P. (2025). Diagnostic accuracy of the novel and biosafe molecular assay Orange G3 TBC compared to GeneXpert for tuberculosis diagnosis in resource-limited settings. Therapeutic Advances in Infectious Disease, 12. https://doi.org/10.1177/20499361251386681
Kayembe-Mulumba, B., N’gattia, A. K., & Belizaire, M. R. D. (2025). One Health, Many Gaps: Rethinking Epidemic Intelligence in Resource-Limited Settings to Prepare for the Global Threat of Disease X. Microorganisms, 13(11). https://doi.org/10.3390/MICROORGANISMS13112615
Kirwan, M., Henson, C., Bancroft-Duroux, B., Colegate, K., Taylor, C., Meharg, D., Cohen, N., & Gwynne, K. (2026). Operationalizing Co-Design in Exercise Interventions with Indigenous Peoples in Australia: Development and Cultural Adaptation of the PrIDE Tools. International Journal of Environmental Research and Public Health, 23(2), 252. https://doi.org/10.3390/ijerph23020252
Kulikova, E. V. (2025). Agile methodologies in banking software: a case-based analysis of implementation at Smart Solution. Vestnik of M. Kozybayev North Kazakhstan University, (2 (66)), 184–193. https://doi.org/10.54596/2958-0048-2025-2-184-193
Kulkova, V. Yu., & Emelyanov, D. M. (2023). Implementation of Agile Methodology in Software Development Project Management in Power Industry Small Business. Economic Environment, (3 (45)), 33–41. https://doi.org/10.36683/2306-1758/2023-3-45/33-41
Leandro-Reguillo, P., Thomson-Luque, R., Monteiro, W. M., & de Lacerda, M. V. G. (2015). Urban and architectural risk factors for malaria in indigenous Amazonian settlements in Brazil: a typological analysis. Malaria Journal, 14(1), 284. https://doi.org/10.1186/s12936-015-0806-0
Lubis, I. N., Permatasari, R., Siahaan, L., Cahyadi, R. A. D., Nainggolan, I. R. A., Syafutri, R. D., Sinambela, M. N., Jauharah, S., Lestari, A., Theodora, M., Prameswari, H., Piera, K. A., Barber, B. E., Anstey, N. M., & Grigg, M. J. (2025). Submicroscopic burden of zoonotic P. knowlesi malaria on Mursala Island and P. falciparum and P. vivax transmission in mainland North Sumatra, Indonesia. MedRxiv, 2025.06.02.25328766. https://doi.org/10.1101/2025.06.02.25328766
Marmot, M. (2005). Social determinants of health inequalities. The Lancet, 365(9464), 1099–1104. https://doi.org/10.1016/S0140-6736(05)71146-6
Mollinedo, J. S., Mollinedo, R. E., Mollinedo, P., Chuquimia, G., Paredes, E., & Sossa, D. (2024). Malaria en Bolivia: Revisión sistemática de los factores de riesgo y estrategias implementadas de prevención, control y eliminación. https://doi.org/10.35170/ss.ed.9786580261390
Murta, F. L. G., Mendes, M. O., Sampaio, V. de S., Junior, A. S. B., Díaz-Bermúdez, X. P., Monteiro, W. M., & Lacerda, M. V. G. (2019). Misperceptions of patients and health workers regarding malaria elimination in the Brazilian Amazon: a qualitative study. Malaria Journal. https://doi.org/10.1186/s12936-019-2854-3
Nalinya, S., Musoke, D., & Deane, K. (2022). Malaria prevention interventions beyond long-lasting insecticidal nets and indoor residual spraying in low- and middle-income countries: a scoping review. Malaria Journal, 21(1), 31. https://doi.org/10.1186/s12936-022-04052-6
Nikhil, S. (2025). A Scrumban Integrated Approach to Improve Software Development Process and Product Delivery. The American Journal of Interdisciplinary Innovations and Research, 07(09), 70–82. https://doi.org/10.37547/tajiir/Volume07Issue09-07
Onwujekwe, O., Mbachu, C., Etiaba, E., Ezumah, N., Ezenwaka, U., Arize, I., Okeke, C., Nwankwor, C., & Uzochukwu, B. (2020). Impact of capacity building interventions on individual and organizational competency for HPSR in endemic disease control in Nigeria: a qualitative study. Implementation Science : IS, 15(1), 22. https://doi.org/10.1186/S13012-020-00987-Z
Pardoel, Z. E., Reijneveld, S. A., Postma, M. J., Lensink, R., Koot, J. A. R., Swe, K. H., Van Nguyen, M., Pamungkasari, E. P., Tenkink, L., Vervoort, J. P. M., & Landsman, J. A. (2022). A Guideline for Contextual Adaptation of Community-Based Health Interventions. International Journal of Environmental Research and Public Health, 19(10), 5790. https://doi.org/10.3390/ijerph19105790
Rau, M. J. (2023). Integrative Strategies for Malaria Elimination: The Role of Surveillance, Vector Control, and Community Engagement. Jurnal Riset Kualitatif Dan Promosi Kesehatan, 2(2), 105–117. https://doi.org/10.61194/jrkpk.v2i2.678
Robortella, D. R., Calvet, A. A., Amaral, L. C., Fantin, R. F., Guimarães, L. F. F., França Dias, M. H., Brito, C. F. A. de, Sousa, T. N. de, Herzog, M. M., Oliveira-Ferreira, J., & Carvalho, L. H. (2020). Prospective assessment of malaria infection in a semi-isolated Amazonian indigenous Yanomami community: Transmission heterogeneity and predominance of submicroscopic infection. PLOS ONE, 15(3), e0230643. https://doi.org/10.1371/journal.pone.0230643
Salcedo, L. S. S., Vasilieva, O., Romero, H. J. M., & Castro, J. H. A. (2015). Ross Macdonald: Un modelo para la dinámica del dengue en Cali, Colombia. Revista de Salud Pública, 17(5), 749–761. https://doi.org/10.15446/rsap.v17n5.44685
Sicuri, E., Bardají, A., Sanz, S., Alonso, S., Fernandes, S., Hanson, K., Arévalo-Herrera, M., & Menéndez, C. (2018). Patients’ costs, socio-economic and health system aspects associated with malaria in pregnancy in an endemic area of Colombia. PLoS Neglected Tropical Diseases. https://doi.org/10.1371/journal.pntd.0006431
Snowden, D., & Boone, M. (2007). A leader’s framework for decision making. Harvard Business Review.
Thomas, G., Lynch, M., & Spencer, L. H. (2021). A Systematic Review to Examine the Evidence in Developing Social Prescribing Interventions That Apply a Co-Productive, Co-Designed Approach to Improve Well-Being Outcomes in a Community Setting. International Journal of Environmental Research and Public Health, 18(8). https://doi.org/10.3390/ijerph18083896
Thombare, D. V., Mailapalli, J., Adeyemi, E. O., & Bommer, S. (2026). Conceptual framework to advancing healthcare system through Agile methodologies, human factors engineering and adaptive leadership. Journal of Health Organization and Management, 40(9), 96–109. https://doi.org/10.1108/JHOM-06-2025-0316
Thorburn, R., & Ansloos, J. (2026). Community Is Medicine: Understanding Indigenous Youth-Led Peer Support in Mental Health and Suicide Prevention. Journal of Prevention and Health Promotion, 7(2), 290–321. https://doi.org/10.1177/26320770251359603
Tungsanga, S., Woods, C., Allu, S., Dart, A. B., Jain, A. K., Jorgensen, L., Hampson, M., Harasemiw, O., Hébert, M., Kappel, J., Kirlin, N., Levandoski, C., Lunney, M., MacDonald, C., Okpechi, I. G., Philp, L., Shmyr, S., Turner, C., Collister, D., … Bello, A. K. (2026). Integrated, Community-Led, Culturally Safe Implementation of a Chronic Kidney Disease Detection Program for Indigenous Communities of Canada: The Kidney Check Program Report. Canadian Journal of Kidney Health and Disease, 13. https://doi.org/10.1177/20543581261447194
Venkatesan, P. (2023). Malaria eliminated in Belize. The Lancet Microbe, 4(11), e861. https://doi.org/10.1016/S2666-5247(23)00251-3
Walters, T., & Insch, A. (2018). How community event narratives contribute to place branding. Journal of Place Management and Development, 11(1), 130–144. https://doi.org/10.1108/JPMD-09-2017-0089
Zachariah, R., Rust, S., Thekkur, P., Khogali, M., Kumar, A. M., Davtyan, K., Diro, E., Satyanarayana, S., Denisiuk, O., Griensven, J. van, Hermans, V., Berger, S. D., Saw, S., Reid, A., Aseffa, A., Harries, A. D., & Reeder, J. C. (2020). Quality, Equity and Utility of Observational Studies during 10 Years of Implementing the Structured Operational Research and Training Initiative in 72 Countries. Tropical Medicine and Infectious Disease, 5(4), 167. https://doi.org/10.3390/tropicalmed5040167
Publicado
2026-07-24
Cómo citar
Flores, R. (2026). Gestión adaptativa con Scrumban para el control comunitario de la malaria en la Amazonía boliviana: Estudio piloto mixto en seis municipios endémicos, 8(15), 469-498. https://doi.org/10.5281/zenodo.21522624
Número
Sección
Ciencias Naturales, Exactas, del Agro, de la Salud e Ingeniería
Derechos de autor 2026 Richard Flores
Esta obra está bajo licencia internacional Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0.
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