Developing a sustainable strategy and enhancing conditions of effectiveness of the JAFA programme in Guadeloupe and Martinique: a realist evaluation.

Abstract

Chlordecone is a pesticide that was used in Martinique and Guadeloupe between 1972 and 1993. The multiple impacts on health and living conditions of the local population led to the implementation of the JAFA (JArdins FAmiliaux) programme, which was launched in 2009 to reduce contamination of part of the population: 'household producers' who consume produce from the animals they breed and gardens that are potentially contaminated. The research question was: what are the key impacts and functions of the approach implemented as part of the JAFA programme between 2015 and 2023? The aim of this study is to understand how and under what conditions the JAFA intervention works in order to produce recommendations in terms of transferability, scaling up and reorientation.

Methods: An iterative theory-based evaluation adapted to a 'complex' intervention is the most appropriate for JAFA and a particularly realist evaluation that highlights the intervention theory of JAFA. Realist evaluation makes it possible to put forward configuration hypotheses in the form of causal chains: contexts - mechanisms - effects. This realist evaluation was developed iteratively with the programme's stakeholders, engaging participating professionals in brainstorming sessions conducted as seminars as well as groups of programme participants in focus group discussions. The results can be refined at each reflection loop with this approach.

Results: Results are based on two series of individual interviews with professionals and members of the public who took part in JAFA, totalling 105 interviews. Three seminars with professionals and two focus groups alternating with the interviews were organized on each island. JAFA's medium-range theory is composed of 22 causal chains: 127 contexts acting on 22 mechanisms. Moreover, 10 recommendations were validated.

Conclusion: The realist evaluation revealed key strategies for improving the programme over the long term, and for transferring, scaling up and redirecting it according to local needs.