JWC, INC. (C) 2017-2019
Global Health Mission in Jamaica
One of the leading causes of death and illnesses in Jamaica are chronic non-communicable diseases. The epidemiologic transition has affected the region and has resulted in a surge in these diseases. Data from the Jamaica Health and Lifestyle Survey 2007-8 provided evidence of these non-communicable diseases and shows it may be increasing.(1)
Jamaicans have a high frequency of familial history of chronic diseases. Half of Jamaicans have a parent or grandparent who has hypertension, one thirds with diabetes and a little less than one fifth who report a family history of stroke or cancer. An article in The Jamaican newspaper (Gleaner) outlined that the ministry data showed in 2009 there were 92,860 males and 132,469 females over the age of 25 suffering from diabetes. Obesity which is a major risk factor for diabetes, affects 38% of women and 12% of men and 53,706. Jamaicans at that time is unaware if they were affected by the disease. (2).
Lifestyle changes may have contributed to more than half of the reported cases of chronic diseases and more males reported having such change. Jamaicans rely on traditional medicine (Herbal medicine), based on tradition. In the 2008 Health and Lifestyle Survey reported that, 40% of Jamaicans who reported being ill in the previous year reported feeling better through using traditional medication. 9% of Jamaicans have never had their blood pressure measured and only 19% of Jamaicans at that time had insurance. A study conducted on the health disparities between the poorest and the wealthiest quintiles showed that the wealthiest quintile had good health of about 62% more than those that were poor. (3)
A part from the non-communicable diseases mental health is an important aspect of overall health and wellbeing, and it was found in the 2000 Health and lifestyle survey that 25% of population showed depressive symptom and this has increased significantly over time.
As it relates to genetic disorder, sickle cell disease is the most common and it was found that one in every one hundred Jamaican is affected by this disease. Studies have been conducted to evaluate the Jamaican population and according to World Health Organization (WHO) 2014 statistics, the top four leading non-communicable diseases in Jamaica are #1 cardiovascular disease which accounts for 37% of death in adults ages 30-70 years, #2 Cancer 17%, #3 Communicable, maternal, perinatal and nutritional conditions 14% and #4 Diabetes 11%. However, death due to HIV, TB and Malaria were also very high.. Other organizations such as the United Nation Children Emergency Fund (UNICEF) statistics shows a deficit in healthcare for Jamaicans. (UNICEF) outlined all 14 Parishes in Jamaica and the poverty level for each by percentages. UNICEF noted that the Parishes with the highest poverty rate are as follow: Trelawney 34.6%, St. Ann 39.6%, Portland 35.7%, and St. Thomas 30.7%.
These Parishes will be the focus of our research and mission to establish ways in which to provide healthcare to areas with a deficit. Research was also conducted through an interview with two mothers from the parish of St. Thomas, and it was found that the district’s only clinic was shut down about 5 years ago. Danvers Pen residents stated that there were no warning and the cause of the sudden shut down is unknown. One mother informed our organization that her 13 year old son recently had an asthma attack, and she traveled from Danvers Pen to the district of Lyssons, which is about 2 hours away to obtain health services. She mentioned that the Princess Margarete Hospital is the only easily accessible hospital. She explained that she traveled by taxi and that she had to face the traumatizing reality that her son could have died. She also explained that there was a health center about 30 mins from her home, which is a distance of 9.93 miles, but the clinic does not handle emergencies.
The Jamaica Ministry of Health (MOH), quotes that “healthy children, equates to Healthy Communities" to improve the health of a community we must first focus on our most vulnerable population. The maternal and child health goals in the year 2015-2018 strategic plan includes reducing maternal and infant mortality rates and increasing breastfeeding rates. The MOH states that their goal is to acquire information from their department to substantiate their request for funding, to assist with offering preventive services in communities that are underserved (country areas/ hard to reach areas or areas with limited access to healthcare).
(Maternal, infant mortality rates and breastfeeding)
In addition, The Ministry of Health’s priority programs and projects are aligned to the National Development Plan - Vision 2030 and the Medium-Term Socio-Economic Policy Framework 2012-2015, which are linked to the National Strategies and the National Development Plan. Maternal child health and infant mortality are among the priority areas structured under the World Health Organization’s six (6) building blocks. The health service delivery in the public sector is provided through a network of secondary and tertiary care facilities consisting of 24 hospitals including 5 specialist institutions (with a bed complement of 4736); and primary care facilities comprising 348 health centers, managed by the four regional health authorities (PAHO/WHO COUNTRY COOPERATION STRATEGY 2010-2015).
Between 1990 & 2015, the under-five mortality rate has been reduced by two-thirds however, it has been reported that this target is far behind. The under-five mortality rate has only been reduced by 14% up to 2005. Under-five mortality rate is 18.0 per 1000 live births (2011). The Infant Mortality Rate (IMR) was estimated at 16.7 per 1,000 live births (2008) compared with 24.5 per 1,000 live births in 2001. Infant mortality rate has reduced by almost one-third, 70% of infant deaths occur in the perinatal period. At Jamaica’s comparatively low mortality levels major resources are needed to reach the target (Ministry of Health’s Strategic Business Plan, 2015-2018). The five leading causes of infant mortality included conditions originating in the perinatal period, Congenital Malformations, HIV, Acute Respiratory Infections and Malignant Neoplasms (WHO Country Cooperation Strategy, 2010).
There have been improvements in maternal health between 1990 & 2015, by a reduction of three-quarters. Maternal mortality ratio is 110 per 100 000 live births (2010). According to the Ministry of Health’s Strategic Business Plan, Jamaica is far behind in targets for child and maternal mortality; it is recognized that this is partly because Jamaica already has comparatively low mortality rates and further gains are mainly dependent on increased financial, technological and human resources.
The Ministry of Health has proposed strategies to provide and maintain an adequate health infrastructure to ensure efficient and cost-effective service delivery target for 2015 in the service Delivery Maternal , Child & Adolescent Health by establishing 11 functional High Dependency Units (HDU) (5 maternal, 6 neonatal) in 6 Regional and specialist hospitals. The outcome has resulted in the establishment of 1 neonatal HDU at Mandeville Hospital (Ministry of Health’s Strategic Business Plan, 2015-2018). Regarding breastfeeding promotion, the Ministry of Health main focus is introducing and certifying Baby-Friendly Hospital (BFH), which is to ensure that in all hospitals breast feeding is exclusive and formula is not given unless illnesses occur for example HIV.
Another neglected area of the healthcare system in Jamaica is children living with developmental disabilities. Developmental disability is a diverse group of chronic conditions that are due to mental or physical impairments. Living with someone with developmental disabilities can be difficult, not understanding their areas of deficits such as language and mobility etc. Developmental disabilities can be detected at an early stage of a person’s life and persist throughout an individual's lifespan. Research has also indicated that there is some help available for children affected by these disorders in Jamaica from many different organizations. However there are barriers which sometimes prevent the implementation of services, such as socio-economic status, education and available resources. Research showed that one in six children, (15%), are currently being diagnosed with a developmental disability or development delay.
Minister of Youth and Culture, Hon. Lisa Hanna, emphasizes the importance of the intervention, noted that often, these children, particularly those with severe disabilities, are abandoned by their parents, because they cannot afford the cost of adequate care and treatment.” The minister has doctors who will go into the home of families with developmental disabilities.
The Jamaican Ministry of Health is working on developing a better comprehensive community mental health systems. Through research it was also found that children with developmental disabilities are living in Jamaica without assistance such as physical therapy, occupational therapy or speech therapy, which are essential treatment to assist families with the children living with disabilities. By going to Jamaica to provide services, we have an opportunity to make a difference through education and counselling. Parents will have the opportunity to learn about the different types of developmental disabilities and how to better take care of children living with these conditions.
Cultural Health Competencies and Disparities in a Tropical Paradise – Jamaica