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Primary Healthcare Reform for Jamaica 2021-2030

Though there have been several attempts at reform in primary health care since 1978, the organization and scope of primary health care services have remained the same despite changing needs of the population. Improvements to the health system have focused on development and expansion of hospital services. New and expanded primary care centres have been constructed over the years but there has been no implementation of an overarching system approach to the improvement of primary health care in Jamaica. A review of the system now has taken into consideration the demographical and epidemiological transition that has occurred since 1978.

Despite a geographical distribution that allows for access and a structural framework that is conducive to integration of health services, the seamless movement of patients, continuity of care and sharing of information has not been achieved. Over time there has been a change in the needs of the population as well as advances in medicine and medical technologies. This reform seeks to improve the existing system by incorporating strategies for integration, and, developing mechanisms to coordinate health care services in the public and private sectors.

Jamaica’s Primary Health Care Reform 2021-2030, will through the network of facilities ensure delivery of population based and individual care services, allow for access to the services by all the population and the delivery of service that meets the needs of the population at the different life stages and will facilitate escalation of services through horizontal and vertical integration. Integration of services does not only refer to integration of clinical services but must also ensure that there is feedback from clinical treatment sites to drive prevention and health promotion programmes in all primary health care programmes.

The reason for the need for change in the organization of primary health care services and the expanded scope of services is the evolutions that have occurred in the health needs of the population. The epidemiological and demographic profiles have gone through transition phases with the result being a shift to non-communicable diseases being the leading cause of deaths and the elderly population have increased as life expectancy has increased. The management of diseases have evolved, and several scientific advances made where early interventions improve morbidity and mortality rates. Also, the environmental impact of climate change and socio-economic factors are impacting more on disease causation and outcomes.

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