Bringing Community-Based Providers into Jamaica’s National HIV Epidemic Control Efforts
On the far west side of Jamaica sits Savanna-la-Mar, the capital city of Westmoreland Parish. Plazas with businesses like hair salons, auto supply shops, bakeries, and hardware stores line the main road. In one of these plazas is Heritage Medical Centre, owned by Dr. Fielden Fairclough.
The center is a one-stop-shop for patients in the community and Dr. Fairclough treats everything from high blood pressure, aches and pains, colds and flus, to HIV infection. In Jamaica, stigma and discrimination against people living with HIV is common.
“Stigma is a hard thing to treat,” says Dr. Fairclough. “Building trust with my patients living with HIV has been critical in helping them to stay on treatment and suppress their HIV viral load (how much of the HIV virus is in the body).”
Importantly, community providers like Dr. Fairclough alleviate the burden on Jamaica’s public health system.
“My patients know that when they come in for care, they will see me,” he says. “They are comfortable talking to me about their life, their partner, and why they are having issues staying on their HIV treatment. It’s all about listening.”
Through the support of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), USAID local partner Health Connect Jamaica is bringing community-based providers into Jamaica’s national HIV epidemic control efforts. Today, the doctor is one of 85 clinicians who operate community-based practices in Jamaica and provide HIV services to low-income individuals — all through the support of PEPFAR, USAID, and Health Connect Jamaica. “Without Health Connect Jamaica some of my patients would not be able to afford care,” he says.
Dr. Alicia Webster, the director of Health Connect Jamaica, says that many people in Jamaica prefer a community doctor for their care because everyone in the community goes to the same place. Patients living with HIV don’t feel singled out.
Many of Health Connect Jamaica’s patient referrals come from the Jamaica Ministry of Health’s public health facilities. “There are some cases where a patient needs more personalized care to ensure that they stay on their HIV treatment plan and those cases are often referred to us,” she says.
Through four case managers, clients receive personalized follow-up, making it easier for them to stay on their life-saving HIV treatment even during challenging life events. For example, one case manager says she filled her client’s HIV treatment prescription for her and checked in on her daily after she had a major surgery.
Just a few blocks down from Heritage Medical Centre and Dr. Fairclough is Royale Pharmacy where Carol Muschette is the owner and one of the four pharmacists on site. Carol has been a pharmacist serving the Savanna-la-Mar community for over 20 years. “I’ve seen my clients from childhood through adulthood,” she says.
For people living with HIV, picking up their medication at a pharmacy can be a difficult experience because of stigma and discrimination.
“We provide all medications in the same brown paper bag so that no one can see what pills you are taking,” which Carol explains is important for her clients living with HIV. “We do whatever we can to make our clients feel comfortable.”
Through Health Connect Jamaica, patients have more options for where and when they receive care so that they don’t have to choose between missing a day of work and seeing their doctor. Today, Health Connect Jamaica serves more than 800 clients and continues to grow.
“People living with HIV deserve choice, flexibility, and convenience when choosing their healthcare provider,” said Dr. Webster. “Through Health Connect Jamaica’s network of providers we are proud to play an important role in Jamaica’s national HIV epidemic control efforts.”
About the Author
Elizabeth Squire was the Communications Advisor in USAID’s Office of HIV/AIDS in the Bureau for Global Health.
