An Introduction to Jamaican Culture for Rehabilitation

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Transcript An Introduction to Jamaican Culture for Rehabilitation

An Introduction to Jamaican Culture
for Rehabilitation Services Providers
Dr. Doreen M. Miller
Dr. Sheila Campbell-Forrester
A Webcast Sponsored by the NCDDR
February 17, 2010 - 3:00 PM (Eastern)
National Center for the Dissemination of Disability Research © 2010 by SEDL
Funded by NIDRR, US Department of Education, PR# H133A060028
Introduction
 The
purpose of this presentation is
to provide an overview of Jamaican
culture and its influence on
disability issues.
2
Introduction
The presentation will address the following:
•History
and reasons for emigration to the United
States
•Jamaicans' concept of disability
•Views on acquired and lifelong disabilities
•Concept of independence
•Jamaican culture
3
Introduction
4
•Typical patterns of interactions between consumers
and rehabilitation service providers,
• Family structure,
• Role of community and gender differences in
service provision, eating habits,
• Recommendations to rehabilitation service
providers
• Ways in which service providers can become more
familiar with the culture.
Geography
5

The country of Jamaica is a West Indian
island located near the center of the
Caribbean Sea. It is among the group of
islands that comprise the Greater Antilles
(the others are Cuba, Haiti, Dominican
Republic and Puerto Rico) and is the largest
of the English–speaking islands in the region.

Jamaica is 90 miles south of Cuba, 100 miles
west of Haiti and 579 miles from Miami.
Geography
6

Approximately the size of Connecticut,
Jamaica has an area of 4,411 square miles
and is 146 miles long. The breadth of the
island varies from 22 miles at its narrowest
point to 51 miles at the widest.

Rugged chains of mountains extend from
east to west. The Blue Mountains include the
highest point on the island, a summit of
7,402 feet. Low elevations form a costal belt
around the island but approximately two
thirds of the landmass lies 1000 feet above
MAP
7
Population


8
In 2004, the Statistical Institute of Jamaica
reported that there were 2.8 million people living
on the island.
Of this number, 700,000 lived in the corporate
area of the capital, Kingston and the city of St.
Andrew). Montego Bay, the second largest city,
had a population of approximately 85,503.
– Median age – Males 26.2, Females 27.6,
Total 26.8
Population

9
The ethnic composition of Jamaica reflects the
historical legacy of African enslavement.
Various historical and sociological reports
suggest that most of the Africans taken to
Jamaica were from the West African coast and
later from Angola and the Congo. Although
African slaves in Jamaica were from among a
variety of ethnic groups, they were
predominantly Coromanties, Eboes and
Mandingoes.
Population


10
The cessation of the slave trade precipitated a
need for new sources of labor to maintain the
sugar estates. To meet the demand for labor,
East Indian immigrants came to Jamaica in
1842. In 1854, Chinese immigrants were added.
Even with the presence of Indians and Chinese,
the need for workers remained high. In 1869,
East Indian indentured servants were introduced.
Today, the ethnic composition of Jamaica is as
follows: African descent 90.9%, East Indian
1.3%, white 0.2 percent, Chinese 0.2%, mixed
7.3% and other 0.6%.
Government

Executive Branch
–
–

Legislative Branch
–
–

–
Supreme Court
Court of Appeals
Political Parties
–
11
Senate
House of Representatives
Judicial Branch
–

Queen Elizabeth II
Governor General
–
–
Jamaica Labor Party (JLP)
National Democratic Movement (NDM)
People’s National Party (PNP)
Education







12
Literacy rate is 87.9% for general population
Males’ literacy rate is 84.1
Females’ literacy rate is 91.6
Educational System—based on British system
Level of education for individuals with disabilities
– 75% Primary level as highest level of education
– 10% Secondary education
– 0.4% University education
(based on 2004 statistics from World Fact Book-Jamaica)
Total number of individuals with disability 111,114
Economy



13
The economic system is sustained by tourism
and bauxite/alumina
Other industries include textiles, clothing, light
manufacturing, rum, cement, paper, chemical
products, telecommunications and agro
processing.
Agricultural products such as bananas, coffee
and citrus
Economy



14
Labor Force—includes agriculture 21%, industry
19%, and services 60%.
Unemployment Rate – 15.9% general population
14% of the population of individuals with
disabilities had a job
– Employment for males 19.5%, females 8.8%
Religion

Jamaicans are predominately Christian with
small numbers of Hindu, Muslim, Jewish,
Bahai and African Caribbean religious
groups.
–
–
–

Rastafarians constitute one of the most
famous religious groups.
–
15
61.3% Protestants
4% Catholics
5.5% Anglicans
Many are reported to live Brooklyn
National Holidays






16
Independence Day is the most celebrated
event (August 6, 1962)
National Heroes Day (October 17)
Christmas
New Years
Easter
Labor Day
National Symbols

17
National Flag
National Symbols

18
Crest
History





19
Early settlers were the Arawaks
In 1494 Columbus claimed the island for Spain
In 1665, the British drove out the Spaniards
and the island was ceded under the Treaty of
Madrid.
In 1834, slavery was abolished
Independence from British rule August 6, 1962
History of Immigration

There were three waves of immigration to the
United States
–
–
–
20
The first wave took place between 1900 and 1920
bringing a modest number of immigrants
The second wave and weakest wave occurred
between 1930 and mid-1960s. The McCarranWalter Act reaffirmed and upheld a quota bill
which allowed only 100 Jamaicans in the U.S.
each year
The final and largest wave of immigration began
in 1965 and continues to the present.
History of Immigration


21
Approximately one million Jamaican
immigrants live in the United States (between
186,000 to 600,000 live in New York).
Jamaicans are the largest group from the
English speaking Caribbean
History of Immigration

22
The migration from Jamaica was so large
that it became a national crisis (brain drain)
resulting in an acute shortage of skilled
workers and professionals such as doctors
and nurses (about 15% of population left the
country in the 1980s).
Cultural Concept of Disability


Cultural concepts that influence views of
disability and illness originate in religious
beliefs related to Christianity and Afro–
Christian sects such as Pocomania.
Major beliefs that may have an influence on
the way Jamaicans view disability:
–
–
–
23
–
–
Disability is a punishment for wrongdoing
Obeah or Guzu
Evil Spirits
Ghosts or Duppies
Natural Causes
Cultural Concept of Disability


24
These belief systems are entrenched in
Jamaican society. They have played a major
role in shaping the attitudes toward disability
and delayed the development of a
comprehensive national rehabilitation
program.
Professionals and the educated middle class
tend to hold a strong belief that disability is a
result of sin.
Stigma and Disabilities


25
The stigma related to disability in the case of
children is often directed toward the parent
and not the child.
The parent is seen as culpable for the child’s
disability, i.e., having a child with a disability
is punishment for a sin or wrong committed
by the parent or ancestor.
Stigma and Disabilities

26
Some disabilities carry more stigma than
others. For example, cognitive or mental
disabilities have the greatest stigma
attached.
Concept of Independence


27
Jamaicans see themselves as independent
thinkers. They take pride in making their own
decisions and controlling their own destiny.
Many object to others telling them what they
"should," "ought" or "must" do. They reject
authority when they believe that their
intellectual capacity to act on their own
behalf is being disregarded or when the
authority figure is perceived to be
condescending.
Concept of Independence



28
Intellectual condescension is a pet peeve of
many. Those who are unable to read are
particularly sensitive to patronizing
intellectual behavior and are not afraid to
confront those who disregard their capacity
to think.
One might say, "mi can't read but mi a no
fool, mi know wa mi a do." (I can't read, but I
am not a fool, I know what I am doing).
Jamaicans often describe themselves as
very assertive and not easily dominated.
Rehabilitation Service Delivery



29
In general, traditional service delivery in Jamaica is
limited, and strong governmental interest is a recent
development.
Increased interest in the rehabilitation needs of
Jamaicans with disabilities occurred as a result of
the World Health Organization's (WHO) International
Year of the Disabled Person (IYDP), observed in
1981.
The commemoration of the International Year of the
Disabled Person served to galvanize grassroots
efforts to improve the quality of life for Jamaicans
with disabilities, highlight the unique needs of
citizens with disabilities and harness governmental
support.
Gender Differences


30
Women tend to take the leadership role in
securing and utilizing services for themselves
and their families.
If a family member is ill, it is the woman who
researches available resources and make
arrangements to get the person to the doctor
or other medical professional, and women
are more inclined to seek service for
themselves than are men.
Gender Differences


Men sometimes engage in denial of their
own needs that may result in remedial rather
than preventative services.
As the chief breadwinners, they are reluctant
to lose time and money from work to seek
medical help.
–
–
–
31
The denial of needs may also be related to the desire to
appear "manly" and strong.
Going to the doctor for what appears to be a minor illness is
sometimes perceived to be a weakness.
Sense of duty and responsibility to provide for the family
Interaction Between Consumers and
Rehabilitation Service Providers



32
Interaction between consumers and service
providers may be influenced by the source of
referral.
Consumers who are referred by the medical
profession will be apt to use the resources
because physicians are among the authority
figures of the society.
Rapport building with physician-referred
consumers is often easier because of their
desire to comply with the doctor's instruction.
Interaction Between Consumers and
Rehabilitation Service Providers


33
Personal pride also can hamper the
relationship between consumers and service
providers. Some Jamaicans resist the use of
public assistance because they are
embarrassed by dependence on
governmental or –poor relief– support.
In an effort to maintain dignity and avoid
being labeled ‘indigent,’ some will remain in
dire need.
Role of the Community



34
Community involvement in rehabilitation is limited,
but increasing public awareness through media
promotion is helping to educate the community about
issues faced by people who are physically or
mentally challenged.
Limited input from the community is particularly
poignant as it relates to employment of people with
disabilities.
Most people with disabilities are employed in the
governmental work force. The private sector has not
yet become a major partner in providing
employment.
Recommendations for Providing
Rehabilitation Services to Jamaicans
35

Greetings or acknowledgment of an
individual's presence is an important cultural
value.

The titles of Miss, Mr., Mrs., Doctor before
one's name is important. If you visit a
Jamaican office or observe people in social
interaction, a title is always attached to a
name.
Recommendations for Providing
Rehabilitation Services to Jamaicans
36

Jamaicans pride themselves on being able to
handle their own problems, so it is important
to ensure that service delivery environments
are supportive of this value

Jamaicans are very proud and will go to
great lengths to maintain their dignity.
Recommendations for Providing
Rehabilitation Services to Jamaicans


37
Privacy is highly valued, so discreet and
confidential treatment of information is
important.
Caring for a family member is often an
obligatory role. If someone is in the hospital,
it is not unusual for family members to insist
on providing routine care similar to the role of
nurses.
Recommendations for Providing
Rehabilitation Services to Jamaicans


38
Family members have strong kinship bonds,
which might appear unhealthy to some
professionals. Providers should refrain from
dismantling these bonds, particularly when a
family member is ill or disabled.
An aunt or uncle might accompany a child to
the doctor or other service delivery agency.
That aunt or uncle should be treated with the
respect of a parent.
Recommendations for Providing
Rehabilitation Services to Jamaicans


39
Appointments should be made as convenient
as possible because Jamaicans have a
strong work ethic and will miss an
appointment before missing work.
Treat the elderly with respect. Voice tone,
physical handling (e.g. manipulation of limbs)
and instructing the elderly should be done
with care and sensitivity.
Recommendations for Providing
Rehabilitation Services to Jamaicans


40
Jamaicans have a strong antipathy toward
the placement of elders or ill family members
in nursing homes.
Jamaicans place a high value on the
intellect, therefore information regarding
cognitive dysfunctions should be presented
with tact and sensitivity.
Recommendations for Providing
Rehabilitation Services to Jamaicans


41
Personal information is considered to be just
that, so information gathering can be a
tedious process. At the beginning, be sure
that the client knows your reason for asking
for personal information and how the
information will be used.
Listen carefully to understand what is being
said. While English is the language spoken in
Jamaica, most Jamaicans, especially the
less educated, speak Jamaican Patois.
Recommendations for Providing
Rehabilitation Services to Jamaicans


42
Acknowledge religious expressions of
patients. Most Jamaicans are very religious
and they see God as their spiritual refuge
and strength in times of crisis.
Network with Jamaica professionals in the
field of rehabilitation who might serve as
informal consultants/advocates on behalf of
those Jamaicans receiving rehabilitation
services.
Suggestions for Becoming more
Familiar with Jamaican Culture



43
Be curious and willing to learn about other
people and their way of life. Read Jamaican
newspapers, novels and explore the Internet as
a medium for listening to Jamaican radio stations
to gain better insight into their way of life.
Recognize that Jamaicans bring with them a
cultural history and a strong national identity
based on their cultural experience.
Remember that "one size does not fit all" when it
comes to culture. Refrain from imposing
American culture on Jamaicans because many
will resent it.
Suggestions for Becoming more
Familiar with Jamaican Culture



44
Ask when in doubt. Most Jamaicans are
proud of their country and are happy to talk
about it.
Be both a teacher/counselor and a student.
The same goes for the client. Learning about
each other is a "two way street."
Learn the symbols and meanings in the
culture (national emblems) and the
importance of national icons (national
heroes). They provide insights into how the
collective identity and consciousness of the
country were developed.
Suggestions for Becoming more
Familiar with Jamaican Culture



45
Examine personal biases and stereotypes
against Jamaican immigrants in the United
States.
Examine personal religious beliefs and, when
possible, create a safe space for consumers
to express their own.
Celebrate your own culture and heritage, but
be open to the differences between people.
Respect, rather than judge, the cultural
background of others.
Conclusions


46
If providers remain open to the culture of this
group, they can provide holistic rehabilitation
services to Jamaican consumers.
Informing themselves about the differences
and similarities between Jamaicans and the
dominant culture will help providers step
beyond cultural barriers and provide the
quality of service that reflects the
fundamental principles of American
rehabilitation.
References





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47

Belgrave, F.Z. and Walker, S. (1991). Differences in Rehabilitation
Service Utilization Patterns of African Americans and White Americans
with Disabilities. Future Frontiers in the Employment of Minority
Persons with Disabilities: Proceedings of the national conference.
Washington: The Committee 25–29.
Black, C.V. (1997). History of Jamaica. Kingston, Jamaica: Longman.
CIA (2004). The World Factbook. Retrieved June 1, 2009 from
http://www.travlang.com/factbook/geos/jm.html
Dechesnay, M. (1986). Jamaican Family Structure: The Paradox of
Normalcy. Family Process, 25, 293–300.
Fiest–Price, S. and Ford–Harris, D. (1994). Rehabilitation Counseling:
Issues Specific to Providing Services to African American Clients.
Journal of Rehabilitation, 60(4), 13–19.
Gardner, M., Bell, C., Brown, J., Wright, R., Gooden, N., & Brown, K.
(1993). Breaking the Barrier. Kingston, Jamaica: Jamaica Council for
the Handicapped, Ministry of Labour & Welfare.
Gleaner Company. (1995). Geography and History of Jamaica.
Kingston, Jamaica: Gleaner Company Limited.
References






48
Harley, D.A. and Alston, R.J. (1996). Older African American
Workers: A Look at Vocational Evaluation Issues and
Rehabilitation Education Training. Rehabilitation Education,
10(2&3), 151–160.
Heinz, A. and Payne–Jackson, A. (1997). Acculturation of
Explanatory Models: Jamaican Blood Terms and Concepts. Middle
Atlantic Council of Latin American Studies Latin American Essays,
11 (April), 19.
Jamaica Information Service. (2000). What is our National
Heritage? Jamaica Information Service.
Leavitt, R. (1992). Disability and Rehabilitation in Rural Jamaica.
London and Toronto: Associated University Press.
Lowe, H.I.C. (1995). Jamaican Folk Medicine. Jamaica Journal, 9,
2–3.
McGoldrick, M., Pearce, J.K., & Giordana, J. (1982). Ethnicity &
Family Therapy, 3–30. Guilford Family Therapy Series. New York,
NY: The Guilford Press.
References







49
Morrish, I. (1982). Obeah, Christ and Rastaman. Cambridge: James
Clarke.
Murrell, N. S. (2009). Jamaican Americans. Retrieved June 1, 2009
from http://www.everyculture.com/multi/Ha-La/JamaicanAmerican.html
National Advisory Council on Disability. (2000). National Policy for
Persons with Disabilities. Jamaica: National Advisory Council on
Disability.
NUA Internet Survey of Online Users in Latin America (2001).
Planning Institute of Jamaica. (2000). Economic and Social Survey
Jamaica 1999. Kingston, Jamaica: Planning Institute of Jamaica.
Schaller, J., Parker, R. and Garcia, S.B. (1998). Moving toward
culturally competent rehabilitation counseling services: Issues and
practices. Journal of Applied Rehabilitation Counseling, 29(2), 40–48.
Statistical Institute of Jamaica. (2000). Demographic Statistics.
Kingston, Jamaica: Statistical Institute of Jamaica.
References





50
Statistical Institute of Jamaica. (1998). Statistical Yearbook of
Jamaica. Kingston, Jamaica: Printing Unit.
Superintendent of Documents. (1999). The World Factbook.
Pittsburgh, PA: National Technical Information Service.
Virtue, E. (1999). Only the brave stay here. The Gleaner. 8A–
11A.
Walker, S., Belgrave, F.Z., Bauner, A.M., Nicholls, R.W. (1986).
Equal to the Challenge Perspectives, Problems, and Strategies
in the Rehabilitation of the Nonwhite Disabled. Bureau of
Educational Research, School of Education. Washington, DC:
Howard University.
Walker, S., Belgrave, F.Z., Nicholls, R.W., Turner, K.A. (1991).
Future Frontiers in the Employment of Minority Persons with
Disabilities. Washington DC: Howard University, Research and
Training Center.
Epidemiology, Treatment Care and
Support of HIV in Jamaica
Dr. Sheila Campbell-Forester
Chief Medical Officer
Ministry of Health
51
Presentation Outline




Overview of the Epidemic
Jamaica’s response to Treatment Care and
Support for people living with HIV/AIDS
(PLWHA)
Major challenges to achieving universal
access in treatment
Key recommendations in moving forward
52
Overview





First case of HIV imported into Jamaica in 1982
Very little was known about the behaviour of
the virus.
The only message we had was that “AIDS kills”.
Stigma and discrimination – a challenge
The absence of adequate treatment, care and
support for PLWHA.
53
Jamaica
Annual AIDS Case Rates in Jamaica,
St. James & Kingston/St. Andrew
(Rate per 100,000 Population) 1982 - 2007
KSA
STJ
Jamaica
Rate per 100,000 pop.
120
100
80
60
40
20
0
KSA
'82 '83
0.1 0.1 0.3 0.3 2.6
1.2
STJ
Jamaica
'85 '86 '87
0
0
'88 '89
3
'90 '91 '92
5.3 6.1 11.7 9.4
1.8
3
'93 '94 '95
'96 '97 '98
'99 '00 '01
'02 '03
'04 '05 '06
'07
13 21.2 32.9 28.8 33.5 38.7 54.6 55.7 50.6 53.7 61.2 57.7 68.9 60.5 55.3
8.4 13.1 17.3 43.6 57.3 44.8 62.1 55.6 71.7 76.1 92.6 89.5 103 92.5 112 97.2 75.9
0.1 0.3 1.4 1.4 2.6 2.8 5.8 5.4 8.8 13.5 20.6 19.7 24.5 25.9 35.9 35.2 36.1 37.9 40.5 42.1 50.7 44.4 41.3
54
HIV/AIDS IN JAMAICA
Sero-prevalence among adults
1.6%
Estimated No. with HIV/AIDS
27,000
Est. No. unaware of HIV status
18,000
No. of persons in need of ARV
6-7000
No. of persons currently on ARV
>5,500
55
A Comprehensive Response


Treatment, care and support a key
strategic line for Jamaica towards
achieving universal access by 2010
Prevention is critical to success and this
includes implementation of behaviour
change strategies with their foundation
in knowledge, attitudes and practices.
56
A comprehensive response


A study in 2008, demonstrated that there was
no knowledge change between 2004 and
2008 in the 24-59 age group but there was a
decline in knowledge in the youth group
where approx. 10% were not able to endorse
the three preventive practices.
This is a challenge for us and contributes to
the gap between those who are infected and
those who know their status.
57
HIV/AIDS KNOWLEDGE
*Correct preventive practices is a Ministry of Health HIV/AIDS Program indicator which measures the proportion of the population able to
endorse correct HIV/AIDS preventive practices. The younger age cohort (15-24 year olds) must endorse 3 preventive practices: condom
use always, one faithful partner, abstinence while the older age cohort (25-49 year olds) must endorse 2 preventive practices: condom use
always, one faithful partner
Hope Enterprises Ltd.; June 2008; 2008
KABP Survey Findings Presentation
58
Jamaica’s Response to Treatment
Care and Support for PLHIV
59
Major pillars of our response


Increased access to Anti-Retroviral drugs (ARVs)
 prevent mother-to-child transmission (pMTCT)
programme
 testing
 access for all infected persons living with HIV
Health system strengthening
 An integrated programme with treatment, care, and
support and prevention
 Community involvement and empowerment
 Strengthening Leadership
60
Major pillars of our response (cont.)





Improving health infrastructure including
laboratory capacity and laboratory information
system
Capacity building
Strengthened monitoring and evaluation
Building Partnerships and creating a
supportive environment
Communications
61
ARV Access






Pro poor health policy
Abolition of user fees providing universal
access to all
More than $1.2 B savings to the population
ARV’s free
Visits to health centres increased
This has implications for early detection and
for treatment, care and support.
62
Access to ARV’s


Jamaica’s Treatment Programme started in
2003 with support from the Clinton
Foundation and was later augmented by a
Global Fund Grant of US$23 Million
This provided the opportunity to establish a
decentralised treatment programme seeing
the establishment of 18 Treatment sites
across the Island
63
Access to ARV’s





Access to ARV’s scaled up through our network of
Primary health care facilities model)
Improvement in quality of care – reducing the
waiting time at health facilities, the quality and
ambience of the workplace, using patient flow
analysis and space planning.
Contact Investigators, and Community Peer
Educators provide the community support.
Voluntary, testing and counselling at treatment sites.
Collaboration with supportive partners e.g. NGO’s,
other agencies
64
Jamaica
Annual AIDS Case Rates by Sex
(Per 100,000 population): 1982 - 2007
Male
Female
60
Rate per 100,000 pop.
50
40
30
20
10
0
Male
Female
'82
'83
0.09 0.09
0
0
'84
0
0
'85
'86
'87
'88
'89
'90
'91
'92
0.26 0.6 1.69 2.2 3.85 3.8 6.39 7.7
0
0
'93
'94
'95
'96
'97
'98
'99
'00
'01
'02
'03
'04
'05
'06
'07
11 16.1 25.7 24.2 29.1 31.9 41.7 41.7 39.6 44.5 46.9 46.3 53.3 50 33.6
1.28 0.85 1.6 1.99 5.35 3.26 6.62 11 15.2 14.6 18.6 18.2 27.5 31.6 33 31.3 34.3 38 48.2 38.8
25
65
Jamaica
AIDS Cases & Deaths
Reported Annually in Jamaica (1982 to 2007)
1600
Cases
Deaths
Number of Cases
1400
1200
1000
800
600
400
200
0
'82 '83 '84
'85 '86 '87 '88 '89
'90 '91 '92 '93 '94
'95 '96 '97 '98 '99 '00
'01 '02 '03 '04 '05
'06 '07
Cases
1
1
0
3
7
35
36
65
70 143 135 219 335 511 491 609 643 892 903 939 989 1070 1112 1344 1186 1104
Deaths
0
1
1
0
9
18
21
40
37 105 108 146 200 269 243 393 375 549 617 588 692 650 665 514 432 320
66
Estimation of HIV MTCT Rate with
Maternal HAART in Jamaica


Jamaica: > 85% receive maternal HAART
(highly active antiretroviral therapy);
> 90% infants receive ARV’s
During Jan 2006 – Dec 2007, (2 years),
estimated MTCT rate was 4.75% (with
19 of 400 PCR’s positive) [Polymerase Chain
Reaction test]
West Indian Medical Journal, March 2008
67
Challenges & Factors
Driving the Epidemic
68
Factors Driving the Epidemic









Early initiation of sexual activity
Limited life-skills and sex education
Insufficient condom use
Multiple sex partners
Stigma and Discrimination
Commercial and transactional sex
Substance abuse: crack/cocaine, alcohol
Men having sex with men & homophobia
Gender inequity and gender roles
69
Jamaica’s Response
The Way Forward to universal
Access
Highly Active HIV Prevention
70
Strategic Way Forward
2007-2012
71
Goal

Universal access to Prevention,
treatment care and support services
72
Behavioral
Change
TREATMENT/
ARV/STI/
ANTIVIRAL
Highly Active
HIV Prevention
Biomedical
Strategies
Social Justice
and Human
Rights
Community involvement
Leadership & scaling up of
treatment/prevention efforts
Combination Prevention
STI = sexually transmitted infections
73
Strategic Areas 2007-2012

Prevention





Building Capacity for HIV prevention in all sectors
Structured targeted interventions among vulnerable
populations - MSM, CSW & IEW*
Comprehensive HIV/AIDS response in the Education
sector
Treatment Care and Support
Enabling Environment and Human Rights



Amendment of the Public Health Act
Anti-discrimination Legislation
Stigma reduction activities
* men who have sex with men (MSM), commercial sex workers (CSW), intimate
entertainment workers (IEW)
74
Strategic areas

Empowerment and Governance





Strengthened capacity and commitment of the Health
Sector
Strengthened capacity of other key sectors
Three ones (M&E, Strategic plan, One Authority)
Effective Procurement
Monitoring and Evaluation


Comprehensive and standard data collection tools
Routine availability and utilization of reports for
programme planning
75
Policy

Advocacy for Supportive Policy and
Legislative Framework to Facilitate
interventions among key populations MSM, CSW, Youth, Young Men, the
Homeless, Drug users, PLHIV etc.
76
The face of AIDS in Jamaica
77
"Investment in AIDS will be repaid a
thousand-fold in lives saved and
communities held together.”
- Dr. Peter Piot, Past Executive Director,
UNAIDS
78