National Policy for the Promotion of Healthy Lifestyles in Jamaica

Objectives

The Five-Year Strategic Plan for Promoting Healthy Lifestyles seeks to improve health and well-being by enabling healthier choices, reducing preventable behavioural risks and creating safe, stimulating and supportive living, learning and working conditions.[1][2]It responds to Jamaica’s major burden of chronic diseases, sexually related conditions including HIV/AIDS, and violence-related injuries and deaths.[1][3]

• Promote healthy lifestyles to reduce risks associated with cardiovascular disease, diabetes, hypertension, obesity, cancer, HIV/AIDS, violence and injury.[4][5]
• Apply the six Caribbean Charter on Health Promotion strategies: formulate public policy, reorient health services, empower communities, create supportive environments, develop personal skills and build alliances, particularly with the media.[1]
• Prioritise daily moderate physical activity, healthier diets and food production, tobacco prevention and control, limited alcohol consumption, appropriate sexual behaviour, and self-esteem, resilience and life skills.[3][5][6]
• Prevent violence, unintentional injury and suicide, with particular attention to young children, adolescents, young adults and economically disadvantaged or high-risk communities.[7][5][8]
• Develop healthy schools, communities and workplaces through supportive policies, legal frameworks, regulation, education, training, research, guidelines and public-awareness initiatives.[9][6]
• Strengthen protective factors through parenting and community support, conflict resolution, mentoring, peer counselling, supervised after-school activities and skills training.[4]

The intended results are lower disease, violence and injury impacts; reduced sexual risk; stronger individual and community protective factors; and a lower economic burden from chronic diseases, HIV infection and violence.[5]The Plan frames health promotion as a shared responsibility of individuals, families, communities, public authorities, industry and wider society.[1]

Implementation

Implementation uses an integrated, intersectoral health-promotion model that embeds prevention and healthier behaviour in daily life across homes, schools, workplaces, health facilities, sports and recreation settings, churches, clubs, communities and public places.[10][1][11]It combines policy, environmental change, education, targeted interventions and treatment-linked lifestyle support, while recognising socio-economic, political, cultural and physical influences on health.[10][9]

• Establish a National Advisory Committee on Health to advise the Minister of Health on policy, strategic planning, legal and policy frameworks, intersectoral collaboration, resource mobilisation and review of implementation progress.[12]
• Appoint a Management Team, chaired by the Ministry of Health, to oversee day-to-day implementation of subprogrammes, meet at least quarterly and receive support from Technical Advisory Groups.[12]
• Assign programme component management teams responsibility for planning and implementing individual programme areas, meeting at least monthly, reviewing progress against indicators and taking corrective action.[2]
• Translate five-year component plans into annual programmes aligned with the Government’s annual budgeting cycle, and implement components incrementally according to available resources and capacity.[2]
• Build partnerships among government ministries and agencies, the private sector, the National Health Fund, non-governmental and community-based organisations, unions, businesses, consumer groups, the media, the entertainment industry and the food and beverage industry.[2][8][13]
• Develop institutional, community-based and hospital-based models for physical activity, healthy eating, reproductive health, violence prevention and healthy settings, supported by public health centres, outreach, counselling, mentoring, peer educators and support groups.[11][8]
• Introduce practical protective measures, including smoke-free government buildings and public places, controls on tobacco promotion, improved food labelling, expanded condom availability and access to reproductive health and violence-prevention services.[11][8][13]

Governance includes progress reporting from programme teams to the Management Team and onward to the National Advisory Committee on Health, the Minister of Health and Cabinet through the Human Resource Council or Committee.[2][12]The Committee reports annually to the Minister, while the Minister reports to Cabinet and receives implementation support from the Human Resource Committee of Cabinet.[12]Monitoring includes programme indicators, research on knowledge, attitudes, practices and beliefs, behavioural surveillance in schools and institutions, evaluation of physical activity, diet and violence-prevention interventions, and enhancement of the Jamaica Injury Surveillance System and Health GIS, Jamaica.[2][11][8]

Annual programmes are intended to inform budget requests, and resources are to be mobilised from government, the private sector, the National Health Fund and non-governmental organisations.[2]The Plan does not specify total budgets, funding allocations, financing gaps, quantitative indicator targets, reporting templates or a detailed evaluation methodology.[2][11][8][13]

Monitoring & Evaluation

The framework establishes a multi-level monitoring and accountability structure, combining programme-level indicator tracking, management oversight, periodic reporting to the Minister of Health and Cabinet, and targeted research, surveillance and evaluation activities.[1][12][2][11][8]

• Require Programme Teams to plan, implement and evaluate their assigned areas, submitting progress reports to the National Advisory Committee on Health and the Minister of Health at least quarterly.[1]
• Require programme component management teams to meet at least monthly, assess progress against approved programme indicators, take corrective action and feed results into Management Team reporting.[2]
• Use monthly Management Team meetings to monitor implementation progress and provide feedback on delivery strategies.[2]
• Require the National Advisory Committee on Health to evaluate implementation of the Policy and Strategic Plan, recommend policy and programme strategies, and report annually to the Minister of Health.[12]
• Report through the Minister of Health to Cabinet, including through the Human Resource Committee or Human Resource Council of Cabinet, which provides direction and implementation support.[1][12][2]
• Use evaluation findings to develop annual programmes, secure ministerial approval in consultation with the Advisory Committee, and support budget submissions through relevant ministries or agencies.[2]
• Evaluate pilot models for healthy schools, healthy communities and healthy workplaces.[6]
• Conduct research on knowledge, attitudes, practices and beliefs concerning smoking and marijuana or drug abuse, and assess the effects of physical-activity and dietary interventions on target groups.[11]
• Develop behavioural surveillance in schools and other institutions, including a Healthy Schools Behavioural Surveillance model addressing sexual behaviour.[11][8]
• Develop evaluation systems for community- and hospital-based violence-prevention programmes; assess effects on risk behaviours across schools, communities and workplaces; and enhance the Jamaica Injury Surveillance System and Health GIS, Jamaica.[8]
• Use research, evaluation and accurate data to inform public education and intended behaviour change.[9]

Although approved programme plans include indicators for outputs or components, the supplied material does not define a detailed quantitative indicator set, baselines, targets, surveillance methodology, reporting templates, responsible reporting bodies or formal accountability procedures beyond the governance and reporting arrangements described.[9][2][11][8][13]

Costing & Financing

No overall policy budget, programme costings, allocations, funding-gap assessment or economic assumptions are specified.[3][4][2][11][8][13]Financing is intended to be linked to annual government budgeting, supported by inter-sectoral resource mobilisation and implementation phased according to available resources and capacity.[12][2]

• Translate five-year component plans into annual programmes aligned with the Government’s annual budgeting cycle, and submit approved annual programmes as budget requests through relevant ministries or agencies.[2]
• Mobilise financial and other support from government, the private sector, the National Health Fund and non-governmental organisations.[2]
• Assign the National Advisory Committee on Health responsibility for advising on resource mobilisation alongside policy, legal frameworks and inter-sectoral collaboration.[12]
• Implement programme components incrementally according to available resources and implementation capacity.[2]

The document presents chronic disease, HIV/AIDS and violence as major economic burdens rather than as financed policy commitments. Hospital-care expenditure for cardiovascular diseases and diabetes mellitus increased from Jamaican dollars 316 million in 1996 to Jamaican dollars 663 million in 1999.[3]Total public- and private-sector ambulatory and hospital-based cardiovascular disease care was projected at Jamaican dollars 1.8 billion in 1999, including Jamaican dollars 332 million in hospital-based costs.[3]

A CAREC/UWI study estimated that HIV/AIDS could cost Jamaica up to 6.4% of gross domestic product by 2005, equivalent to Jamaican dollars 70 billion in 1997 terms.[4]Violence accounted for 11% of the Kingston Public Hospital major trauma hospital budget, contributed to cancellation of one in three elective lists per week, and had an intensive care unit cost of Jamaican dollars 8 million in 2002.[4]Reported 2002 hospital-care costs were Jamaican dollars 12,962 per patient, ranging from Jamaican dollars 3,000 to Jamaican dollars 128,000.[4]