Health Promotion Strategic Plan for NCDs in Jamaica 2020-2025

Objectives

Jamaica’s 2020-2025 Health Promotion Strategic Plan for non-communicable diseases provides a national collaboration framework led by the Ministry of Health and Wellness to reduce exposure to modifiable risk factors, promote health across the life course and create health-promoting environments.[1][2]It supports the risk-factor-reduction and health-promotion priority of the 2013 National Strategic and Action Plan for Non-communicable Diseases and contributes to the Ministry’s Vision 2030 commitment to healthy lifestyles.[1]The plan aligns with the Ministry vision of “Healthy People, Healthy Environment” and the Health Promotion and Protection Branch vision of “Healthy Choices, Safe Environment, Productive Jamaica”.[3]

• Reduce behavioural risks associated with tobacco use, harmful alcohol use, unhealthy diets and physical inactivity, while addressing social, environmental and economic determinants, inequities, gender and human rights.[4][5]
• Increase awareness of hypertension and diabetes status among people aged 15 years and over to at least 80% from baseline by 2025.[6]
• Increase sufficient physical activity, fruit and vegetable consumption, and reduce sugar-sweetened beverage consumption and salt or sodium intake, each by 5% by 2025.[1][7]
• Reduce harmful substance use among people aged 13 years and over, including reducing harmful use among adults by 1%, reducing it among young people by 3%, and increasing the age of initiation among young people to 14 years.[8]
• Develop and implement a five-year Mental Health Promotion Plan by 2025 to strengthen self-care, access to education and support, and supportive environments for positive mental health.[9]
• Advance prevention, health literacy and chronic-disease care education through culturally and age-appropriate public education, social marketing and life-course interventions.[10][11]

The strategic framework applies the Social Ecological Model and Life Course Concept. It addresses health determinants and behaviours across individual, interpersonal, community, organisational and policy or enabling-environment levels, and from preconception and pregnancy through childhood, adolescence and adulthood.[1][12]The plan therefore prioritises settings-based health promotion in schools, workplaces, communities and health-care facilities, rather than disease-specific action alone.[4][2]

Its wider national context includes five priority programme areas: risk-factor reduction and health promotion; comprehensive and integrated management of non-communicable diseases and injuries; surveillance, research, monitoring and evaluation; public policy and advocacy; and leadership, governance and capacity building.[3]The plan responds to a substantial burden from cardiovascular diseases, cancer, chronic respiratory diseases, diabetes, sickle cell disease, mental health conditions and injuries.[4]

Implementation

Implementation uses a multisectoral, multi-component delivery model in which the Ministry of Health and Wellness sets policy, norms and standards, while Regional Health Authorities deliver public-health services and support monitoring and evaluation across four health regions.[3]The public delivery network comprises 24 hospitals, six specialist institutions, 13 health departments and 316 health centres.[3]Action is intended to combine supportive environments, community participation, partnerships, empowerment and equity across schools, workplaces, communities and health-care settings.[12]

• Expand Jamaica Moves, including school, workplace and community interventions on physical activity, healthy eating, age-appropriate health checks and broader non-communicable disease risk reduction.[13][10]
• Deliver school programmes through physical-activity breaks, activity beyond timetabled physical education, National School Moves Day, healthy-food promotion, school gardening, nutrition screening, mental-health literacy and evidence-based drug prevention.[14][7][15]
• Strengthen workplace wellness through physical-activity initiatives, nutrition tools and screening, wellness committees, substance-use prevention and referral, employee-assistance arrangements, mental-health counselling and manager training.[16][17]
• Support communities through social marketing, healthy and safe activity zones, organised activities, stakeholder training, faith-based and community-based organisations, healthy food demonstrations, backyard gardens, family programmes and infant and young-child feeding support.[18][19]
• Use legislation, taxation, labelling, advertising controls, food-industry engagement, public education and treatment services to address tobacco, alcohol, unhealthy diet and inactivity.[5][13]
• Build health-promotion capacity among Ministry staff, clinical personnel and external partners through universities, webinars, peer learning, certification and five-year training arrangements.[20]

Partners include Regional Health Authorities, other government ministries and agencies, the National Health Fund, National Family Planning Board, National Council on Drug Abuse, schools, employers, universities, professional bodies, civil-society, faith-based and community organisations, and international partners such as the Pan American Health Organization.[3][21][22]Named disease-focused partners include the Heart Foundation of Jamaica, Diabetes Association of Jamaica and Jamaica Cancer Society.[22]

Operational planning is informed by stakeholder consultations, key-informant interviews and SWOT analyses, and builds on initiatives such as Health Promoting Schools, Jamaica Moves in Schools, the Jamaica Food and Nutrition Security Policy and the National School Nutrition Policy.[5][13]Implementation risks include scarce resources, insufficient funding, staffing shortages, weak policy enforcement, natural disasters, disease outbreaks, violence, poverty, political change and limited engagement beyond the health sector.[23]

Monitoring is to begin with a monitoring and evaluation plan, use programme data and national surveys including the Jamaica Health and Lifestyle Survey and Global School-based Student Health Survey, and involve quarterly review meetings, a mid-term evaluation and a final evaluation in 2025.[10]Indicators cover programme reach, training, school, workplace and community implementation, awareness, physical activity, nutrition, mental health and substance-use measures.[11][14][8]

Monitoring & Evaluation

Monitoring and evaluation are embedded as a priority programme area, with a plan to develop an initial monitoring and evaluation framework, use routine programme data and national surveys, conduct quarterly implementation reviews, and complete mid-term and final evaluations in 2025.[3][10]

• Track progress towards the 2025 outcome objectives, including awareness of hypertension and diabetes status, physical activity, diet, salt or sodium and sugar-sweetened beverage consumption, harmful substance use, and implementation of a five-year mental health promotion plan.[1][6]
• Use the Jamaica Health and Lifestyle Survey, Global School-based Student Health Survey, Healthy Lifestyle surveys, school-based body mass index assessments and other programme-monitoring data as evidence sources.[21][10]
• Review monitoring findings quarterly through meetings of key staff and use results to identify implementation adjustments.[10]
• Conduct a mid-term evaluation and partner workshop, followed by a final evaluation in 2025 to assess achievements and inform subsequent health-promotion planning.[10]
• Measure coverage of social marketing in schools, workplaces and communities; completion and use of the monitoring and evaluation plan; delivery of health-promotion training; and implementation of school, workplace and community programmes.[11][6]
• Monitor physical-activity delivery through indicators on participating schools and workplaces, trained stakeholders, safe activity zones, organised community activities and implementation of physical-activity measures.[14][24]
• Assess nutrition interventions through nutrition-environment assessments, policy implementation, healthy-food measures, vendor certification, nutrition screening, body mass index assessments, use of nutrition professionals and reports on infant and young-child feeding support.[25][26][7]
• Track substance-use prevention through student and workplace reach, training registers, screening, brief intervention and referral implementation, employee programme completion, community interventions, social-marketing impact surveys, and baseline and impact surveys.[8][15][17]
• Monitor mental-health promotion through school mental-health literacy, workplace counselling access, community promotion programmes and the presence of supportive environments for positive mental health.[9][27]
• Use stated implementation targets, including reaching 147,250 students through evidence-based school drug-prevention programmes; training personnel in 70% of cohort schools; implementing screening, brief intervention and referral in 50% of cohort schools; and reaching 20% of targeted workplaces.[8]
• Track school physical-activity targets of 75% of cohort schools providing three five-minute activity breaks, 60% institutionalising one hour of activity outside timetabled physical education, and 50% of physical education teachers in cohort schools receiving training.[24]
• Assess workplace and community targets, including 30% of employees in targeted workplaces completing a substance-use programme, 10% reducing use, 50% of targeted workplaces providing mental-health counselling, 80% of targeted communities implementing an NCD-status awareness initiative, and 50% of targeted communities meeting specified physical-activity targets.[17][18]
• Strengthen monitoring because existing health-promotion outcomes are not adequately captured, and use additional research, including research on social determinants and cultural beliefs, to validate and refine interventions.[21][23][20]

The material identifies surveillance needs for alcohol-advertising controls and enforcement of smoking bans, restrictions on alcohol sales to minors and related regulatory measures.[5][13]Detailed indicator definitions, reporting schedules, surveillance governance and formal accountability arrangements are not consistently specified beyond the listed reports, reviews, evaluations, technical working groups and implementing partners.[14][25][27]

Costing & Financing

The plan presents non-communicable disease prevention as an economically important and cost-effective investment, but does not provide a total strategy budget, detailed costing framework, funding-gap estimate or comprehensive financing plan.[28][5][13]

• Recognise that the four major non-communicable diseases account for about 15% of Jamaica’s health budget, while the estimated macroeconomic burden of non-communicable diseases and mental health conditions over 2015 to 2030 is US$18.45 billion.[28]
• Note a reported return of 2.10 Jamaican dollars for each dollar invested in non-communicable disease prevention and control.[28]
• Project that implementing 17 World Health Organization-recommended interventions could save more than 5,700 lives, restore 67,400 healthy life years, avoid more than 47.3 billion Jamaican dollars in productivity losses, save 29.8 billion Jamaican dollars in direct medical costs, and raise gross domestic product by 0.11 percentage points by year five.[28]
• Use tobacco-tax revenue allocated to the National Health Fund and consider increased tobacco and alcohol excise taxes as potential financing measures.[5][13]
• Address resource requirements for staffing, infrastructure, equipment, materials, continuing education, formal health-promotion training, research, technical assistance and programme delivery.[21][23][22]
• Mitigate risks from scarce resources, competing programmes, insufficient health-promotion funding, staffing shortages and overcrowded facilities.[23]

Most intervention sections specify activities, partnerships and performance targets without assigning costs, budget allocations, expenditure ceilings, financing sources or resource-mobilisation targets.[10][14][8][17]