Program

Health

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Program Description

Jamaican Context

Chronic diseases dominate Jamaica’s epidemiological setting. Like other chronic diseases such as cardiovascular disease and diabetes, reproductive health disorders are rooted in unhealthy lifestyle behaviors such as early sexual initiation, multiple partners, unprotected sex, gender-based violence, and alcohol and drug use. These behaviors among Jamaica’s youth increase the risk of sexually transmitted infections, as well as the spread of HIV/AIDS, and contribute to a number of health and social problems for the country. Recognizing this causal relationship, the Government of Jamaica has adopted a “healthy lifestyles” policy that emphasizes early intervention to encourage young people to pursue healthy behaviors.

The Jamaican HIV/AIDS epidemic is characterized as generalized but with low prevalence. However, there is a concentrated epidemic among homosexual and bisexual men, female commercial sex workers, and those with an existing sexually transmitted disease. There is considerable under-reporting of HIV infection and AIDS cases and for this reason the magnitude of the epidemic in Jamaica is not known with precision.

USAID’s Assistance

USAID has been a major donor for family planning and reproductive health programs in Jamaica for more than forty years. Since the 1960s, total fertility rates have declined significantly and contraceptive prevalence rates have increased to an impressive 70%. Building on this initial success, USAID narrowed its target group to address a gap in the reproductive health program—namely, youth—and expanded its health assistance to include HIV/AIDS prevention and control. USAID’s assistance will continue to address adolescent reproductive health and HIV/AIDS while expanding the focus to include substance abuse and violence. The target groups will continue to be youth, those sub-groups that are especially at risk for HIV infection, and people living with HIV/AIDS.

Expected outcomes of USAID assistance include:

• Healthy Behaviors among Adolescents Increased USAID will address youth in a more holistic manner. USAID’s assistance will build on the foundation of earlier adolescent reproductive health initiatives, while broadening the core activities to address two additional behavior areas—gender based violence and substance abuse. It will seek to promote healthy lifestyles in accordance with Jamaica’s national health program. To achieve the targeted behavioral change, program activities will include:
  • Expanding access to youth-friendly services,
  • Improving knowledge, attitudes, and skills related to healthy behavior,
  • Increasing community support and involvement, and - Supporting implementation of improved national policies and guidelines.
• Impact of HIV/AIDS Mitigated among Targeted At Risk Populations To maximize impact on HIV/AIDS prevalence, USAID’s assistance will target the populations at risk of HIV transmission in high prevalence areas of the country. Activities will emphasize engagement at the community level in prevention, care, and treatment, as well as support for policy reform at the national level. USAID will mobilize resources from the private sector, NGOs, and the religious community and will collaborate closely with other major donors, such as the World Bank and Global Fund in support of Jamaica’s HIV/AIDS National Strategic Plan. Addressing issues of stigma and discrimination will also be a high priority.

Increased healthy behaviors among youth and mitigated impact of HIV/AIDS among the most-at-risk sub-populations—both anticipated outcomes of USAID’s health assistance--support the Jamaican government’s “healthy lifestyles” policy by improving adolescent health and stemming the HIV/AIDS epidemic.