CHIEF Medical Officer Dr Jacquiline Bisasor-McKenzie has declared Jamaica’s decades-old primary health-care model as no longer fit for purpose, saying a system built to combat maternal and childhood illnesses must now be transformed to deal with the country’s growing burden of chronic diseases.

Speaking during last Thursday’s Health Hurricane Response Programme (HHRP) working breakfast, Bisasor-McKenzie said the country’s network of more than 320 primary health-care facilities was largely established during the 1960s and 1970s, when reducing maternal and infant deaths was Jamaica’s most pressing health priority.

Today, however, diabetes, hypertension, cardiovascular disease, and other non-communicable diseases (NCDs) have overtaken those concerns, requiring a fundamentally different approach to health-care delivery.

“There was a need for reform at this time. There have been several reforms that have happened in the health system over time, and why this reform was necessary was to ensure that we are able to treat the conditions that we are seeing now because what drives health system planning are what drives morbidity, what drives mortality and also what sustains health,” she said.

She explained that the existing classification of type one to type five health centres reflected the country’s health needs more than five decades ago, when community-based services focused heavily on antenatal care, childhood immunisation and infectious diseases.

“Now NCDs is a major problem that we have. Diabetes, hypertension, cardiovascular diseases, this is where our problems lie. Can our type one health centre that just was built for a midwife manage the problems associated with NCDs? No. Can our type two health centres that were built to manage immunisations, antenatal, postnatal care, sanitation issues, can they manage NCDs? No,” Bisasor-McKenzie said.

The chief medical officer argued that inconsistent staffing and services have also eroded public confidence in many health centres, with patients often bypassing them because doctors are not consistently available.

Under the reform programme, type one, two and three facilities will be consolidated into community health centres designed to provide more reliable services, including permanent medical officers, nurses and community health aides, while expanding treatment for chronic diseases alongside traditional maternal and child healthcare.

District and comprehensive health centres will also receive additional diagnostic and specialist services, reducing the need for patients to travel to hospitals for routine screening and follow-up care.

Bisasor-McKenzie said the reforms are being accelerated through the HHRP, which will upgrade 120 facilities islandwide, including 41 in the five western parishes affected by Hurricane Melissa.

“While Hurricane Melissa was, indeed, a terrible thing that happened, it certainly has a benefit in that we are able to do the necessary upgrades to the health centres in that area…we’re really looking forward to getting these health centres upgraded so that we can be able to offer the care that is needed to the population,” she said.