Integrating places of worship (PoWs) into the primary care pathway to prevent and control non-communicable diseases (NCDs) in the Caribbean

S. Harding, U. Read, K. Cruickshank, Kings College London, United Kingdom; R. Gobin, M. Rambaran, P. Mohamed, T. Thomas, School of Medicine, University of Guyana; P. Ricketts, D. Johnson, Ministry of Health, Dominica; Shamdeo Persaud, Ministry of Health, Guyana; M. Bullock DuCasse, T. Davidson, Saddler, Ministry of Health Jamaica; D. Simeon, J. Hospedales, Caribbean Public Health Agency.

Funding Obtained:

UK-MRC Health Systems Strengthening (HSS) Project, amount unknown

Start Date:

April 2016

End Date:

March 2019

Rationale:

The project is most advanced in Guyana. The administrative and staffing infrastructures are in place. Partnerships have been established with the Ministry of Public Health, PAHO/WHO and the religious community – Christians, Muslims and Hindu. 8 Primary Health Centres have been identified in each of 2 administrative regions (3 and 5) based on location, number of staff and size of population served. PHCs were paired according to similarity of these characteristics, then each member of each pair was randomly assigned to either intervention or comparator arm. All PoWs within the catchment areas of the selected PHCs were mapped. PHC-PoW clusters were created by selecting at least 1 temple, 1 church and 1 mosque within the catchment area of each PHC; POWs were selected primarily on the basis of congregation size (largest available).The first project Steering Committee meeting was held on April 28th, 2017 at the University of Guyana, chaired by Prof Nigel Harris, Chancellor of UG. Progress reported included: Study protocol, Concept Mapping Protocol, Sampling Protocol, Qualitative Methods Protocol, Quantitative Baseline Survey: Questionnaire completed. PoW Readiness Assessment Questionnaire, PHC Readiness Assessment Questionnaire, Health Advocates training manual drafts under review. These will be shared with the other study sites
The project was launched in Jamaica on July 3, 2017, with more than 80 attendees and all media houses present. Two major umbrella groups of Christian organizations were represented (Jamaica Council of Churches [JCC] and Jamaica Umbrella Group of Churches [JUGC]). The JUGC, which includes the JCC, represents 96% of Christian organizations on the island. The JCC is the older group (76 years). Greetings from the JCC and JUGC were passionate, positive, and supportive; SDA representative said opening prayer. The Minister of Health gave a well thought out, passionate, engaging and supportive speech which was well received. He made it clear that he is targeting the Churches as a policy position in the NCD response and felt privileged to be with us. Extensive media coverage followed the launch.
The Project PI in Dominica, Dr. Paul Ricketts is on extended medical leave, and this has impacted their implementation