The COVID-19 pandemic has put a strain on Dominica’s already fragile health system, but by revitalizing a primary health care approach and providing support to other health workers through CHWs, the country is in a better position to respond to the crisis.
Donna Edwards is one of the community health workers (CHW) who have been instrumental in providing primary health care services to communities at risk of COVID-19 in Dominica’s Roseau Health District.
“I decided to be trained to become a Community Health Aide because I have a love for my community and other communities. During the pandemic, we have been able to teach hand-washing techniques, proper wearing of masks and social distancing,” said Donna.
The group of CHWs received initial training in people- and community-centred health care from September 2018 to March 2019, with the Community Health Aide Programme. This was part of a larger primary health care (PHC) and health systems strengthening programme supported by PAHO/WHO and funded by the UHC Partnership, one of WHO’s largest initiatives on international cooperation for UHC.
The urgent need for community health workers (CHW) became clear in 2017, when hurricane Maria devasted the island of Dominica and inflicted major damage on the health system. Nurses left the island and the remaining health staff became overwhelmed. A thorough post-hurricane assessment of the health system and its needs was conducted by PAHO/WHO with the aim to strengthen and rebuild. The training of CHWs was one of the many recommendations, and the Community Health Aide programme was initiated with the support of the Ministry of Health, Wellness and New Health Investment of Dominica in partnership with PAHO /WHO and the UHC Partnership.
Dominica has a long history in primary health care, with a focus on providing local health and social services to communities based on their needs. The UHC Partnership has allowed Dominica to strengthen and intensify this approach, and implement important changes within the system that places primary health care at the centre of the country’s drive to improve health and well being.
The UHC Partnership works in 115 countries through funding provided by the European Union (EU), the Grand Duchy of Luxembourg, Irish Aid, the Government of Japan, the French Ministry for Europe and Foreign Affairs, the United Kingdom - Foreign, Commonwealth & Development Office and Belgium.
When COVID-19 struck in early 2020, CHWs were recognized for their important role in the national emergency response and in delivering essential health services to the community. The Minister of Health, Wellness and New Health Investment, Dr Irving McIntyre, acknowledged the invaluable role of the CHWs at the first level of care in Dominica.
“The training received during the Community Health Aide Programme proved adequate and instrumental in Dominica’s response to COVID-19. The CHWs played a significant role in contact tracing,” Dr McIntyre said.
PAHO/WHO Representative for Barbados and the Eastern Caribbean Countries, Dr Yitades Gebre said, “CHWs represent an important health resource to the country at the time of this global pandemic and increasing demand to provide wide range of health services.
The COVID-19 pandemic has put a strain on Dominica’s already fragile health system, but by revitalizing a primary health care approach and providing support to other health workers through CHWs, the country is in a better position to respond to the crisis. A strong and resilient health system is essential for effective public health measures of testing, tracing, isolating and treating persons with COVID-19 to slow the spread and prevent community transmission.
So far, Dominica has managed to prevent community transmission through its effective public health measures, including the actions and support of the CHWs who continue to be at the heart of the COVID-19 response.
