The number of people with dementia is not currently routinely monitored in Jamaica. However, in 2011, the Ministry of Health and Wellness, with technical support from PAHO conducted a multi-stakeholder assessment of the National Health Information System (NHIS) which followed the guidelines of the Health Metrics Network (HMN) Framework and used the HMN Assessment Tool version 4.00. The assessment evaluated six key components of the NHIS, Resources, Indicators, Data Sources, Data Management, Information Products and Dissemination, and Use (MOH, 2011).

The assessment report demonstrated that the NHIS’ strengths included its range of sources, including census data, national surveys, and a vital registration system, as well as efficient monitoring of core health indicators (which did not include dementia at that time). Its weaknesses included lack of stakeholder collaboration and participation, lack of adequate infrastructure, human resources, poor reporting mechanisms and limited use of data. Following consultations with various stakeholders, recommendations were produced which continue to be implemented to the present day and which may serve to compliment some of the technical and policy products of the STRiDE project.

For example, it was recommended that private sector health professionals be targeted through their professional associations and that legislation be introduced to ensure private-sector compliance and cooperation in data sharing with the NHIS committee. This recommendation is particularly relevant for dementia data gathering as dementia data may be housed with private sector mental health professionals (due to its stigmatised nature and the ease of accessibility of private sector psychiatrists over public sector ones) and therefore not accessible to the NHIS. It is important to note that the data collected by the NHIS is used to inform national level policy and planning.

Regarding expansion of data sources, it was recommended to explore possibilities of maximising opportunities of current national surveys, which may provide a means to routinely capture dementia-related data as this indicator is not included currently in any of the national surveys or census data collection tools.  Other reported recommendations were to improve health workers ability to diagnose diseases through continuing education and address programme-specific initiatives which could contribute data to the wider NHIS. In the case of dementia, under-diagnosis, or late diagnosis, which is a common issue in LMICs, are due in part to a lack of awareness as well as stigma around dementia and associated myths, such as that it is a normal part of ageing.

Programme-specific initiatives go hand in hand with another recommendation made by the assessment report which calls for better representation among data sources, including adolescent health, mental health, and environmental health assessments. Lobbying for the inclusion of dementia can improve representation of mental health among older persons, as well as the physical and mental health of their carers.

In summary, although information systems focused on dementia do not yet exist within the wider NHIS, other than the data being gathered on a one-time basis for the Global Dementia Observatory, the Ministry of Health and Wellness has made some useful recommendations which provide a promising environment in which STRiDE findings can potentially be integrated, supplemented and complimentary (National Health Information System Assessment Report (MOH with technical support from PAHO), 2011).

References:

Ministry of Health. (2011). National Health Information System Assessment 2011: Jamaica. Available from: https://moh.gov.jm/wp-content/uploads/2015/07/FinalNHISAssessJAMReport.pdf