Primary Healthcare Enhancement Programme

While Dominica doesn’t explicitly name a program called the Primary Healthcare Enhancement Programme, the nation has undertaken significant health system reforms under broader initiatives such as the Health Systems Transformation and Universal Health Coverage (UHC) Partnership, supported by organizations like the Pan American Health Organization (PAHO) and the World Health Organization (WHO). The programme is key to the government’s commitment to universal health coverage and disaster preparedness, especially in rural and underserved areas.

Goals and Scope of Dominica’s Primary Healthcare Enhancement Programme

At its core, such a programme would seek to upgrade existing health centres to withstand natural hazards better while expanding their service delivery capacity. It aims to improve preventive care, maternal and child health services, chronic disease management, and mental health access. Enhancing infrastructure and staffing would ensure that essential care is available within walking or short commuting distance for most residents.

Infrastructure and Upgrades

Dominica’s healthcare reforms have involved the retrofitting and reconstruction of multiple healthcare facilities, including:

• Grand Bay Health Centre: Retrofitted under the PAHO Smart Hospitals initiative, this centre now features improved structural resilience, energy efficiency, and enhanced service delivery capabilities.
• La Plaine Health Centre: Also upgraded through the Smart Hospitals project, it has been enhanced to ensure continued operation during emergencies and disasters.
• Marigot Hospital: A newly constructed facility that began phased operations in September 2023, offering a wide range of medical services with modern amenities.
• Newtown Health Centre: Identified for transformation into an environmentally-efficient facility as part of a five-year PAHO initiative.
• Roseau Health Centre: It underwent upgrades, including roof repairs, security enhancements, and yard paving, and continued improvements are planned.
• Bagatelle Health Centre: Received major renovations, including fencing, electrical, and plumbing work, totaling nearly $200,000 in investments.
• Colihaut Health Centre: A new facility nearing completion, aimed at enhancing regional healthcare access.
• Wesley Health and Wellness Centre: The Emelda James Health and Wellness Facility has been established to serve the local community’s healthcare needs.
• Bellevue Chopin Health Centre: One of the centers constructed with CBI funding to decentralize healthcare services.
• Soufriere Health Centre: Built to provide top-notch medical services and improve healthcare accessibility.
• Vieille Case Health Centre: Established to deliver comprehensive healthcare services to the northern communities.
• Penville Health Centre: Constructed to enhance medical service delivery in the area.
• Mahaut Health Centre: Developed to ensure residents access quality healthcare services.
• Ansé De Mai Health Centre: Established to serve the northeastern communities with essential medical services.

These upgrades reflect Dominica’s commitment to building a resilient and accessible healthcare system, ensuring reliable access to primary healthcare services for communities across the island.

Community Impact and Future Direction

In villages like Belles, La Plaine, Castle Bruce, and Soufrière, the enhanced clinics now serve as medical centres and designated community shelters. Integrating healthcare with disaster response planning reflects Dominica’s move toward a resilient healthcare system aligned with its Climate Resilience and Recovery Plan (CRRP).

The Ministry of Health aims to expand its healthcare programme to include mobile outreach units and community health workers, strengthening early detection and public health education. This will also support the implementation of non-communicable disease monitoring, mental wellness programmes, and improved maternal support in rural areas.

Dominica’s Primary Healthcare initiatives represent a long-term investment in the country’s human capital and a shift toward localised, equitable, and climate-smart health service delivery. The initiative continues to receive technical and financial backing from partners, including the World Bank, Pan American Health Organization (PAHO), and Caribbean Development Bank (CDB).