Primary Health Care

We support primary health care centers and hospitals in establishing and improving the systems, tools, and practices necessary to provide high quality health care to patients, focusing on chronic diseases. At the community and individual levels, we connect people with diagnosed chronic diseases to a community health worker, who supports them in managing their condition and monitoring key biomarkers each month. Then, we close the loop by connecting those patients and their community health workers to their local primary care provider.

In partnership with the Dolores de la Cruz Maternidad front-line hospital, which serves our core communities, we operate primary health care clinics (“operativos“) every four months to facilitate continuity for patients, and create a mutual learning ground for international and local physicians. Dominican medical providers, international medical volunteers, community health workers, HHI staff collaborate to provide preventive healthcare services, education, and treatment for both acute and chronic conditions to over 500 individuals during each operativo. We promote pre-clinic case finding and appointments, a standardized medication formulary, medical records for all patients, basic diagnostics, and next-day lab results. When patients are referred for follow-up or specialty care, HHI community health workers and staff work with each patient and family to ensure they are effectively connected. We work closely with hospital administration to ensure equipment, procedural, and professional development needs are identified and met.

HHI’s Chronic Care Program is a key piece of our commitment to primary health care. Chronic illnesses, including heart disease, diabetes, and cancer, account for 68% of all deaths in the Dominican Republic. Prevention efforts are crucial to decreasing the long-term burden of these diseases, as are comprehensive treatment and support programs for individuals who have already been diagnosed. Our Chronic Care Program provides patients with year-round access to medication, regular check-ups and monitoring, individualized medication adherence counseling, and support for health behavior change. Our focus is on hypertension and diabetes management, and our prevention efforts focus on the risk factors of poor nutrition, lack of physical activity, tobacco use, and alcohol use. The Chronic Care Program lies at the intersection of our Community Health Workers Program, primary care system strengthening, and commitment to addressing public health challenges.

Understanding the challenges and opportunities faced at Maternidad, we work with primary health care centers and hospitals across the province to establish measures of quality excellence, train physicians and nurses, and provide support and guidance for continuous learning and improvement. Health and the ability to access health care are influenced by social, cultural, and economic factors, so we promote the practice of serving as a medical home and providing community-based support, to ensure primary care programs treat each patient as a whole person.

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