Strategies for Community Health Promotion

COMMUNITY HEALTH PROMOTION STRATEGIES

Strategies for CommunityHealth PromotionNameInstitutionDateStrategies for CommunityHealth Promotion

Health promotion refers to the process through which people andcommunity is enabled to increase its control over and improve theirhealth to reach a complete state of social, mental and physicalwell-being. The health promotion can be effected for individuals orgroups and involves identification and realization of the aspirationsso as to satisfy the needs, cope or change with the environment.Healthy living is a resource for everyday life where each person isentitled to have irrespective of the background, social affiliationsor any other factor. Therefore, health promotion is a responsibilityof health sector and goes beyond healthy lifestyles to incorporatethe state of wellbeing.

Therefore, this paper provides a promotion for health promotionstrategies in Ontario. Currently, the Afro-Caribbean youths agedbetween 15 and 29 years old have been adversely affected by theHIV/AIDS menace. The main courses of the increased prevalence includelow income, inaccessibility to quality formal education, increasedrate of unemployment and poor social networks amongst others. This isevidenced through the increased levels of drug and substance abuse,mental illness and high rate of deaths amongst the youth.

The main approach proposed in the current paper is thesocio-environmental approach. The program will take two years. Thetimelines and budgets related to the interventions involved arepresented in this paper.

The HIV infection has been a major challenge for most of theAfro-Caribbean youths. The menace leads to increase mental illnesses,substance and drug abuse and increased death rate. Therefore, fromthe community diagnosis carried out in previous papers, the currentpaper presents the strategies for promotion of community health.

Profile of Afro-Caribbean Aged 18-29 Years

A community diagnosis was carried out for Afro-Caribbean aged 18-29years living in Ontario. The diagnosis carried out was based onhealth promotion model with the objective of evaluating the healthstatus in relation to social, physical and biological environment.The assessment data indicated that 4,348 youths in were diagnosedwith HIV in Ontario from1985 to 2011 from which 51% were females. Outof the HIV cases diagnosed, about 20% were Afro-Caribbean. TheAfro-Caribbean aged between 15 and 25 years of age represented 25%while those between the ages of 25 and 34 comprised of 31.2%. About24% of the Afro-Caribbean aged 15 years and above have not reachedhigh school. The Afro-Caribbean aged 25 years and above earnedaveragely $29,700 annually while their fellow Canadians earned$37,200 annually. For all the deaths resulting from HIV/AIDS, about32% can be accounted for amongst the Afro-Caribbean women.

Community Challenges

There is challenge of high rates of drug and substance abuse, mentalillness and increased death rates amongst the youths. TheAfro-Caribbean in Ontario are the most vulnerable to HIV/AIDS thanany other racial group. This group of people experiences variouskinds of vulnerabilities as well as health disparities than the otherpeople.

The proposed strategies aim at covering the range of determinants andvulnerabilities while at the same time focusing on addressing theHIV-related issues faced by Afro-Caribbean in Ontario in future.

The Afro-Caribbean youths in Ontario do not have access to qualityeducation. The publications on education review in Canada,particularly in Ontario show that Afro-Caribbean are the mostvulnerable group with very few of them having the access to highereducation. The PHAC reports (2014) show that approximately 24% of theAfro-Caribbean aged over 15 years does not have a high schoolcertificate, about 12.7% in the same age gap have a university degreewhich is comparatively lower than those 15.4% for the entirepopulation in Canada. Also, PHAC (2014) shows that approximately 20%of the Afro-Caribbean immigrants possess a university education whencompared to all the immigrants with university degree.

Despite the formulation of anti-racist policies to encourageimmigration of the Afro-Caribbean, the government failed informulating the policies on access to education. This implies thatthe Afro-Caribbean youths without education do not have access togood employment. Therefore, lack of sustainable money makes themengage in irresponsible behaviors such as irresponsible sexualbehaviors.

On the other hand, low income has been a major challenge. Studiesshow that average university Afro-Caribbean graduate earnsapproximately $29700 compared to fellow Canadians who earn $37,200annually. Also, the social networks available in Ontario address theneeds of mainstream groups only and ignore women and youths who arethe most vulnerable. Lack of commitment and social support networksof health agencies will continue exposing the Afro-Caribbean youthsto HIV/AIDS.

From the community diagnosis carried out, it was identified thatAfro-Caribbean living in Ontario are poor with poor living standardsand least salaries. Also, the Afro-Caribbean gays are more vulnerableto HIV/AIDS than the non-gay youths. Afro-Caribbean is the thirdlargest minority group but the most vulnerable to HIV/AIDS.Therefore, it can be concluded that poverty is among the majorfactors that enhances the increased compromise for the youths wherethey end up engaging in unbecoming behaviors like irresponsible sex.Poverty is as a result of increased illiteracy and low levels ofincome.

Inequality in education sector has disfavored Afro-Caribbean youths.This makes them feel discriminated against with some of them getunsustainable salaries. Also, lack of social networks to addresshealth needs have contributed to the high prevalence of HIV/AIDSamong the Afro-Caribbean youths.

Program Outline

Due to the current situations and the challenges facing theAfro-Caribbean youths, there is need to develop strategies forpromotion of community health.

Target Group

The two main groups targeted in this programare youths and adults with limited formal education or low income.The participation is voluntary and participants will not be charged

Program Outcome

It is anticipated that by the end of theproject all people within the institution will be able to practicethe HIV/AIDS preventive measures that will see the reduction of thepandemic by 30 percent by the end of year 2017. Also, by the time theprogram comes to an end, it is anticipated that the Afro-Caribbeanwill be in a position to develop sensibility around their personalsexual practice that will enhance their knowledge of HIV/AIDS and howto adequately protect themselves. This will enable the aggregategroup develop an informed measures towards prevention of HIV/AIDS byseeking assistance and consulting medical practitioners available intheir community.

ProgramOutline

Overall Goal

The four-year program proposed will have to contribute to developmentand implementation of efficient strategies for community healthpromotion.

Objectives of the program

  1. To reduce or stop spread of HIV/AIDS amongst the Afro-Caribbean aged between 15 and 29years

  2. To increase the knowledge and awareness of unsafe behaviors that contribute to HIV/AIDS

  3. To increase the accessibility of services for the Afro-Caribbean living with and/or affected by HIV/AIDs

Program Outline

The program will take two years and developmentwill be in five phases.

Phase 1: Need Assessment

This step will involve conducting a survey todetermine the needs of the aggregate population. During the survey,the gaps within the community will be identified. These include thelevel of accessibility to medical services, the availability oftraining and awareness centers and any other factor that might becontributing to the current situation in Ontario. The main milestonefor this phase will be needs assessment report completed by thenurses.

Phase 2: Develop Education Resource forPublic Consultation

From the previous assignments, lack of formaleducation has been a major factor leading to the increased level ofunemployment and consequent engagement in behaviors that exposeyouths to drugs and unsafe sexual intercourse. As such, the educationgap will be identified and existing resources that can be adoptedidentified. The research content will be sought and draft resourcedeveloped. The main milestones for this project will be identifiededucation resource and draft resource report. Also, during thisphase, the feedback of the management for the draft resource will besought and collated to revise resources accordingly. The mainresources in the current program will be finances and human resource.

Phase 3: Develop Social Support Consultation

This phase will involve identifying the socialsupport groups in Ontario. This will involve developing questions forconsultation process and sending the support groups therecommendations to help in funding the aggregate population inOntario. The main milestones for this phase will be social groupsidentified and recommendations sent to support groups to support theAfro-Caribbean youths and women in Ontario.

Phase 4: Creation of Community Awareness

This phase will involve developing a trainingprogram on HIV/AIDs and prevention amongst the Afro-Caribbean. Thisprocess is scheduled to take 6 months. This will be conducted in linewith the needs identified in phase 1. The main milestone for thisphase will be trainings conducted.

Phase 5: Program Evaluation

This step will involve evaluating the programto determine whether the objectives have been met. Also, theevaluation process will assess the effectiveness of the program tothe population intended. The main milestone for this project will beevaluation report.

Below is a Gantt Chart showing the programtimelines.

Program Delivery Timelines

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Develop a brief survey

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Identify the gaps in the community

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Milestone: Survey completed by the nurses

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♦28-02-2015

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Collate the survey responses

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Milestone: Needs Assessment Completed

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Phase 2: Develop Educational Resource for public consultation

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Identify educational resource gaps

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Milestone: Education Resource for Development Identified

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♦30-04-2015

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Research existing resources that can be adopted

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Research resource content

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Develop draft resource

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Milestone: Draft Resource Developed

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Seek feedback for the draft resource from management

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Collate feedback and revise resource accordingly

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Milestone: Resource Developed and read for public consultation

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3.0.

Phase 3: Develop Social Support Group Consultation

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3.1

Develop questions for consultation process

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Identify the social support groups

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Milestone: Social Support Groups identified

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Send recommendations for the community to support groups

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Milestone: Recommendations for assistance sent

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Phase 4: Creation of Community Awareness

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4.1

Trainings on HIV/AIDS prevention

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Milestone: Trainings conducted

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&nbsp♦30-06-2016

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Phase 5: Program Evaluation

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Objectives fulfillment

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Benefits to Intended population

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Milestone: Evaluation Report

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♦31-12-2016

EstimatedBudget

Estimated Budget: Ontario Health Promotion program

Administration

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Estimated Amount ($)

In-kind($)

Notes

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Stationary

150

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Postage

80

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Phone

300

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Printing

100

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Travel

28000

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Equipment

1000

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Software

5678

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Total

35308

0

0

Staff Expenses

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Staff Salaries

30000

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Attendance

3000

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Travel

29000

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Staff Development

25000

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Others

2000

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Total

89,000

0

0

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Resource Development

10000

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Postage Dissemination

700

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Printing

150

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Marketing Consultancy

12000

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Others

3000

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Total

25,850

0

Training

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Venue

20000

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Catering

17000

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Presenter fess

1000

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Stationary

5000

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Others

1000

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Total

44,000

0

0

Evaluation

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Consultancy fees

25000

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Representation

13000

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Evaluation Report Development

3000

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Others

2300

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Total

43,300

0

0

Grand Total

237,458

The entire program will take 2 years. Thebreakdown for the budget is shown in the table above. The entireprogram will require $237,458. The main target for funding arewell-wishers, government, NGOs and other organizations.

ProgramPlanning Implementation

This will involve six main steps as outlined below

  1. Manage the planning process

  2. Conduct situational Assessment

  3. Set goals, population of interest and outcome objectives

  4. Choose strategies and activities and assign resources

  5. Develop indicators

  6. Reviewing Plan

Step 1: Managing the Planning process

The planning process normally will start by identifying the problem.In this case, the program team led by the project officer will beinvolved in determining the effects of HIV/AIDS on environment orlocal community. After identification of the problem, then the peopleat risk are identified. In this case, women and youths are the mostvulnerable population. The management of planning process entailsconsideration of the participants, time available, resources, datagathering and decision making. The main participants in this programwill be the nurses, youths, local government, NGOs and otherpartners. The planning process will, therefore, incorporate allpartners in each process. Due to the past history of conflictsbetween participatory health promotion ideals with cost and politicalissues, the participatory planning will take longer, approximately 3months. In terms of resources, there are currently no funds for thisprogram. However, it is anticipated that the program will be fundedby well wishers, the local government, NGOs and other personnel.Currently, the budget is $500,000 Million. The information requiredwill be on the number of Afro-Caribbean aged 15-29years infected withHIV/AIDS, their source of income, their educational level and theircurrent job opportunities. The situational analysis will providedecision makers with critical information required to execute theprogram. Thereafter, decision will be made taking into considerationthe political context of Ontario, challenges that might deter makingof timely decisions and any decision on timelines and allocation ofresources. Four years will be required to plan, stakeholders andpartners will be identified and degree on involvement clarified, thedecisions will made and the project coordinator will have the finaldecision, the planning resources will be assessed and work plan willbe developed.

Step 2: Situation Assessment

This will involve assessing the needs by looking beyond theindividual to social health determinants. The program team led by theproject officer will conduct a situation assessment to enhance theirknowledge of population of interest and give the trends and issuesthat can easily affect implementation of the program.

Inthe case of Afro-Caribbean, the situational analysis will involveidentifying the main questions on risks and quality of life,gathering data, developing a plan for data collection, organizing,synthesizing and summarizing data, communicating the information andconsidering how to proceed with planning.

What is making the HIV situation better and worse amongst theAfro-Caribbean

Step 3: Setting Goals, Aggregate population and Objectives

The goal of proposed health promotion program is to improve andreduce the prevalence of HIV/AIDS amongst the Afro-Caribbean youthsaged 15-29years of age. Also, this program aims at enhancing theknowledge and awareness on HIV/AIDS amongst the Afro-Caribbeanyouths, as well as increases the accessibility to healthcare andother social networks. This will ensure that the number ofAfro-Caribbean infected with HIV/AIDS reduce from 4348 to aconsiderably lower number. To achieve the health outcomes, changesare anticipated from the Afro-Caribbean youths, social networks,societies, organizations and other partners. The Afro-Caribbeanyouths must be willing to accept the program and change theirbehaviors, social networks should not discriminate while offeringservices like funding, government should setup policies that willensure accessibility to education and other organizations must chipin and offer their help towards reducing the number of HIV/AIDSinfections. Things that are required to change include attitudes,knowledge, and self-efficacy and personal behaviors.

Long term Goals

The long term goal for this program will entail reducing theprevalence of HIV/AIDS amongst the Afro-Caribbean youths aged 15 to29 years by 30% by the year 2017.

Short term goals

  1. Within 12 months, 40% of the youths and women infected with HIV/AIDS will be aware and knowledgeable on how to manage their conditions without necessary engaging in unbecoming behaviors.

  2. The social support network, 12 months after the start of the program, would have given funds to at least 50% of the unemployed youths and women living with HIV/AIDS.

  3. To ensure that by the end of the second year after the start of the program, 90% of the youths and women infected with HIV/AIDS can access the healthcare services

Step 4: Chose strategies, activities and assign resources

The main strategies will involve enhancing the education, creatingawareness on HIV/AIDS, improving the living conditions by fundingyouths and women and increase the accessibility to health careservices. This will involve building on strategy development andplanning, coordinating with the partners and allocating theresources.

Step 5: Develop Indicators

Normally, an indicator depicts a specific measure indicating thelevel at which objectives or goals have been achieved. Below are thethree indicators for the objectives of the current study

  1. The indicator for creating awareness on HIV/AIDS will be percentage of youths engaging in constructive lifestyles

  2. Reducing the cases of HIV/AIDS will be indicated by reduced number of infected youths from the current number 4,348.

  3. Increased accessibility to healthcare services will be indicated by increased number of Afro-Caribbean youths visiting the heath care institutions

Step 6: Review the Plan

The plan will be reviewed to determine its completeness, logic andattractiveness. This will involve testing the program beforedissemination. This will be performed through use of small pilotprojects to test for consistency, appropriateness, comprehensivenessand accuracy.

Implementation

The interventions identified will be implemented through holdingevents, seminars, broadcasting, use of social media, distributing andposting documents, changing environment and enacting policies. &nbsp

Evaluation

The major goals of evaluation will be to identify whether theobjectives of the program have been met, the people who would havereceived the intervention, any recommendations for futureimprovements and effects of the intervention on behavior. The twomain types of evaluation that will be carried out for this programwill involve process and outcome evaluation. Process evaluation willenhance documentation and verification of the program as per therequirements while evaluation of the outcomes determines whether theintroduced intervention produces the results as expected. This willentail both the pre and post tests to assess whether the interventionresulted into the desired changes.

Theoretical Approach to be utilized for the interventions

The main approach used in developing and implementing program forAfro-Caribbean to in Ontario is Socio-Economic Approach.

Socio-Economic Approach

A socio-environmental approach will be used to address the challengesfacing Afro-Caribbean. This approach is critical when addressing thesocio-determinants of health like income, employment, socialisolation, education and early life experiences.

The health and behaviors of individuals can be influenced at variouslevels. The socio-environmental model is critical in planning of thepublic health intervention. Planning a successful interventionrequires proper understanding of the interaction betweeninterpersonal, communities, individual, organizational and societallevels. For instance, the interventions that encourage individualswork more would be unsuccessful if they do not have the community asa walking path. Also, intervention promoting good behaviors would notbe successful without understanding the personal characters, theincome choices or the availability of the opportunities. Therefore, awell-planned intervention needs a holistic approach for it to becomprehensive and sustainable.

The main health promotion actions commonly applied in this approachinclude creating environment that support health amongAfro-Caribbean, working with the community so as to strengthendevelopment and advocacy for public policy.

Role of community nurse

The role of community health nurse will be multi-faceted. Stanhopeand Lancaster (2010) noted that the community health nurse isinvolved in monitoring health status in order to identify thecommunity health problems, inform, educate, mobilize the community,inform, identify and solve the problems related to health, developplans and policies that support community health efforts and mobilizethe community partnerships. The community nurse is also involved withdevelopment of plans and policies that support the community andindividual efforts. They should work together in enforcing law andregulations to protect and ensure safety, as well as linkAfro-Caribbean to the required personal health serviced as well asensure provision of healthcare that may otherwise be unavailable. Thecommunity nurse should ensure that the workforce in personal andpublic health care remain competent, especially when administeringservices to the Afro-Caribbean youths in Ontario. Also, the communitynurses should play a major role in evaluating the effectiveness andaccessibility of the healthcare services by the Afro-Caribbean youthsand women. Furthermore, the nurses should carry out research andinnovations to come up with effective interventions to promotewellness and prevent spread of diseases. The community nurses shouldengage political leaders with the aim of mobilizing the resources andformulating policies to safeguard human rights. It is also the roleof community nurses to educate people in Ontario on importance ofsafe sex, condom accessibility and abstinence. The dissemination ofinformation materials is also critical as far as community healthcare provision is concerned. For those youths infected and unable toget to hospitals, the community nurses should provide training andsupervision services in their homes. These, amongst others, will becrucial in strengthening the capacity of the health systems toprovide quality health care as well as help in preventing prevalenceof HIV/AIDS.

Conclusion

Due to the HIV/AIDS challenge facing the Afro-Caribbean youths inOntario, this paper has presented a program proposal to be utilizedin the move towards reduction of prevalence of HIV/AIDS. The programwill take two years and the execution timelines will be divided intofive phases. The phase 1 to 5 are needs assessment, development ofeducational resources for public consultation, developing socialsupport group consultation, creation of community awareness andprogram evaluation respectively. On the other hand, the programplanning implementation will involve six main stages. The stages I to6 are management of the planning process, conducting situationalassessment, setting goals, population of interest and outcomeobjectives, choosing the strategies, activities and assigningresources, choosing strategies and activities and assigningresources, developing indicators and reviewing the plan respectively.The main resources involved include the program team led by theprogram officer.

The estimated budget is $237,458. It is anticipated that the programwill be completed funded hence the government, NGOs and well wishersare encouraged to join hands towards funding this program. Theprogram will be critical in reducing the prevalence of HIV/AIDSamongst the Afro-Caribbean youths aged 15-29 years by ensuring theaccessibility to formal education, enhancing accessibility to healthcare services, and increasing the awareness on HIV/AIDS prevention.The community nurses will be the major drivers in this program. Themain outcome indicators will be reduced death rate, reduction incases of mental illness, increased accessibility to health careservices and increased accessibility to formal education by at least30% by the end of the program.

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