Clínica de Familia La Romana’s unique, multi-disciplinary, family-centered approach includes specialized medical care, social services, community outreach, prevention, and education programs provided through these key clinics and programs.
1.HIV Vertical Transmission Prevention Program
This program was established in 1999 as the first program of Clínica de Familia and is aimed at preventing the transmission of HIV from pregnant women to their babies. It was the first program of its kind in the Dominican Republic to provide triple antiretroviral therapy, effectively reducing the rate of transmission from around 40% with no intervention to near-elimination. This extremely effective program served as the basis for the Ministry of Health to change the national treatment guidelines to reflect the Clínica de Familia´s protocol.
2.Comprehensive HIV Care
Clínica de Familia, which uses a family-centered approach, is one of the largest HIV clinics in the Dominican Republic, providing medical care, antiretroviral treatment, and preventative services to more than 2600 children and adults with HIV. Each person who is newly diagnosed with HIV is started immediately on antiretroviral treatment and provided psycho-social support services.
3.Adolescent Program
Clínica de Familia’s Adolescent Program began in 2008 and currently includes reproductive health services for teens, as well as community and school-based comprehensive sex education programs.
4. Comprehensive Health Clinic for Key Populations
This program provides services for sex workers, trans women and men who are at risk for STIs and HIV, including men who have sex with men, clients of sex workers, and batey residents. The program is focused on preventive health services, including primary care, sexually transmitted infection care and treatment, and includes a community outreach component, focused on prevention and recruitment to come to the clinic for medical check-ups and testing.
5.Mental health and psycho-social support services
Clínica de Familia´s holistic model of care includes mental health counseling services (offered at the clinic and in the community) and HIV test counseling. In addition, the social work department helps provide case management, primarily to clients with HIV, and also oversees a kitchen garden project to address issues of food insecurity and a pediatric nutrition program aimed at reducing malnutrition in children with HIV. The community health promotion program includes outreach workers focused on prevention in key populations, health promoters providing support to clients with HIV and their families, and client navigators focused on preventing clients with HIV from being lost-to-follow-up. 6.Primary Care Services
Clínica de Familia offers high quality, low-cost medical services to the community in general. These services include primary care, obstetrics, gynecology, pediatrics, cardiology, diabetes care, nutrition, pulmonology, nephrology, internal medicine, family medicine, psychiatry, urology, orthopedics, geriatrics, palliative care, infectious disease, ear, nose and throat, dermatology and family planning services. Additionally, the clinic offers imaging and diagnostic services, including x-rays, ultrasounds, echocardiograms, electrocardiograms, biopsies, and laboratory testing.
7.Programs for Children
Clínica de Familia´s pediatric HIV program is made up of a multidisciplinary team of pediatricians, nurses, health promoters, social workers, and psychologists who work together to provide the best care possible to this very vulnerable population. Clinic psychologists and educators also facilitate support groups for adolescents with HIV, which focus on helping them accept their diagnosis, support one another, know that they are not alone, and give them tools for successfully managing their HIV diagnosis, with a particular focus on their emotional well-being and adherence to treatment.
Clínica de Familia´s pediatric nutrition program provides support to malnourished children with HIV, providing them with monthly food packets, home visits that include education and counseling, and clinical follow-up with our pediatricians. A kitchen garden project complements the pediatric nutrition program. Participants receive technical assistance with their gardens and donations of soil, seeds, plants and tools. This program has helped reduce the food insecurity of participating families.
Each December, the clinic organizes a holiday party for all of the children up until age 12. The children participate in games, dances and contests, eat lots of yummy food, and all receive gifts at the end of the party.
Clínica de Familia began Camp Hope and Joy for children with HIV in 2005. This summer camp provides an opportunity for the children to have fun in a safe and loving environment and is filled with activities aimed at improving their mental health and self-esteem.
Research
Research is an important aspect of Clínica de Familia´s work, and its original research projects on public health issues and interventions provide vital new information for local, national and global understanding and planning. Published research has included studies about HIV prevalence among pregnant women, male circumcision, disclosure of HIV diagnosis to children, an analysis of the HIV treatment cascade, a family planning health coaching model, STI prevalence in key populations, an evaluation of the clinic’s sex education program, and the use of infographics with HIV-positive clients, among many others. Research funding has been provided by Columbia University, University of Colorado, the National Institutes of Health, the Children’s Hospital of Philadelphia, and Grand Challenges Canada, among others. A list with links to recent Clínica de Familia publications can be found on their website.