Health spending in Dominican Republic is low compared to other countries in the region. This limits the system’s capacity to offer quality services and access the necessary resources.
There is also inequality in access and a great disparity in accessing health services between urban and rural areas, as well as between different socioeconomic groups. This approach is taken by the Santiago internist, Dr. Mary Anne Butler, former dean of the Faculty of Health Sciences at the Pontificia Universidad Católica Madre y Maestra (PUCMM). The academic and internist argues that people who live in rural areas, with low incomes and little education, have less access to quality health services and, therefore, have a higher incidence of poverty. maternal mortality, neonatal and infant mortality and pregnancy in adolescents, he says.
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Deficiency
As far as infrastructure is concerned, it is poor, many health centres lack adequate infrastructure, including dilapidated facilities, lack of essential medical equipment and supplies, he argues.
In health centres, there is a lack of trained personnel, the shortage of well-trained health professionals is especially evident in rural areas. In addition, health personnel face difficult working conditions, low wages and lack of incentives to work in remote areas.
The resources
There is poor management of resources, as they are diverted to non-priority matters and this affects the effectiveness of health programs and services.
Limited coverage
Although efforts have been made to expand health insurance coverage, a significant portion of the population is still uncovered, limiting their access to essential medical services, Butler said.
Chronic diseases
For the professional, the Healthcare system faces a significant burden of chronic diseases such as diabetes, hypertension, and emerging infectious diseases that require different care approaches and sustained resources.
Insecurity via
The professional analyzes the road insecurity experienced in the Dominican Republic, which has significantly increased the number of polytraumatized patients and all the consequences that this entails.
Education and prevention
The lack of effective health education and prevention programs limits the system’s ability to proactively address health problems, resulting in a greater burden of preventable diseases, Butler said.
Gender inequalities
Even in the 21st century, there are factors such as gender, ethnicity and level of education that influence the access and quality of medical care received by the population.
Mental health
According to data from the Ministry of Health, the prevalence of mental illness in the Dominican Republic is approximately 20% of the population, with anxiety and depressive disorders being the most common. Mental illnesses generate significant costs in the health economy not only due to the work incapacity they entail, but also due to the chronicity they generate when there is no timely detection and treatment.
Old age
For a society, it is not just about living longer, but about living better. The increase in the elderly population represents an enormous challenge, as we are faced with a population that is longer-lived but not necessarily healthier, he explains. This sector of the population needs health coverage that guarantees a dignified old age. To overcome these obstacles, a comprehensive approach is needed that includes an increase in investment in health, improved infrastructure, effective supervision of the training of health personnel and the implementation of effective health education and prevention policies.
Indicators
Neonatal mortality in 2023 was around 22%, a figure that shows a gradual decrease compared to previous years. Maternal and infant mortality continue to show red figures, which puts the country in the spotlight of international organizations.
There is a sector of the population without insurance coverage, nor is there unemployment insurance.
Primary Care
It is not being implemented effectively and patients are no longer being treated in regional hospitals.
