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Dominican Republic: Healthcare System
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 The Dominican
Republic shares the Caribbean island of Hispaniola with Haiti. The
island was reached by explorer Christopher Columbus on his first
trip to the New World from Europe in 1492, and was inhabited by
indigenous Tainos before the arrival of Spanish colonists.
Traditionally a sugar producer, the economy of the Dominican
Republic is currently dominated by the service sector of the
service industry, and the country is now the largest tourist
destination in the Caribbean. As a middle income country, the
Dominican Republic has per capita GDP of over USD5,000. Local
inhabitants have a strong passion for music and sports; merengue
dancing and baseball are both extremely popular.
According to UN health agency the World Health Organisation (WHO),
life expectancy in the Dominican Republic is 66 years for males
and 74 for females. These figures are below the regional average
for the Americas. Demographic concerns in the Dominican Republic
include problems associated with migrants from neighbouring Haiti.
Overall health expenditure per capita in the Dominican Republic is
USD449, which is only a small fraction of the WHO Americas
regional average, and represents 6.0 percent of GDP. Approximately
41.4 percent of total health spending comes from government
expenditure. Private Dominican Republic health insurance
represents about 22.5 percent of overall private health spending,
with the remainder coming from out of pocket expenditure.
Communicable diseases are prevalent above the regional average in
the Dominican Republic, with 11 cases of HIV per 1,000 adults and
95 cases of tuberculosis per 100,000 people.
However, thanks to improvements in health care, figures show that
an increasing number of childbirths in the Dominican Republic are
attended by skilled health care professionals, and as a result of
improved postnatal care, children aged less than five years old
with stunted growth and early mortality have both steadily
decreased over the past twenty years. However, Dominican hospitals
and health centres are relatively understaffed, with a shortage of
nurses and midwives. ‘Brain drain’ is a serious concern as many
skilled health professionals seek more lucrative opportunities in
North America.
The Dominican Ministry of Social Health and Public Welfare (SESPAS
in Spanish) cooperates with the WHO in implementing health
policies in line with the UN’s Millennium Development Goals for
2015. These include providing universal primary health care,
improving environment, water and sanitation conditions, attract a
greater number of skilled health professionals, and improve
programs in the prevention and control of communicable and
vaccine-preventable diseases. No serious disease outbreaks have
been reported by the WHO Global Alert and Response team recently
within the Dominican Republic. However, a recent outbreak of
cholera attributed to Haitian migrants and refugees has been
contained, and the Pan American Health Organisation (PAHO) has
reported an increase in H1N1 flu outbreaks. There have also been
reported outbreaks of the waterborne disease leptospirosis.
Being a major tourist destination, there are several travel
advisories applicable to the Dominican Republic. Before travelling
to the country, visiting a travel health clinic in your home
country four to six weeks before your trip is advised. Routine
vaccinations such as hepatitis, typhoid and rabies should all be
updated if necessary. Malaria is also a serious issue outside of
the major cities, and affects most resort areas too. Long-sleeved
clothing, mosquito nets, insect repellent and anti-malarial
medication are all advised. Bringing medication from your home
country is recommended in order to ensure the safety and
appropriateness of your supply. There are several commonly used
anti-malarial pills which are not effective in the Dominican
Republic, or which have serious side effects, so consulting with
an experienced travel physician beforehand is strongly advised.
Tropical health issues can be a serious concern in the Dominican
Republic, but major health problems are rare and do not occur much
more often than in developed countries. However, there is a
general risk from a number of major infectious diseases in the
country. Also, travellers with myopia are encouraged to wear
glasses rather than contact lenses as the sanitary conditions in
the Dominican Republic may increase the risk of eye infection when
wearing, cleaning and storing lenses.
As with most travel destinations, the most common medical problems
for tourists involve gastrointestinal discomfort. It is strongly
recommended to drink only bottled water, or if none is available,
water treated with iodine or other purification tablets. The
Dominican Republic also has several tasty varieties of tropical
fruits and exotic vegetables; these should be washed thoroughly
before consumption. Raw or undercooked foods should be avoided.
Acute cases of diarrhoea, nausea and vomiting can be treated with
over the counter medication, although if these symptoms persist a
physician should be consulted.
Although the Dominican Republic is becoming increasingly wealthy
and infrastructure investment and medical facilities dedicated to
tourists are improving, there remain serious limitations with
local Dominican Republic medical insurance. Hence, special
arrangements must be made before travel to the region. Emergency
evacuation is often required for situations requiring serious
medical attention, which usually means travel to the mainland
United States, which has the world’s highest health care costs. As
such, Globalsurance advises all expatriates and travellers in the
Dominican Republic to purchase a comprehensive global health
insurance policy with an emergency evacuation benefit prior to
arriving in the country.
If you are planning to visit the Caribbean and the Dominican
Republic is on your itinerary, Globalsurance is available to
assist with your any health insurance needs. Globalsurance’s
experienced teams worldwide provide free consultation anytime 24
hours a day, with options for individuals, families and tour
groups. Policies available through Globalsurance cover medical
services including: dental, maternity, specialist consultation,
transportation, inpatient services and more. Contact a
Globalsurance adviser for more expatriate health insurance
information today.
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