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Health

The Dominican Republic’s health system is governed by the General Health Law -42-01 and Law number 87.01, both enacted in 2001 by the Dominican Social Security System.

According to statistics that came out in 2004, every one in 10,000 Dominican inhabitants has access to the following: 10.3 doctors, 12.7 nurses, 1.6 bio-analysts, 0.07 radiology technicians, 0.58 pharmacists, 1.6 dentists and dentist assistants, 0.3 psychologists, 0.08 health educators, 0.4 social workers, 4.6 promoters, among other technicians.

The legislative advances accomplished seek to reduce imbalance that affects important segments of the population, in spite of progress made in recent years. Even though 99% of pregnancies and childbirth are attended by health professionals (doctors, obstetricians, and nurses), every 24 hours another woman dies as a result of complications during pregnancy and at childbirth, according to an ENDESA 2002 survey of health demographics.

Furthermore, the same research determined that in the area of infant health, 8% of children in urban areas are classified as suffering from chronic malnutrition (low height for their age) in comparison with 11% of children in rural areas. In terms of overall malnutrition rates (weight deficiency for their age), 4% of urban residents and 7% of rural residents are found to suffer. There is, at the same time, a tendency towards a decreasing death rate in the first year of life. Between 1997 and 2002, 31 in 1,000 newborns died.

Even though 99% of pregnancies and childbirth are attended by health professionals (doctors, obstetricians, and nurses), every 24 hours another woman dies as a result of complications during pregnancy and at childbirth. 8% of children in urban areas are classified as suffering from chronic malnutrition. There is, at the same time, a tendency towards a decreasing death rate in the first year of life.

The Health System

The current health system is supported by both public and private funds, in a society in which each citizen contributes according to their salary. 

Public Funding for Medical Services

The characterizing feature of the Dominican health system is that it provides free services and is publicly supported, in an attempt to provide special protection to those people and population groups living in poverty. In this sense, primary care centers and the gradual decentralization process in public health administration play a fundamental role.

Health Risk Administrators

Law 87-01 allowed for the creation of Health Risk Administrators (ARS), which are public, private or mixed entities, decentralized, with their own equity and legal personality. These entities must be authorized by the Health and Safety at Work Superintendence in order to manage the health and safety plans, according to the provisions in the Basic Health Plan, for a number of beneficiaries. The ARS serve as the health insurance system comprising The Dominican Social Security Institute (IDDS), private health insurance companies and all registered self-managed insurance in the country.

National Health Insurance (SeNaSa)

National Health Insurance (SeNaSa) was created with the enactment of law 87-01, which formed the Dominican Social Security System. This piece of law established that SeNaSa is the public autonomous and decentralized institution responsible for the administration of health insurance for subsidiary, contributory, and contributory-subsidiary enrollees from the public sector and contributors from the private sector that join voluntarily.

Institutional Reorganization Process

The legal framework of the Dominican Republic’s health system has changed substantially, with the enactment in 2001 of the General Health Law (1942-2001) and the law creating the Dominican Social Security System (1987-1901).

The Reform of the Dominican Health Sector was meant to form the National Health System, which is headed by the Ministry of Public Health. The cornerstone of the reform is to achieve the effective separation of the functions of  governing of the system to ensure the safeguarding, financing and provision of health services, to guarantee universal access to the Dominican people.

The Ministry of Public Health (MSP) maintains a single portal that offers Dominican citizens a tool to complete processes and services from the ministry: http://www.msp.gob.do/ventanilla 

MSP’s General Directorate of Epidemiology is the Branch that disperses notifications of epidemics, alerts and quick response to emergency epidemiological situations. http://digepisalud.gob.do

Links:
The Ministry of Public Health (formerly Secretary of State of Public Health and Social Assistance, SEPAS): http://www.sespas.gov.do
National Health Insurance (SENASA): http://www.arssenasa.gov.do/index/index.asp?idCook=das654d666s54s6df464fs65