At What Cost? In Search of an Efficient Model of Rural Health in the Dominican Republic

Health care is one of the most salient issues in contemporary society. To a large extent, the delivery is a reflection of the social values, the political will, and the financial resources of a nation. The Dominican Republic has a unique set of challenges around which a unique health delivery system has evolved. This paper first explores the history and structure of the health care system. Focusing on rural communities, it then reviews the challenges to health including shortages of medical personnel and supplies, high maternal mortality, challenges in the water and sanitation sectors, and cultural prejudice. Finally, it offers solutions that are derived from successful programs employed internationally, always held to the standard of culturally and financially feasible in the Dominican context