Descriptive and comparative analysis of health status and health care delivery in Haiti and Dominican Republic. Are there lessons to be learned?

Background: Haiti and the Dominican Republic (DR) are neighboring countries.  Despite having a similar size population, geography, climate and natural resources, both health status and health care delivery are very different. These differences are relatively new, as they started to diverge in the 1950’s.

Method: Secondary data from 2006-2009  from PAHO, WHO, and Ministere de la Sante Publique were analyzed.  Descriptive analyses were conducted to identify the magnitude of differences.

Results: This study found continued, wide, health inequalities existing between the two countries. Below are the most important findings. Life expectancy in Haiti is 61 years compared to 73 for DR. The proportion of the population with access to  safe drinking water is 58% for Haiti and 95% for DR. Infant mortality rate for Haiti is 60/1,000 live births and 25/1,000 in DR.  Adult mortality for Haiti is 282/1,000 population and 209/1,000 for DR. The number of physicians  is  3/10,000 population  for Haiti and  20/10,000 for DR. The number of dental personnel are near 0/10,000 population for Haiti and 8/10,000 for DR. Hospital beds number 8/10,000 population for Haiti and 20/10,000 for DR. The percentage of external expenditure out of total health care costs is 65.8% for Haiti and 1.7% for DR. 

Discussion: This study shows the large disparities in social and health indicators between the two countries. Few indicators are available using age-adjusted rates.  However, considering these constraints, the study presents clear levels for Haiti to achieve in public health and health care delivery.