Find Health and Medical expertise in Dominica

Health services within the country are made up of a network of 52 health centres and two district hospitals. The Princess Margaret Hospital is the national referral hospital and provides curative, rehabilitative and other complex medical services. A recent upgrade has reduced the number of people having to seek treatment abroad. There is a smaller hospital at Portsmouth and cottage hospitals at Marigot and Grand Bay. The Ministry of Health is responsible for the provision and financing of health care services.

The Dominican government is an active participant in the Eastern Caribbean Drug Service, which is a regional pooled procurement scheme for importing pharmaceuticals and medical supplies. This enables the country to maximise the value of health care services to its citizens through the advantage of collective bulk buying along with neighbouring countries. The pharmaceuticals industry in Dominica remains largely unregulated, except with regard to dangerous drugs.

Only a third of health care in Dominica (28%) was paid for by patients or funded by other non-governmental entities – such as private insurers, charities or employers – in 2012. Total health expenditure constituted 5.9% of GDP (2012), of which 72% was covered by the government.

Health care is overseen by the Ministry of Health, the mission of which is to promote the well-being of all citizens of Dominica through the provision of preventive, curative and rehabilitative health care, compatible with acceptable standards of human dignity at a cost that is affordable and sustainable. The health system in the country is made up of a mix of public and private health providers, but is dominated by public provision of services. Primary care services in the country are of a high quality, however, secondary care is limited and tertiary care is unavailable on the islands and requires travelling to off-island facilities – as a result, such care is only available to some income groups. USAID has been working with Dominica to assess the burden of disease in the country as the absence of tertiary care may pose a significant risk to the health of citizens of Dominica.

Communicable and non-communicable diseases

Non-communicable diseases (NCDs) in Dominica accounted for an estimated 85% of all mortality in 2008. In 2008 the most prevalent NCDs were cardiovascular diseases (36%). Cancer, non-communicable variants of respiratory diseases and diabetes contributed 21%, five per cent and nine per cent to total mortality, respectively (2008). Communicable diseases along with maternal, perinatal and nutritional conditions in Dominica accounted for an estimated 11% of all mortality in 2008. A government paper on HIV/AIDS reported a cumulative 410 HIV cases (150 of which resulted in death) in the period 1987–2013. Dominica is a non-endemic country for malaria. Estimated incidences of tuberculosis (TB) have halved in the period 1990–2012, while estimated mortality (when mortality data excludes cases comorbid with HIV) almost decreased slightly during this time.

In 2013 government expenditure on health was 4% of GDP. In the most recent survey, conducted between 1997 and 2009, there were 50 doctors, and 417 nurses and midwives per 100,000 people. Additionally, in the period 2007–12 all births were attended by qualified health staff and, in 2013, 93% of one-year-olds were immunised with a dose of measles. In 2011, 96% of the country’s population was using an improved drinking water source and in 2005, 81% had access to adequate sanitation facilities.

Dominica was not an original signatory to the International Covenant on Economic, Social and Cultural Rights, but acceded to it in 1993 and has written the covenant into law. It includes ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’. The covenant commits signees to providing healthy and hygienic environmental conditions, controlling epidemic diseases, improving child health and facilitating access to health services without discrimination.