The Business Year

Dr. Altagracia Guzmán Marcelino

DOMINICAN REPUBLIC - Health & Education

Healthy Concerns

Minister, Public Health and Social Assistance

Bio

Dr. Altagracia Guzmán Marcelino holds a degree in pediatrics and infectology. She was Minister of Health between 1997 and 1999 and the state health-risk administrator between 2004 and 2014. She is a health sciences teacher at the Universidad Autónoma de Santo Domingo, Executive Director of SeNaSa, Deputy to the National Congress, and President of the Health Commission.

TBY talks to Dr. Altagracia Guzmán Marcelino, Minister of Public Health and Social Assistance, on its work to combat the effects of flooding, its work to increase wages in the sector, and her priorities for the future.

What are the major health concerns regarding massive flooding in the northern part of the country, and what has been the ministry’s response?

When floods occur, disease and health issues can increase. There is the deterioration and/or contamination of water supply systems in various locations, which interrupts supply. This increases the chances of contracting acute diarrhea, cholera, malaria, and leptospirosis for example, or the reproduction of the Aedes aegypti, known for transmitting dengue, chikungunya, and Zika. In these cases, the Ministry of Health, in coordination with the National Health Service (SNS) and the service network, develop a series of actions to guarantee prevention and control of these events with epidemic potential. Some of the actions that we help implement are the strengthening of epidemiological surveillance and monitoring of environmental risks, intensification of disease outbreak surveillance, development of actions to guarantee water potability, activation of the Water, Sanitation, and Hygiene Group (GASH), intensifying the risk-communication strategy, development of home visits in affected areas, diffusion of educational messages through mass media outlets, coordination with the Emergency Operations Center (COE), coordination between the DPS/DAS, regional health services, and establishments to treat people in need, among many others.

What is the current progress with some of the other UN Sustainable Development Goals related to health?

With regards to transmittable diseases, the Dominican Republic is advancing; in 2016, 6,645 probable cases of dengue were notified, with a 61% decrease in cumulative incidence compared to 2015 when 17,051 cases were notified. One year after the Zika epidemic started, levels of reported cases lowered until the end of the epidemic in 2016. In the last four weeks of 2016, the levels of acute diarrhea were stable and leptospirosis cases caused by flooding in the north are showing a decreasing tendency. Furthermore, there were no cases of human rabies, poliomyelitis, measles, or rubella, and there was a significate reduction in whooping cough cases.

What will be the impact of the wage-increase agreement signed with the Dominican Medical Association?

There will be a huge, positive impact in the quality and quantity of services offered to the population, especially for citizens who use the Public Network, as well as a significate improvement in the quality of life of health workers. The agreement impacts seven of the main axis on which an efficient health system should work on. In few words, the agreement looks to develop an integral attention model, create conditions that allow the system to overcome the deficit of qualified human capital in less favored communities, have an autonomous Single Network of Public Services capable of offering efficient attention, innovate to surpass health insurance deficiencies, develop a wage policy that surpasses imbalances, recognizes merits, and stimulates good performances. The agreement will increase base salary and variable salary by 25% and incentive payment by 60%, per geographical location, performance, antiquity or years of service, and recertification. In addition, a single salary was consolidated for doctors or health personnel that worked in the two institutions of the public system, after unifying hospitals in a single network directed by the SNS. Finally, the agreement includes pension with full salary for all health personnel.

What are the main priorities for the Ministry of Health during the current administration?

Our main priorities as Ministry of Health are the reduction of maternal mortality from 106 to 70 per every 100,000 live births; the reduction of the mortality of children under five years from 27 to 18 per every 1,000 live births; the reduction of the mortality of children under one year from 23 to 16 per every 1,000 live births; the reduction of teenage pregnancy by 20%; the reduction of mortality associated with dengue by 20%; the reduction of premature mortality by transmittable diseases by 20%; the reduction of cancer-related mortality by 20%; the reduction of mortality associated with accidents by 25%, or 41.7 for every 100,000 habitants; the reduction of morbidity and mortality caused by HIV in vulnerable groups; and the reduction of family health expenditure.

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