LOOKING AT HEALTH CARE
The Dominican health care system includes a private sector made up of non-profit and for-profit private organizations, and a public sector. About 20% of the population has health insurance, mostly through the private sector. Private insurance plans may be provided by insurance companies or private hospitals or centres. 

The public sector consists of four agencies, of which two provide insurance. The Dominican Social Security Institute insures low-income wage earners in government-owned corporations. The Social Security Institute of the Armed Forces and National Police provides health insurance for members of the armed forces and the police and their families. These two agencies operate their own medical facilities, although they sometimes purchase services from other private or public facilities to keep up with demand. The Ministry of Health and Social Welfare provides health care to the uninsured population. The Essential Drugs Program purchases and distributes drugs and medical and surgical equipment for the Ministry.
The Ministry of Health and Social Welfare is structured on three levels: central, regional and provincial. The central level sets standards. Eight regional offices direct and oversee the operation of health services at the provincial level. Each region has clinics staffed by medical interns and nurse's aides that provide basic health care, but not all communities have hospitals.

 The basic needs of rural communities are often unmet. This is particularly true in the northeastern and southeastern areas of the country, where vaccinations and clean drinking water are seldom available. Less than half of the rural population has access to clean drinking water. Rural people usually use herbal medicines, particularly herbal teas, to treat common ailments.
   Did you know?
A disease known as dengue is becoming increasingly widespread in many Caribbean nations, including the Dominican Republic. It is spread by mosquitos. At present, there is no known vaccine or treatment.
Life expectancy is 70 years and infant mortality is about 40 deaths out of 1,000 live births. Cardiovascular disease is the most frequently reported cause of death. Injuries caused by accidents or violence rank second. However, many deaths in rural areas occur without medical attention, and their causes are not reported. At present, the country's chief health priorities are to combat nutritional deficiencies and eradicate communicable disease. Reducing infant and maternal mortality is also a primary objective.

 Changes in the country's economy, particularly the shift from agriculture to service industries and tourism, have led to a decrease in health expenditure. Social spending has been allocated to economic adjustments, such as compensating for inflation, rather than health care. The government is working to reform the health care sector.