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 The Dominican Foundation and our partner IDDI (Dominican Institute for Integral Development) is greatly committed to the concept of Maternal Child Healthcare. The objective of this program is to establish an integrated and participatory health model that reduces mortality and morbidity in children under five and women of fertile age, while involving the community in its own development.
Although we hope to expand this project throughout the Dominican Republic, initially the target community of this project is the squatter slums of Buenos Aires (28,600 inhabitants) and a portion of Libertador (43,249 inhabitants), in city of Santo Domingo, Dominican Republic.
Why is this program important?
Similar to other countries of the Third World, the Dominican Republic (DR) is suffering from the consequences of a massive migration of its population to urban areas. At present, 55% of Dominicans live in urban centers, and the number increases annually by 6.3% Santo Domingo is the primary destination of this migration with 27% of the country's population at date, and with an estimated population of approximately 4 million by the year 2000.
Of this population, 64% live in marginal areas, occupying only 20% of its geographical area. The marginal communities grow at an unprecedented rate at close to 10% annually and lack organized service, such as electricity, drinking water, drainage and sewers, and disposal of human and domestic waste, etc. The growth of these communities has proceeded in a completely chaotic manner, and, as a result, the social, economic, cultural, and physical life of its inhabitants is also characterized by chaos and anarchy
One of the most alarming factors in these marginal communities is the poor health status which especially affects the population of young children, the most vulnerable group. Past studies conducted in Santo Domingo have noted that 77.4% of children surveyed in the Capital were ill, 37.7% suffering form acute respiratory infections, 10.3% with fever, 22.2% suffering from diarrhea, and 24.2% from eye and skin conditions.
The conventional medical services for these ill children were very deficient: 65.6% received no medical attention at all, 13.5% received a minimum level of medical assistance, and 19.4% received moderately sophisticated level of assistance. The primary cause of mortality for children under four is diarrhea, with an average of 5.2 episodes per child per year. Children under one, experience an average of 6.7 episodes per year.
This situation is more serious in the marginal communities, because the population is exposed to poor availability and quality of water, alack of sanitation, drainage, and sewer system, which make life very deficient in all aspects.
Target Communities
The larger geographical area of Herrera was selected due to its marginality and significant health needs. The Buenos Aires and Libertador communities are subjected to tremendous health and environmental hazards that, coupled with the communities' limited possibilities to resolve these problems, has created extremely difficult living conditions. The problem is even more serious given the fact that the inhabitants of these communities have limited possibilities to resolve their problems on their own, because they work individually with little hope, and the organizations that have been formed to improve living conditions have been ineffective.
Several key factors influenced the selection of Buenos Aires and Libertador as the target communities for the proposed project:
- The project complements the health activities that IDDI has been implementing since 1988 in these slums. It will extend the coverage and quality of services that this population has been receiving over the past years.
- Though IDDI has been working systematically in Herrera in primary health care achieving a very positive impact in the area, it is still necessary to establish the complementary and self-sustainable mechanisms of primary health care actions. They include, among others, the creation of a health reference system in coordination with the Ministry of Public Health (SEPSIS).
- On the other hand and in spite of IDDI's achievements, more community participation is required. This implies:
- More training of community leaders in the topics related to maternal child health care.
- More organizational support for the grass roots groups that will promote more responsibility on their part for the operational aspects of the project over the long term. In this way the community can learn to manage its own affairs and coordinate activities with the Dominican Government.
In summary, IDDI has been working in Herrera since 1988 with excellent results in areas related to primary health care and community organization and education. In Buenos Aires specifically, IDDI has a long track record in community health care.
 Having faced similar conditions throughout the city of Santo Domingo, IDDI has developed an approach that focuses on strengthening existing community organizations so that communities can achieve the capability of resolving the problems and needs of their population and people can participate more fully in the decision - making process of their country's development. IDDI's experience in the community of La Zurza has shown that this approach is practical and successful when it is combined with a catalyst which in the case of the proposed project is the improvement of the health status of young children and women of fertile age. That is to say, that this project will not only improve the health conditions of the marginal communities but also develop mechanisms of self-determination which will sustain the preventive health activities in the long run.
Cost of Project and Fundraising Goal: Total: $250,000
If you would like to learn more about this project, please contact us at info@dominicanfoundation.org.
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