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Case Study

Photo: USAID/Stephanie Molina

Dr. Audrey Reynoso, a recent graduate of the training program, showcases a poster detailing patients’ rights and obligations. The training program is developing the skills and knowledge that will propel the new healthcare system into the future.

Challenge

Mismanagement and inefficiency have long characterized the Dominican Republic’s health system. The quality of health services is hampered by poorly trained staff and internal corruption. In fact, a USAID-sponsored study on maternal mortality attributed the country’s high mortality rate — one of the highest in Latin America — directly to serious mismanagement in the nation’s public hospitals. With approximately 70% of Dominicans relying on the public health system, the problem needed to be addressed. In 2001, the Dominican Congress approved a new social security system that significantly changed the way health services were organized, managed, and financed. But translating policy into practice has been challenging for healthcare providers.

Initiative

To help this transition, USAID is providing financial support and technical assistance for a post-graduate training program in Health Services and Social Security Management, held at INTEC University in Santo Domingo. The training, designed for senior healthcare managers, aims to develop the knowledge and skills needed to effectively build and manage the new healthcare system in the Dominican Republic. The first class of 30 students began training in August 2003. Over the next two years, another 60 students were trained.

Results

Since the program is designed for working healthcare professionals, students have been applying knowledge gained in the classroom to their jobs every day. Graduates have already become ambassadors for change at the hospitals where they work. In the San Pedro de Macoris province, five students designed patient-flow analyses and user-satisfaction surveys to improve the Alejo Martinez Hospital’s overall performance. As a result, patient wait time has decreased and bottlenecks have been virtually eliminated. The Dominican Republic’s healthcare system still has a long way to go, but USAID-sponsored training is helping healthcare professionals find the right path.

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