Santo Domingo — During the presentation “Diagnosis of Family Health Insurance (SFS) in the Dominican Republic”, Dr. Pedro Ramírez Slaibe explained that 97% of the Dominican population is affiliated to a health regime, either contributory or subsidized.

Currently, 54% of Dominicans are registered under the subsidized regime (5,718,718 people), 45% under the contributory regime (4,704,115 citizens), and the remaining 1% (93,616 people) under the pension modality.

The specialist in Family Medicine made a historical account in which he stressed that Family Health Insurance was created to guarantee universal coverage of health services without exclusions. This includes promotion and prevention, patient rehabilitation, and coverage during pregnancy and postpartum.

It also gives the member the freedom to choose their Health Risk Manager (ARS) and the service provider where they will receive care.

In the event of loss of employment, the patient enjoys all the benefits for 60 days, and after these, his condition will be seen if he continues in the contributory regime or goes to the subsidized regime, where the unemployed and their families, people with disabilities, and those in a situation of destitution receive care.

According to Ramírez Slaibe, this is protected by Article 129 of Law 87-01 on Social Security, which establishes that all citizens have access to a Basic Health Plan, regardless of their social, labor, or economic status and the financial regime to which they belong.

Family Health Insurance came into operation in the Dominican Republic in 2002, and the contributory regime in 2007. Between 2020 and 2021, affiliation with the subsidized regime accelerated, incorporating more than two million people into Social Security, “going from 85% to 97% of the affiliated population we have today,” he said.

The system has 10,516,449 affiliates, and collections rose from 58,565,404,586.57 in its origins to 101,485,179,143.17 in 2024, practically doubling.

“The FSS has made significant progress in terms of health coverage and access in the Dominican Republic, but it continues to face significant challenges in equity, financing and quality of services,” he said.

The population of 46 to 60 years of age grows

According to the doctor, one aspect that is worrying is how age groups have been changing over the years. Today, there is a growth in the population between 46 and 60 years old, which, although it continues to contribute and be productive, is the next to move to the pension system.

“This situation leads to the need to rethink the redefinition of per capita,” he said.

Out-of-pocket expense

Regarding out-of-pocket spending, the director general of the Center for Research and Studies in Health Management explained that despite the fact that it was calculated at 61.24% in 2004 and at 42.2% in 2020, “the reduction has not been so significant,” taking into account inflationary rates.

He pointed out that the most frequent expenses are medicines, uncovered procedures, and co-payments.

Proposals and reforms

Ramírez Slaibe concluded his presentation, which was part of the workshop on Social Security and Health organized by the Social Security for All Foundation (FSSPT), by proposing proposals and reforms for the common welfare.

“The gap between the original design and the current reality reflects the need for profound reforms to ensure the sustainability of the system and guarantee the right to health of the entire population,” he said.

As a possible solution, he proposes reforming the Basic Health Plan, expanding coverage of essential medicines and high-cost treatments, strengthening primary care, and incorporating mental health and rehabilitation services.

Similarly, review the sources of financing of the Basic Plan, implementing the contributory-subsidized regime, which allows informal or unemployed collaborators to continue contributing. It also proposes to establish better cost control mechanisms.

The doctor requested that the network of providers be redesigned and more efficient referral mechanisms implemented, thus guaranteeing greater equitable access to health centers.

Finally, Ramírez Slaibe understands that, to achieve these objectives, a dialogue between the State, the actors of the health system, and civil society is necessary to build a “more efficient, equitable and sustainable” system.

One of three firemen, who were injured while battling the blaze that destroyed Mae’s School in Subryanville, Georgetown, died Saturday night at the Georgetown Public Hospital Corporation (GPHC), prompting claims by his family of hospital negligence. Voshaun Manbodh (1871), 27, was injured on February 5 when the burning structure collapsed on him and two other ...

President Irfaan Ali announced that a system was being put in place for mothers to receive the GY$100,00 cash grant within one week of giving birth before they leave hospital. He told mothers at the launch of the initiative that officials of the Ministry of Finance and Regional Health Officers would be collaborating to ensure ...

The primary health centers of Santo Domingo, Santiago, San Francisco de Macorís, Baní, and San Cristóbal report many respiratory conditions.

Influenza, syncytial influenza, adenovirus, and COVID-19 are some of the respiratory viruses affecting the country in the last four weeks, leading to increased consultations and emergencies reported by health centers. The epidemiological report issued by the Ministry of Public Health indicates that the circulation of influenza A (H1N1) pdm09, influenza A (H3N2), Adenovirus, SARS-CoV-2, and parainfluenza has been reported in week eight. So far this year, respiratory syncytial viruses, influenza B Victoria, and metapneumovirus 1, 2, and 3 have circulated, so Public Health assures that it continues with surveillance in monitoring these viruses.

Official surveillance

The Ministry of Health asked the population to go to the vaccination centers. Recently, there has been a latent threat with the virus that spreads against measles; the recommendation is to get vaccinated. Vaccines have saved millions of lives. In the case of the flu, it does not prevent it, but people do not complicate themselves with the severity and deaths. For this reason, it urges parents and guardians to update their children’s vaccination schedules, which contributes to preserving children’s health and preventing the circulation of measles viruses in the country. Public Health said that the government country has more than 1,400 vaccination posts distributed nationwide, offering all the vaccines of the official scheme free of charge. These immunizations are available as a tool to prevent disease.

The country’s measles vaccines are available in two doses: the first at 12 months of age, along with rubella and mumps vaccines, and the second booster dose at 18 months. The entity highlights the importance of children at this age receiving their vaccines according to the established schedule.

Primary Care

Vaccination corresponds to Primary Care, so vaccination posts are located in the First Level Care Centers (CPNA), diagnostic centers, Children’s Hospitals, maternity hospitals, subcenters, Primary Care Units (UNAP), dispensaries, medical offices, the Health City, the Plaza de la Salud General Hospital, some private clinics, Profamilia, and the Santo Domingo Health Center.

In response to the call of the World Health Organization (WHO) to strengthen prevention measures due to the increase in measles cases in the region, the ministry has intensified epidemiological surveillance in ports  and airports

San Pedro De Macori—Faced with the concern of citizens who fear the appearance of cases of measles in the country, Dr. Goldny Mills, professor of epidemiology and preventive medicine at the Central University of the East (UCE), said that since 2001, there have been no cases of the disease, and in 2010, the Dominican Republic was declared free of measles, which is highly contagious.

He understands that the population must catch up with the vaccines of our children and thus avoid the appearance of cases and possible outbreaks of measles, since on January 29 of this year, the World Health Organization (WHO) warned about the increase in cases of measles on a global scale and the occurrence of imported cases in the countries of the Americas.

He indicated that this 2024 report suggests that more than half of the world’s countries are at high risk from a measles outbreak. He warned that the children most at risk are those under five years of age and those over one year old who do not have complete vaccinations, so they must be vaccinated.

Dr. Mills, former Provincial Director of Health in San Pedro de Macorís and teacher of the department of students called (Pollitos) of the UCE, who work all year round bringing prevention of epidemiological diseases to neighborhoods, fields and bateyes of the province, called on the population not to neglect the vaccines of their children.

He said that the country’s primary focus is for parents and guardians to review their children’s vaccination cards and ensure that every child over five has at least two doses of the MMR vaccine.

The epidemiologist said that measles is a highly contagious and potentially serious disease caused by a virus, specifically paramyxoviruses, which affects children who do not have an up-to-date vaccination schedule.

The government is on the cusp of completing a purpose-built geriatric hospital, with Senior Minister Dr William Duguid confirming that the project remains firmly on track for completion this year. The facility, intended to revolutionise elderly care, is part of a broader effort to address the needs of the nation’s ageing population.

Providing an update during the closing session of the Estimates debate on Friday, Dr Duguid detailed the significant progress made across various sections of the facility, highlighting that the ambitious project remains on schedule.

“Barbados will have a purpose-built geriatric hospital for its people,” he said. “We are making significant construction progress on this facility, and we are on target to have it completed this year,” he said. “The west wing is moving at pace, with slicking and priming completed on all floors. The first coat of paint is already being applied to the ground and first floors, and the installation of mechanical, electrical, and plumbing systems is nearing completion.”

The new geriatric hospital offers a modern, well-equipped environment tailored to meet the needs of the nation’s ageing population. In March 2023, during a groundbreaking ceremony to officially start construction of the Waterford, St Michael facility, officials announced that the project would be completed in just under two years at a cost of $1.307 million for phase one of the project. No projections were given for the cost of phase two of the three-storey state-of-the-art facility.

During the first phase of construction – the main hospital building – 300 beds and ten lounges were built, along with two treatment rooms per floor, a rehabilitation unit outfitted with a gym and pool for therapeutic services, a daycare facility, staff offices, amenities, and ancillary services. Phase two focused on another 105 bedrooms and six lounges. 

He further outlined the advancements in other critical areas of the hospital, noting that exterior lighting and fixtures are being installed, while the administration core is progressing rapidly. “Slicking and priming of walls in the administration section are underway, and preparation for similar work is happening in the south wing. Kitchen drains are being installed, and the final portion of the ground floor slab is being prepared for casting,” he explained. “Construction and plastering of internal block work are ongoing on all floors.”

The minister emphasised that significant strides had also been made on other integral components of the hospital, including the annex, chapel, central plant, and generator building. “In the annex, slicking and priming are ongoing on all floors, while the superstructure and internal block work construction have been completed, with plastering nearing completion. Over at the chapel, the installation of the standing seam roof sheeting is in progress, and the interior finishing is well advanced,” Dr Duguid added.

The mechanical infrastructure, which is crucial to the hospital’s operational efficiency, has also seen notable headway. “The chillers have been placed on the concrete plinths in the chiller yard, with connections being made for chilled water pipes,” he said. “Installation of equipment in the pump room and central plant is progressing at speed. Meanwhile, the generator building’s structure has been completed, and interior and exterior painting is underway.”

Dr Duguid also highlighted key developments in the hospital’s surrounding infrastructure, stating that work on the main road and sidewalks is substantially complete. “We have finished cutting the wall and installing the sidewalk, while work on the internal access road and drainage installation is ongoing. Ninety per cent of the walkway along Waterford Main Road has already been cast, and we are now reinforcing the remaining portion.”

With nearly all trenches for the chilled water pipes dug and connections completed, the minister reaffirmed the government’s commitment to seeing the project through to completion. 

(SZB)

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Santo Domingo.- Agriculture Minister Limber Cruz announced that while African Swine Fever (ASF) has not been completely eliminated, the government has a structured plan for its total eradication. Significant progress has been made in biosecurity, laboratory infrastructure, and disease prevention within the pork industry.

Cruz highlighted that upon taking office, the country lacked the necessary diagnostic capabilities, forcing authorities to wait weeks for test results from the United States. Now, thanks to upgraded local laboratories, ASF detection can be completed in just two hours. This efficiency has drawn international recognition, with the FAO and other global organizations using the Dominican Republic as a reference in ASF detection and control.

Recent tests conducted in February identified ASF in 11 small-scale pig farms, but the virus has been kept under control, with no cases reported in large farms or commercial breeders. The Minister reaffirmed that ongoing collaboration between government agencies and pork producers is key to eradicating ASF entirely.

“We need fresh ideas! We value your input!” The words echo in meeting rooms across Barbados, often met with a mix of hope and skepticism. Too often, passionate service professionals, our nurses, teachers, police officers, and frontline workers, offer innovative solutions only to be met with resistance: “That’s not how we do things here.” This repeated dismissal breeds learned helplessness, a quiet erosion of initiative that leaves our vital services stagnant and our dedicated professionals burned out. This isn’t just about workplace morale; it’s about the quality of care and service our nation receives.

Barbados thrives on the dedication of its service professionals. From the bustling tourism sector to our essential public services, these individuals are the backbone of our communities. Yet, the very systems they serve within can inadvertently stifle their creativity and problem-solving. While we’re known for our vibrant spirit and “Bajan ingenuity,” too many good ideas remain unspoken, lost to the fear of rocking the boat or being labeled a troublemaker. This silence isn’t golden; it’s costly.

The consequences of learned helplessness are far-reaching. For individuals, it manifests as chronic stress, exhaustion, and burnout. The constant state of alert takes a toll, impacting mental and physical health. For organizations, it means lost innovation, decreased productivity, and high turnover. And for Barbados as a whole, it translates to a decline in the quality of essential services we all rely on.

The good news is that learned helplessness can be overcome. The key lies in fostering a culture of empowerment and providing service professionals with the tools they need to reclaim their agency. This is where self-care coaching, reframed as a strategy for professional development and organizational health, can play a transformative role.

Self-care coaching isn’t about spa days and bubble baths. It’s about equipping individuals with practical skills to:
Challenge Limiting Beliefs: Coaching helps professionals identify and dismantle the negative self-talk that perpetuates learned helplessness. It teaches them to recognize their value and advocate for their ideas effectively. For example, a teacher might learn to confidently propose new teaching methods, even if they deviate from tradition.

Develop Resilience Strategies: Service professionals often face challenging situations and resistance to change. Coaching provides them with strategies to navigate these obstacles, manage stress, and bounce back from setbacks. A nurse, for instance, might learn techniques for managing the emotional toll of demanding shifts while also developing strategies for advocating for better patient care.

Foster Collaboration and Communication: Coaching can facilitate open communication and collaboration within teams. It helps professionals express their concerns constructively, build consensus, and work together to implement positive changes. Imagine a police officer using coaching skills to facilitate community dialogues and build stronger relationships with residents.

Drive Systemic Change: When service professionals feel empowered, they become agents of change within their organizations. They can champion new initiatives, advocate for policy improvements, and create a ripple effect that transforms workplace culture. This could involve a group of firefighters working together to improve safety protocols or a team of tourism workers developing innovative ways to enhance the visitor experience.

To leaders across Barbados: Investing in self-care coaching is not an expense; it’s an investment in the future of our essential services. It’s about creating workplaces where professionals feel valued, supported, and empowered to contribute their best. It’s about building a stronger, more resilient Barbados.

To every service professional: Your well-being matters. Your voice matters. Don’t let learned helplessness silence you. Seek out resources, connect with colleagues, and become an advocate for positive change within your workplace and your community.

Let’s break the cycle of learned helplessness and unleash the full potential of our service professionals. Together, we can build a Barbados where everyone thrives.

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School principals have urged swift action to regulate vendors operating outside school premises, citing concerns over students’ health and the circumvention of nutrition policies. 

Robin Douglas, president of the Barbados Association of Principals of Public Secondary Schools (BAPPSS), has called for immediate legislation to address the issue, on the heels of recent  reports of suspected psychoactive substance sales to primary school children.

He expressed concern that at present, students can buy what they want from  vendors before school in the morning and afterwards in the afternoon and nothing can be done about it.

Using the Schools’ Nutrition Policy and a recent revelation by the National Council on Substance Abuse (NCSA) of the suspected sale of psychoactive substances to primary school children as a reference point, Douglas stressed that while he could not accuse any vendor of criminal activity, there is urgent need for legislation to control what is happening outside the gates of schools.

“There is need for legislation to be rewritten to be able to have something to say to persons outside of the schools’ compound. My school here at Combermere would not be the only problem, this is a problem across all schools, where vendors that are on the outside of the compound, there is nothing that you can do to stop them from being where they are,” the BAPPSS leader told Barbados TODAY.

Acknowledging that the situation poses a challenge to school administrators, Douglas, principal of the Combermere School, suggested that the time may now be right for the call for legislation to be heeded to hasten the legal process.

“The sooner, the better. There is need to heed a strong call that indicates there are major concerns regarding, not just the dietary concerns, but more concerns for the mental and physical health of our children because of the concerns regarding the things that we can’t control,” he said.

“The reality is,” the educational administrator added, “if you have a nutrition policy that is being circumvented by the fact that children can either buy what they want to eat in the morning or just hold their money and buy it when they leave in the evening, then the nutrition policy is being circumvented, and the in-school canteen, they comply with the measures for the nutrition policy, would of course, see a reduced revenue from students who would then buy outside. So it is a difficult situation, and there are not many avenues for school administrators to take.”

Douglas gave an assurance that administrators would not want to deprive anyone of opportunities to make an honest living, but at the same time, he is adamant that school authorities still needed to be more vigilant and watch for any signs of changes in behaviour so they can determine the source.

The BAPPSS president insisted: “I would not be so bold as to suggest that anybody is doing anything criminal. Persons are trying to make a living. However, one of the main difficulties is the way in which it works against the implementation of our nutrition policy.”

He suggested the need for even greater vigilance over what children are consuming in light of the suspected sale of drugs to students.

“There is little that can be done regarding external vending. Without having evidence to suggest that someone is involved in that type of activity, you certainly can’t place that upon persons. It is about vigilance and response given the current concerns that you would have,” Douglas contended.

He said while there is no legal backing to move vendors from outside schools, the only other possible options may be if they are operating from people’s lands without permission or don’t possess health certificates. Vendors can also circumvent these certificates, he explained.

 emmanueljoseph@barbadostoday.bb

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