RESUMO
PIP: Data from the Dominican Republic's 1991 Demographic and Health Survey (DHS) and other surveys of recent decades were the basis for this assessment of maternal and child health, morbidity, and mortality. The first of three major sections describes changes in infant mortality over the past three decades and estimates maternal mortality rates using the sister survival method. The major causes of infant death are also identified. The second section provides data on the incidence and treatment of diarrhea and acute respiratory infections in young children. The third section uses information from the Household Questionnaire of the 1991 DHS to assess maternal morbidity and to analyze the coverage of prenatal care. Infant mortality in the Dominican Republic is known to have declined, but there is no consensus on the current level. Analysis of trends and internal consistency of estimates from different sources suggests that infant mortality declined from around 100/1000 live births in the early 1960s to 43/1000 in the late 1980s. Despite the progress, the Dominican Republic still has the second highest level of infant mortality among the Caribbean islands. The neonatal mortality rate exceeds the postneonatal rate, and marked geographic and socioeconomic differentials persist. A high proportion of infant deaths are caused by respiratory and diarrheal disorders and preventable infections. Application of the sister survival method to 1991 DHS data indicated that the maternal mortality rate declined from 25/10,000 live births in 1971 to around 18/10,000 in 1980, with the decline due in large part to improved health services. The 1991 DHS data indicated that 16.6% of children under five had at least one diarrheal episode and one-fifth had signs of respiratory infection in the two weeks preceding the survey. Both diarrhea and respiratory infections had their greatest incidence in children 6-11 months old. 30% of the children with diarrhea and 40% with respiratory infections were taken to a health facility. 31.6% of children with diarrhea received oral rehydration therapy. The 1991 DHS data showed that 37% of children 12-23 months old were completely vaccinated and only 1% had no vaccinations. Prenatal care was obtained from a physician for 97% of births in the five years preceding the 1991 DHS. Over 90% of deliveries occurred in health facilities and nearly 90% were professionally attended.^ieng