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SPECIFIC HEALTH PROBLEMS IN DOMINICA
Analysis by population group:
Children (0-4 years): Neonatal
health services at the main hospital are limited to basic secondary
care; tertiary care is not available on the island. More than 99%
of all births are assisted by a trained health care professional.
From 1996-1999, 58 perinatal deaths occurred, 35 from slow fetal
growth and fetal malnutrition. Of the 95 infant deaths 1996-1999,
59% were early neonatal deaths with prematurity the underlying cause
in 64% of these. In 1996-1999, 16 deaths occurred in the 1-4 age
group, 25% from congenital abnormalities. The immunization program
routinely offers DPT, Polio, BCG, MMR . In 1997, coverage with DPT
and polio reached 92 and 97%, respectively. No cases of vaccine
preventable diseases were reported during 1997-2000. Normal growth
is reported for 89.8 percent of children in that age group, but
9.2% were obese 1997-2000. In 1999, 10% of newborns had low birthweight.
In 1999, 103 cases of gastroenteritis were reported. Diarrheal diseases
caused 2 deaths in 1997, one in 1998 and none in 1999. Only one
death in 1999 was recorded from acute respiratory infections.
Schoolchildren (5-9 years): At age 5 all school
entrants are screened in the school health program for vision, hearing,
anemia, growth and development and general physical health. In 1996-1999,
14 deaths in 5-9 years olds occurred -- 11 were males; 5 were accidental,
3 from motor vehicle accidents and one, homicide.
Adolescences (10-14, 15-19 years): Adolescents
represented 22% of the population in 1999; 3% were illiterate. Health
risks are alcohol use, other substance abuse, STIs including HIV,
violence, accidents and underemployment. During 1996-1998, 78 cases
of suicide and attempted suicide were reported -- more than half
( 53%) in adolescents under 18 years. Suicide accounted for 3 deaths.
During 1996-1999, 66 deaths were recorded in this age group. The
leading causes of death were transport accidents, injury due to
violence, other accidents, and epilepsy.
Indigenous Population: In 2000, the Carib Affairs
department was established for community development and poverty
alleviation. Changes in the socio-economic conditions and increased
access to health and education have improved the health status of
the Caribs. In 1999, the following health concerns were identified
- lack of potable water, solid waste disposal, violence, drug abuse
including alcoholism, tuberculosis, sexually transmitted infections,
and helminthiasis. The Carib Territory is served by two health centres.