Health Systems Transformation
Health Systems Transformation in Dominica refers to a comprehensive, long-term initiative to modernize the island’s healthcare services, policies, and infrastructure in line with its national development goals and the push toward Universal Health Coverage (UHC). Led by the Ministry of Health, Wellness and Social Services and supported by international partners such as the Pan American Health Organization (PAHO) and the World Health Organization (WHO), this effort focuses on delivering equitable, resilient, and efficient healthcare to all communities, particularly in light of vulnerabilities exposed by Hurricane Maria in 2017.
Strengthening Governance and Hospital Management
Following years of centralized oversight, one of the most significant milestones in this transformation was the establishment of the Dominica Hospital Authority, which introduced a Board of Directors and Chief Executive Officer to manage hospital services more autonomously. This reform enhances transparency, operational efficiency, and accountability across facilities like the Dominica-China Friendship Hospital and district clinics.
The new governance framework supports more effective budgeting, human resource planning, and response readiness, particularly in health emergencies or extreme weather events.
Infrastructure and Resilience Upgrades
In partnership with PAHO, Dominica has advanced the Smart Hospitals Initiative, which retrofitted the Grand Bay Health Centre and La Plaine Health Centre to be structurally resilient and energy-efficient. These upgrades were not cosmetic but functional, ensuring continued operation during and after natural disasters. Each facility has improved roofing, solar energy systems, rainwater harvesting, and enhanced internal layouts to facilitate better service delivery.
Additionally, facilities such as the Marigot Hospital have been constructed to expand the reach and specialization of medical services in underserved regions. Other centers like Newtown, Bagatelle, and Roseau have undergone renovations including fencing, triage areas, and emergency backup systems.
Integration of Digital Health Technologies
Another core element of the transformation involves digital modernization. With funding through the OECS Digital Transformation Project, Dominica has implemented a Health Management Information System (HMIS) to digitize patient records, streamline case tracking, and reduce inefficiencies. This is complemented by the launch of an Electronic Immunization Registry, which ensures accurate and timely vaccine coverage data.
By integrating digital tools, the healthcare system is better positioned to analyze population health trends, track outbreaks, and improve continuity of care across the island.
Workforce Capacity and Community Health Workers
Dominica’s Health Systems Transformation includes major investments in human resources, particularly in rural healthcare delivery. The country trained 27 Community Health Workers (CHWs) to act as frontline agents in primary care. These workers serve villages where travel to larger clinics can be difficult, offering services such as blood pressure monitoring, home visits, referrals, and health education.
The CHWs are now an integral part of Dominica’s primary care model, helping to prevent and manage chronic illnesses such as diabetes and hypertension in early stages and easing the burden on larger facilities.
Public Health and Resilience Strategy
Aligned with the national Climate Resilience and Recovery Plan (CRRP), the transformation embeds disaster risk reduction within public health planning. Clinics double as storm shelters, and response protocols have been strengthened with health cluster coordination, pre-positioning of medical supplies, and post-disaster psychological support programs.
Health campaigns now emphasize climate-linked health risks, from water-borne diseases to mental health trauma, and use local councils and faith-based organizations to support outreach.
Looking Forward
Dominica’s Health Systems Transformation is a dynamic, evolving process. While progress has been made, challenges remain: shortages of medical professionals, limitations in transportation logistics, and gaps in mental health care still require attention. However, through sustained partnerships and local engagement, the island continues to lead regionally in building a health system that is responsive not only to today’s needs but to the hazards and population shifts of tomorrow.