Dominican Republic: Niños Primeros en Salud
In 2009, building on years of collaboration with the leadership of the town of Consuelo, Dominican Republic, CHOP opened a flagship pediatric clinic in the Centro de Salud Divina Providencia, called Niños Primeros en Salud (“Kids First in Health”) or NPS.
The program offers comprehensive pediatric care in a primary care clinic, and health education to the most impoverished children under the age of five and their families in the barrios (neighborhoods) of Consuelo. The program is also dedicated to providing opportunities for education, training and research, for both the community and the next generation of pediatric service providers.
CHOP Global Health and our Dominican partners have developed a program that aims to improve the health of children in the program. The program has several key pillars that make this possible. These include:
- Nutrition. We provide food supplements and education to malnourished children and their families in the barrios. Since the start of the program in 2009, incidence of malnutrition among NPS patients has reduced from 10 to 2 percent.
- Breastfeeding. We promote exclusive breastfeeding in new mothers through peer support groups and home visits during pregnancy and after the birth of the child. Exclusive breastfeeding for the first six months, and complementary breastfeeding up to two years, is recognized by the World Health Organization as an important intervention for improving child survival and promoting healthy growth and development for the rest of a child’s life.
- Deworming. We provide de-worming medication to children and family members on a regular basis. In tropical and sub-tropical countries with poor sanitation and difficulty accessing clean drinking water, parasites are common. When left unaddressed, they can cause diarrheal diseases — a significant cause of malnutrition — and other complications. We prevent parasites from causing these serious problems for our patients.
- Immunization. We deliver scheduled, timely vaccinations to children in the program to avoid preventable illnesses, including diphtheria, tetanus, pertussis, and tuberculosis. NPS vaccination rates have gone up from 49 percent of children in the program receiving all required vaccines in 2009 to over 95 percent in 2015.
- Community Health Promoters. Health promoters work in their own communities as trusted advocates for health among their neighbors. We educate and enable health promoters to work as an extension of the clinical program in their own barrios (neighborhoods).
- Academic Collaboration. CHOP Global Health works with the Dominican Republic’s largest pediatric hospital, Hospital Infantil Robert Reid Cabral (HIRRC) in Santo Domingo. Each month 1-2 senior pediatric residents rotate with us, doing a rural pediatric elective in Consuelo. To date, over 100 of the Dominican Republic’s future pediatricians have rotated through the NPS program, providing them a firsthand view of health inequities in their own country. CHOP also coordinates multiple research projects in conjunction with other academic institutions, including Dominican healthcare providers including HIRRC and Clínica de Familia La Romana as well as partners in North America (see below for more information). At Clinica de Familia a CHOP David N. Pincus Pediatric Global Health Fellow provides pediatric care and is an integral member of the clinic team.
CHOP Global Health Allies continue to provide programmatic expertise and hands-on support throughout the year to the clinic and staff in the Dominican Republic.
Learn more about our partner organizations:
- Robert Reid Cabral Children's Hospital (Santo Domingo)
- Columbia University International Family AIDS Program (IFAP)
- Clínica de Familia La Romana
- The Pincus Family Foundation
- The Lundy Law Foundation
DR Rotation: Residents rotating in the DR live in Consuelo and experience a diverse out-patient, Spanish emersion rotation in Consuelo and La Romana. An intermediate level of Spanish is required, either at time of application or with Penn Medical Spanish course completed before the trip. Residents can also elect to take Spanish classes in Consuelo. Clinical experiences will include NPS clinic, home visits with a pediatric nurse, bateye outreach and pediatric and adolescent clinics in La Romana.