Rising to the challenge: Integrating diabetes care in the Dominican Republic
The increasing burden of diabetes and other NCDs is reshaping health systems in the Dominican Republic. With WDF’s support, the country is meeting the challenge, upgrading protocols, training health workers, and strengthening people-centred primary care nationwide.
15 May 2026 Anna Thabuis
Across Latin America and the Caribbean, diabetes and other non-communicable diseases (NCDs) are accelerating, reshaping health systems. This is especially pronounced in the Dominican Republic, where an estimated 17.6% of the population is living with diabetes, the highest prevalence in the Caribbean.
Behind this statistic are millions of individual stories, and in primary health clinics, this means more screening, more follow-up visits, and more conversations about prevention and management. In response to this growing burden, the Dominican Republic is rising to the challenge, rethinking how chronic diseases are prevented and managed, and strengthening integrated, people-centred primary care.
This shift is among others anchored in the PAHO/WHO HEARTS initiative, which has been rolled out nationally since 2019. HEARTS aims to strengthen cardiovascular care within primary health services through standardised, evidence‑based protocols. While it initially focused on hypertension, HEARTS now includes diabetes care through the introduction of the Module D technical package. Diabetes and hypertension share risk factors and complications, and are often linked: hypertension increases diabetes risk and diabetes raises hypertension risk.
The World Diabetes Foundation (WDF) is supporting the Ministry of Health and the Ministry of Public Health and Social Assistance of the Dominican Republic (MISPAS)’s implementation of the HEARTS initiative across 18 provinces (five regions) by the rollout of integrated diabetes and hypertension services at targeted facilities. Building on previous collaborations in the country, the current initiative strengthens integrated diabetes and hypertension care is aligned with MISPAS’ commitment and strategy to addressing NCDs.
Turning policy into action
National strategies only make a difference when they are visible in day-to-day care, in how patients are screened, counselled, treated, and followed up. This is where the PAHO/WHO HEARTS model has become most tangible in the Dominican Republic: inside primary health centres, where dedicated Diabetes and Hypertension Corners are changing what routine care looks
Across the Dominican Republic, Diabetes and Hypertension Corners, dedicated spaces for prevention, screening, counselling, and follow-up, are taking root in primary healthcare facilities. Integrated into routine clinic visits, these corners combine screening, counselling, and follow-up in one place, making it easier for people to return, ask questions, and stay engaged with their care over time.
Establishing a dedicated space is one step. Making it work consistently across the country requires leadership, training, and the tools to deliver care reliably every day.
The Ministry of Health and MISPAS fully own the initiative, ensuring that design and implementation are closely aligned with national priorities. “The Minister of Health and Ministry of Public Health and Social Assistance show strong commitment to the NCD agenda, with diabetes, hypertension, and chronic kidney disease as key priorities,” says Line Bechmann, WDF Programme Manager. “I experienced a dedicated NCD unit that truly believes in intersectoral coordination to support implementation and sustain results.”
Progress, however, ultimately depends on what happens every day in health facilities. Through WDF support, more than 150 primary care centres are being strengthened with improved protocols, staff training, better equipment, and more regular supervision. Small changes, such as having the right tools available or clearer treatment pathways, add up to more reliable follow-up and better control of both diabetes and hypertension.
Building skills at the community health level
Once the protocols and training are in place, the next step is making sure health care workers at the community level feel confident delivering this care every day.
Shifting mindsets, alongside strengthening clinical skills, is essential to improving diabetes and other NCD care in the Dominican Republic.
For Stepany Nunéz Crisósteno, a clinical intern at the at the Guano Primary Health Centre, that shift began in the training room. “As medical students, we thought chronic diseases never improved,” she recalls. “But it’s the opposite.”
Through WDF-supported training workshops aligned with the PAHO/WHO HEARTS initiative, hundreds of doctors, nurses, and health promoters are building the skills needed to prevent, detect, and manage diabetes and hypertension in everyday practice. This is a part of the Healthy and Tasty (SALSA) Strategy, which combines practical nutrition counselling with community engagement, helping people understand what to change, why it matters, and how to sustain it.
Reflecting on her training under the SALSA strategy, Stepany explains “The first thing [we learned] was how to take blood pressure correctly and identify patients with both diabetes and hypertension or with both diagnoses.” The trainings focus on practical application, reinforcing standardised protocols while encouraging teamwork across cadres.
The initiative is also bringing technical expertise and care to the community level through the training of final-year nutrition students to support clinics by counselling patients and delivering tailored nutrition programmes. By placing students directly in clinics and communities, the pilot helps address workforce gaps while building a new generation of professionals with hands-on experience in diabetes and NCD care. The strategy is currently being piloted in six primary health centres: four in Santiago province and two in Santo Domingo, where partner universities train nutritionists.
In addition to the training under SALSA, there are national workshops organised to train primary health teams. These go beyond single conditions, addressing common comorbidities such as tuberculosis and HIV, and promoting a more integrated, patient-centred approach to care.
Investing in early and continuous training strengthens the healthcare workforce and also shapes how care is delivered on the ground, ensuring support for those living with diabetes, from the first screening to long term follow up.
From guidelines to healthy habits
For people living with diabetes and hypertension, integrated care goes beyond diagnosis and medication. It is reflected in practical, everyday support: clear information, regular follow-up, and encouragement to make changes that feel achievable.
Patient education and awareness-raising are built into routine care, helping ensure that people leave clinics with tools they can use at home. Services include nutrition counselling, guided exercise sessions, and educational workshops that support individuals to better understand and manage their condition.
For José, who lives with hypertension, this approach has made a tangible difference. “They tell us we need to eat healthier and exercise to maintain our health,” he says. “That’s why I’ve kept my blood pressure under control. I had to make a change.”
Monthly support groups further reinforce this model of care. Alongside clinical advice, they create space for shared experience and mutual encouragement. Participants learn about nutrition and treatment management, and many leave with greater confidence to manage their condition, knowledge that extends beyond the clinic walls.
Scaling impact
The rising burden of diabetes is met with strong national prioritisation of NCDs, creating an opportunity for lasting impact. “With continued donor support and growing experience within the Ministry of Health and MISPAs, the future of diabetes and hypertension care looks increasingly promising,” reflects Line Bechmann. Since 2019, HEARTS has scaled nationally alongside Ministry-led health reforms and now reaches roughly 80% primary health clinics in the country, positioning the Dominican Republic as a leader in the region.
WDF is supporting the roll out of the HEARTS in Guatemala, Belize, Panama, and Peru, strengthening diabetes and other NCD services in primary health systems across the region. The Dominican Republic’s experience shows what coordinated leadership and sustained partnership can achieve. Training, standardised protocols, supervision, and patient education are no longer add-ons, but part of routine primary care.
As diabetes and NCD care continues to expand, these foundations will be essential to meeting the country’s growing NCD burden, today and in the years ahead.