Date of Award


Document Type

Latin America


Beginning in 2001, the Dominican Republic experienced a series of healthcare reforms contributing to the current structure of the Dominican healthcare system, influencing access to specialized type 1 diabetes (T1D) care, affordable insulin and medications, and diabetes education. As type 1 diabetes is a misunderstood and understudied issue in the Dominican Republic, the goals of this research are twofold. First, this project situates T1D care in the context of the Dominican healthcare system, analyzing its impact on T1D patients. Second, it addresses how the Dominican Republic can better meet the health-related needs of its citizens who have type 1 diabetes through various T1D policies, programs, and investments. A comparison of case studies from the United States, Colombia, Ecuador, and a nine-country cross-regional analysis will highlight successful solutions that have increased access to T1D healthcare resources, providing alternative solutions applicable to the DR. Utilizing theories of healthcare accessibility defined by dimensions of approachability, acceptability, availability, and accommodation, affordability, and appropriateness, this thesis analyzes accessibility to T1D resources in the Dominican Republic, while simultaneously providing solutions for these gaps in care.