Dominican Republic and Haiti: Country Studies

Dominican Republic and Haiti: Country Studies
strong correlation among urban residence, literacy, and declining
fertility. The reduced fertility rate in urban areas is closely
tied to a lower rate of marital unions for urban women, and
double the rate of unstable unions for urban women compared
to rural women.
Rates of contraceptive use are up since the late 1980s. In the
mid-1990s, reported rates of contraceptive use were 13 percent
for women and 17 percent for men. Rates of contraceptive use
are higher in urban than rural areas. Studies suggest that the
demand for family planning services exceeds available programs
and that many women lack access to modern contraceptives
and birth-control information.
Nutrition and Disease
According to mid-1980s surveys, average daily nutritional
consumption was estimated to be 1,788 calories per person, 80
percent of the FAO daily minimum requirements. An estimated
50 percent of Haitians consume less than 75 percent of
recommended caloric intake. Cereals and vegetables supply
more than 50 percent of food energy, and meat and dairy
products supply about 5 percent. One study found that 25 percent
of households had consumed no animal products in the
preceding week. Millet and starchy roots are key sources of
nutrition in low-income households, and bread is tending to
replace other cereal foods in urban areas. Peasant households
confronting chronic malnutrition are inclined to adopt agricultural
strategies that limit risk and ensure short-term survival
rather than long-term well-being. Witness the shift away from
cereals into higher production of starchy root crops since 1950.
Inadequate nutrition is an important factor in Haitian disease.
Anemia, for example, is common among children and women.
Infant and child health is poor. Infant mortality in 1996 was
seventy-two per 1,000 live births, about double the regional
average. Although comparative data show evidence of a decline
in infant mortality in recent decades, almost half of all deaths
occur within the first five years. Children ages twelve to twentyfour
months are at high risk for malnutrition because of
increased vulnerability during weaning. The proportion of
one-year-old children who die before reaching age five has
increased somewhat since the late 1980s, a period that coincides
with severe economic and political crisis.
For children ages one to five, the principal causes of death
are diarrheal illnesses (37 percent), malnutrition (32 percent),
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