For decades, malnutrition in the Dominican Republic was synonymous with hunger. Children in rural provinces and low-income neighborhoods often depended on public school food programs that fell short and malnutrition rates rose. In the ’90s, chronic child malnutrition affected more than 30% of children younger than 5. Over time, however, the country has made measurable progress. By the early 2010s, undernourishment had dropped by more than half, partly thanks to school food programs and targeted interventions.

The New Face of Malnutrition

Today, the face of malnutrition in the Dominican Republic has changed. While stunting still affects 6.7% of children under age 5, the more pressing concerns are anemia, obesity and overweight. According to UNICEF, about 8% of children under 5 are overweight. Likewise, 31% of public school students were overweight or obese during the 2021–2022 school year. At the same time, nearly 28% of children under 5 still suffer from anemia.

As nutrition specialist Ana Carolina Báez Abbott told The Borgen Project in an interview: “Now the problem isn’t underweight, but overweight and obesity… and often these overweight children have micronutrient deficiencies. What we call hidden hunger.” The country now grapples with what public health experts call the “double burden” of malnutrition: undernutrition and overnutrition coexisting in the same communities.

Band-Aid Policies Yield Uneven Results

This transition highlights a pattern of “band-aid” solutions. The government and international organizations previously focused on school feeding programs to reduce hunger. By 2013, the FAO reported that undernourishment had declined by more than half compared to the ’90s. Yet policymakers ignored the quality of meals, which often filled stomachs but lacked the nutrients needed for healthy development.

Abbott explained that when she worked with the Programa de Alimentación Escolar (School Feeding Program), her team uncovered serious flaws in the menus. “There was a high sugar content in the school menu,” said Abbott. “For example, a juice with an average of 23 grams of sugar that the children consumed daily. We decided to exclude it and replace it with fresh fruit.”

She also noted efforts to improve fiber intake: “We ensured that every lunch dish included vegetables, along with protein and carbohydrates. It was a way to educate children on proper nutrition.”

Today, the government’s promises tell a similar story. The ruling Modern Revolutionary Party (PRM) has pledged investments in rural health infrastructure. In its 2025 report, the Ministry of Public Health estimated that malnutrition and obesity cost the country 2.6% of GDP annually. Health budgets remain skewed toward urban hospitals, leaving rural maternal and child nutrition programs underfunded.

Approval of Schooling Feeding Program

In 2024, legislators made school feeding a permanent state policy, banning junk food in cafeterias and guaranteeing potable water. This represents a milestone, showing that nutrition is finally being addressed as a permanent right rather than a temporary fix.

Still, as Abbott notes: “These are changes that you may not see results from right now, but you are preventing children from receiving a super-high sugar load… and that impacts the reduction of health complications in the future.”

Her perspective aligns with findings from Diario Libre’s 2022 and 2024 reports: the Dominican Republic has established key tools like the National Institute of Student Welfare (INABIE) and school nutrition laws — but their impact depends on how effectively these programs are implemented, especially in rural areas.

While progress is undeniable, the country still struggles with underlying inequities, where malnutrition has evolved and not disappeared. Rural poverty, limited access to nutritious food and weak program delivery mean that the country still fails its youngest citizens.

Abbott emphasized the role of poverty and inequality: “The problems of poverty and inequality exacerbate the problem. Many mothers stop breastfeeding early and opt for sweetened formulas, creating children with a preference for sweets from a very young age.”

A Political Gap

The Dominican Republic’s struggle with malnutrition is political as much as it is nutritional. Budget priorities favor urban hospitals over preventive care. Maternal and child nutrition remain secondary concerns in national planning. Lawmakers pass laws but fail to implement them fully.

According to Abbott, stronger public policies are essential. “We need more public policies, more laws and regulations,” she explains. “We need schools to be safe spaces where what is sold in cafeterias is controlled. And we need massive educational campaigns to raise awareness among the population.”

The 2024 nutrition law, INABIE’s expanded reach and the PRM’s rural health pledges show that nutrition is gaining attention on the national agenda. The challenge is no longer whether policies exist, but whether they are strong enough, consistent enough and inclusive enough to close the remaining gaps.

Abbott points out that measures like food reformulation and labeling could help: “There is a proposed regulation for front-of-package labeling with nutritional warnings… we, as a state, have a responsibility to inform consumers.”

The Road Ahead

Malnutrition in the Dominican Republic has changed forms over the decades, but it remains a serious problem. The Dominican Republic has reduced hunger but now faces a more complex challenge: tackling anemia, obesity and stunting together. This requires moving beyond short-term fixes toward structural change: investing in maternal diets, rural programs and school nutrition that emphasizes quality, not just quantity.

Until then, malnutrition in the Dominican Republic will remain a familiar story told in new forms: a problem solved on paper, but not in the lives of Dominican children.

– Shannon Garrido

Shannon is based in Brighton, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr