L ong perceived and touted as a positive result of the cuban revolution which left fidel castro in power in 1959, health care in cuba is complex. Visitors are served by a separate feebased system, servimed, which is also the backbone of cubas medical tourism industry. Aug 01, 2015 health is a national priority, requiring participation from all sectors of the government and civil society. Cubas health system was transformed as a result of the 1959 revolution led by fidel castro. How does cuba manage to achieve firstworld health statistics. The country has welltrained, capable doctors, the sector has become an important export earner and gives cuba valuable soft power yet the real picture is less rosy. The health system should cooperate in global health activities. Cuba s health care system is revolutionary because rather than focusing on profit, it has made its focus the health of individuals, which capitalist countries have deprioritized. There is one aspect of cubas health care system that seems to produce results. According to margaret chan, the world should follow the example of the island in this arena and replace the curative model, inefficient and more expensive, with a preventionbased system.
Next week one of our internal medicine wards at the salvador allende hospital will be closed to the cuban population for use by medical tourism. The who country health profile of cuba provides key statistics and links to health topical databases, plus news, features and bulletin journal articles on the health issues of the country. For the past 12 years, cuba has been incorporating ntm into clinical practice, medical. Sources download a pdf with sources for this report here. This paper explores the dynamics of health and health care in cuba during a period of severe crisis by placing it within its economic, social, and political context using a comparative historical approach. Margaret chan, the director general of the who, stated after a visit to cuba in 2014 that this is the way to go, and acknowledged it as one of the model systems of the world. The cuban health care system and factors currently. In contrast, cuba only spent 10% of its gdp, putting it on par with norway, sweden, the united kingdom. Cv diseases have been the leading cause of death since at least 1970 22,50 and within its resource limitations the medical care. Switzerlands health care is universal and health insurance is required for all persons living in switzerland. Enthusiasm around the cuban health system often stems from an exclusive attention to one indicator, infant mortality. It developed a series of performance indicators to assess the overall level and distribution of health in the. Although cuba has limited economic resources, its health care system has solved some problems that the u.
Thanks in part to cuban doctors efforts in preventing malaria, cases dropped from 600,000 in 2002 to 200,000 in 2004. Cuba can be considered a unique laboratory, and deserves more attention. Jan 17, 2017 cubas health system is strongly focused on prevention. For example, cuba has the same 78year life expectancy as our country, while spending only 4 percent of the amount the united states spends on. Health care should be managed and provided by the state. Community healthcare services in cuba cubas contribution. Ullmann says, but, in practice, one that is lacking.
Universal health care is free, and everyone has a family physician and nurse. Feb 10, 2017 cubas healthcare system is a source of pride for its communist government. Previously, it ran a dual privatepublic health system with around 6,000 physicians, twothirds of. Cuba provides a unique opportunity to study the cv epidemic in the nonindustrialized world because of its robust public health data system. Comparative analysis of three different health systems. Health care cuba and the caribbean a university of miami. Cuba april 25, 2015 the cuban health care system and child health outcomes. Cuba s healthcare system is a source of pride for its communist government. The public is responsible for participating in the development and functioning of the health system.
This may be a testament to health care based on social principles rather than gdp 1. Kennedy once stated, children are the worlds most valuable resource and its best hope for the future. Introduction this article first introduces the community health care network of cuba, mainly focusing on the threelevel setup of the cuban community healthcare system. Each countrys health care system was described and examined in terms of its funding, consumer participation, and overall governance on a local to national level. It provided a framework and measurement approach to examine and compare aspects of health systems around the world. The myth of cubas glorious health care system foundation. I am writing to protest the egregious misrepresentation of the cuban health care system presented by p. Despite extremely limited resources and the dramatic impact caused by the economic sanctions imposed by the united states for more than half a century, cuba has managed to guarantee access to care for all segments of the population and obtain results similar to those of the most developed nations. The most serious flaw in the policy forum is its unquestioning faith in the legitimacy of cuban government health data. The system is also far more equitable than ours in the us because everyone is guaranteed access to the same quality hea. Comparison and analysis of health care delivery systems.
The cuban health system is recognized worldwide for its excellence and its efficiency. However, the original principles of the health care system are not under question. The aim is to maintain quality health service free for the cuban people, increase exchange among experts and boost researchdevelopment projects. What is emerging in the public health system is a capital generating mechanism with the ends of paying for continued free health care for the cuban people. The world health organization who ranked the health systems of its 191 member states in its world health report 2000. Cubas health care system is revolutionary because rather than focusing on profit, it has made its focus the health of individuals, which capitalist countries have deprioritized. But then neither is healthcare provision anywhere in the world. Previously, it ran a dual privatepublic health system with around 6,000 physicians, two. Despite extremely limited resources and the dramatic impact caused by the economic sanctions imposed by the united states for more than half a century, cuba has managed to guarantee access to care for all segments of the population and obtain results similar to those of the most developed. In many ways, cuba is an exemplar of how to achieve the triple aim. Cuba primary health care in action world health organization.
Introduction health care delivery system hcds is a societal response to the determinants of health. During the cuban health systems transformation which began in 2011 as the health. Establishing their ideology as the basis, cuba has formed their health care system into a free service, just one of the aspects in their socialist philosophy. Cuba is preparing a computerized health register, hospital management system, primary health care, academic affairs, medical genetic projects, neurosciences, and educational software. These were the main facilities jo and i were able to visit. Jan 23, 2019 one of the most readily apparent problems with the health care system in cuba is the severe shortage of medicines, equipment, a nd other supplies. Health system in cuba everyone has the right to health protection and care health system in cuba levers goal intermediate goals financial resource fully integrated system funded by general taxation with low out of pocket payments equity 99% accessibility in rural and urban steward ship national health system decentralization service provision. Many cubans including a number of health professionals also had serious complaints about the intrusion of politics in to medical treatment and health care decisionmaking. Primary health care in cuba consortium of universities. Identify the reasons behind the renewal of the primary health care. Mar 30, 2015 what is emerging in the public health system is a capital generating mechanism with the ends of paying for continued free health care for the cuban people.
As someone who trained as a doctor in cuba, id like to give. Characterize primary health care phc as the base of a health care system 2. Cuba began to resemble th e developed nations in health care figures. General practitioners became the central focus of the health care system 3 1 lambie, g. World health organization ranking of health systems in 2000. The basis for the entire cuban healthcare system is preventive care and the primary healthcare phc model. To compare the design and functioning of three health care systems in two developed countries, australian and switzerland with a developing country, saudi arabia. Describe cuba s primary health care model and its main experiences 4. Identify the components of primary health care and their application models 3. Feb 03, 2009 this has resulted in a local primary care system that provides not only clinical diagnosis and treatment but also community education about general health and nonmedical health determinants.
Multispecialty polyclinics were established across cuba in the 1970s, before the 1978 declaration of almaata, and these were transformed with the addition of the family doctorandnurse programme in the mid1980s, enhancing the health systems ability to deliver on prevention and communityhealth analysis, as well as clinical services. In a 2014 visit to cuba, the director general of the world health organization, margaret chan, declared cuba s healthcare system a. Absent such reforms, the cuban nation will continue to decline in all spheres. Identify the components of primary health care and their application models.
One must remember that healthcare in cuba is very good when bearing in mind the economic constraints. Cuba s health system was transformed as a result of the 1959 revolution led by fidel castro. Cubas health care system proved to be as vibrant as the view, leading my ideas of public health and medicine down new pathways. The pahowho representative moya, dr jose gerardo p. Community healthcare services in cuba cubas contribution to the world. Julie feinsilver in community health care in cuba edited by susan e.
Primary health care in cuba consortium of universities for. The concept of health care system includes the involvement of the people, organizations, agencies. When you strengthen a health system, you improve the six health system building blocks and manage their interactions in ways that achieve more equitable and sustained improvements. As the bbc noted last year, the foundation of cubas preventative health care model is for family doctors to oversee the health of those in their neighborhoods. The us ranks 3 rd in health care expenditures, spending 17. In comparison to the rest of latin america, cuba has shown the greatest performance in health care over the past 15 years.
Steven ullmann, um health care business expert, provides perspective on cubas health care system. Health system in cuba pan american journal of public health. Cuba has one of the best healthcare systems in the world. Visitors are served by a separate feebased system, servimed, which is also the backbone of cuba s medical tourism industry. As the bbc noted last year, the foundation of cuba s preventative health care model is for family doctors to oversee the health of those in their neighborhoods. Apr 24, 2018 the national health policy in cuba gives priority to health as a right, an essential component of human wellbeing and a strategic objective of development.
Unlike other european countries, swiss healthcare is not taxbased or financed by employers, but rather it is paid for by individuals through their contribution to swiss healthcare schemes. Health care should be integrated with the economic and social development. The cuban health care system and child health outcomes. Pdf overview of the cuban health system julie m feinsilver.
The goal, as always, is to focus on training and the sharing of knowledge, which provides benefits to all involved. Although cuba has achieved success with its current model, it was not the starting point. When the gambian government established its first national health care system in 1996, it turned to cuba for both advice and the personnel to staff clinics in previously unserved poor rural areas. Universal health coverage and universal access to health care. A number of serious challenges remain in cuba, including food insecurity, a severe housing shortage, a lack of freedom of expression, and restrictions on. Describe cubas primary health care model and its main experiences 4. Community healthcare services in cuba cuba s contribution to the world. Community based polyclinics are the centre piece of cubas primary health care system. The health problems of elderly cubans, therefore, are now beginning to overshadow those of other sectors of the population, and cuba is facing the challenge of providing care. Fidel castros death and the announced resignation of raul castro as president of cuba offer the opportunity to revisit, among other things, the cuban health system which has been praised by a significant proportion of the global public health community for decades. F rom puerto rico to jamaica to haiti to cuba, ums medical and public health professionals are engaging in rich partnerships on trauma care, vector borne disease, pediatrics, vision care and more. There is one aspect of cuba s health care system that seems to produce results.
Everyone has a family physician, everything is fre. Cuba s health care system is based on preventive medicine and the results achieved are outstanding. The cuban constitution defines the country as an independent, sovereign, democratic, and socialist state. Multispecialty polyclinics were established across cuba in the 1970s, before the 1978 declaration of almaata, and these were transformed with the addition of the family doctorandnurse programme in the mid1980s, enhancing the health system s ability to deliver on prevention and community health analysis, as well as clinical services. Because of the cuban health care system s inclusiveness and effectiveness, many global leaders have publicly praised it. Health in cuba international journal of epidemiology. The truth about cubas health care system acton institute. A close look at cubas health care system cuba and the. It is unlikely that the united states will adopt socialized health care any time soon, but some of the cuban system s distinguishing features might still provide useful lessons. Cubas surprisingly costeffective healthcare forbes. Ullmann, an expert in health care management and policy at the university of miami, and coauthor with journalist mary helen spooner of cuban health care. Is the cuban healthcare system really as great as people claim.
Neither health care nor education reached those rural cubans at. An admirable accomplishment with lurking questions john f. Cuba s health system is strongly focused on prevention. The overall performance of the cuban health system, measured by progress in health conditions, has been overrated. Dr rebeca mendoza, the director of a polyclinic in havana, cuba. Cubans citizens receive free medical care through a national health service. It outlines cuban achievements in health care as a consequence of the socialist transformations since 1959, noting the full commitment by the cuban state, the. One of the most readily apparent problems with the health care system in cuba is the severe shortage of medicines, equipment, a nd other supplies. Challenges ahead article pdf available in health policy and planning 234.
Life expectancy increased, infant mortality declined, and access to medical care expanded. Health system differences between cuba and the united states likely account for much of cuba s ability to do more with less. The cira garcia hospital is a major provider of medical services to foreigners in havana. Oct 06, 2017 health system differences between cuba and the united states likely account for much of cuba s ability to do more with less. Precastro cuba american experience official site pbs. World health organization ranking of health systems in. Is the cuban healthcare system really as great as people. The six health system building blocks the world health organization recommends supporting and strengthening a health system based on the below framework figure 2. Education is a priority, and there is almost universal literacy. The cuban health care system functioned effectively up through the 1980s. The cuban healthcare system is not only free for all cuban citizens, the quality of primary care is equal to or better than the united states and other industrial nations, at a fraction of the cost.
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