It provided a framework and measurement approach to examine and compare aspects of health systems around the world. Previously, it ran a dual privatepublic health system with around 6,000 physicians, twothirds of. Cuba primary health care in action world health organization. For the past 12 years, cuba has been incorporating ntm into clinical practice, medical. 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. Visitors are served by a separate feebased system, servimed, which is also the backbone of cuba s medical tourism industry. Full text full text is available as a scanned copy of the original print version. Cuba has one of the best healthcare systems in the world. Health care should be integrated with the economic and social development. Is the cuban healthcare system really as great as people claim.
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. Cuba myths and facts washington office on latin america. Cuba s capital, havana, was a glittering and dynamic city. Dec 22, 2014 the us ranks 3 rd in health care expenditures, spending 17.
How does cuba manage to achieve firstworld health statistics. Cuba s healthcare system is a source of pride for its communist government. 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. Aug 01, 2015 health is a national priority, requiring participation from all sectors of the government and civil society. Dr rebeca mendoza, the director of a polyclinic in havana, cuba. Feb 10, 2017 cubas healthcare system is a source of pride for its communist government. Ullmann says, but, in practice, one that is lacking. Community healthcare services in cuba cuba s contribution to the world. Steven ullmann, um health care business expert, provides perspective on cubas health care system. 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. In many ways, cuba is an exemplar of how to achieve the triple aim. Cubas surprisingly costeffective healthcare forbes. The cuban health care system and child health outcomes.
World health organization ranking of health systems in 2000. 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. Comparison and analysis of health care delivery systems. Is the cuban healthcare system really as great as people. Community healthcare services in cuba cubas contribution. Cuba can be considered a unique laboratory, and deserves more attention. The health system should cooperate in global health activities. Health system differences between cuba and the united states likely account for much of cuba s ability to do more with less. Primary health care in cuba consortium of universities for. Identify the components of primary health care and their application models 3.
It developed a series of performance indicators to assess the overall level and distribution of health in the. The overall performance of the cuban health system, measured by progress in health conditions, has been overrated. 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. To compare the design and functioning of three health care systems in two developed countries, australian and switzerland with a developing country, saudi arabia. World health organization ranking of health systems in. 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. Although cuba has achieved success with its current model, it was not the starting point. 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. The concept of health care system includes the involvement of the people, organizations, agencies.
The truth about cubas health care system acton institute. 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. 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. The cira garcia hospital is a major provider of medical services to foreigners in havana. The us ranks 3 rd in health care expenditures, spending 17. Visitors are served by a separate feebased system, servimed, which is also the backbone of cubas medical tourism industry. 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. An admirable accomplishment with lurking questions john f. Cuba s health system was transformed as a result of the 1959 revolution led by fidel castro. 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. 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. 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. Community based polyclinics are the centre piece of cubas primary health care system. Cuba april 25, 2015 the cuban health care system and child health outcomes.
Health system in cuba pan american journal of public health. The pahowho representative moya, dr jose gerardo p. 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. Because of the cuban health care system s inclusiveness and effectiveness, many global leaders have publicly praised it. Community healthcare services in cuba cubas contribution to the world. Identify the components of primary health care and their application models. Cuba began to resemble th e developed nations in health care figures. Enthusiasm around the cuban health system often stems from an exclusive attention to one indicator, infant mortality rate imr, the value of which has been manipulated by a state seeking political legitimacy. Universal health coverage and universal access to health care. Cv diseases have been the leading cause of death since at least 1970 22,50 and within its resource limitations the medical care. As someone who trained as a doctor in cuba, id like to give. 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. Challenges ahead article pdf available in health policy and planning 234.
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. Cuba is preparing a computerized health register, hospital management system, primary health care, academic affairs, medical genetic projects, neurosciences, and educational software. 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. Julie feinsilver in community health care in cuba edited by susan e. These were the main facilities jo and i were able to visit. 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. 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. The cuban health care system functioned effectively up through the 1980s.
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. 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 myth of cubas glorious health care system foundation. In comparison to the rest of latin america, cuba has shown the greatest performance in health care over the past 15 years. A number of serious challenges remain in cuba, including food insecurity, a severe housing shortage, a lack of freedom of expression, and restrictions on. 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 goal, as always, is to focus on training and the sharing of knowledge, which provides benefits to all involved. Thanks in part to cuban doctors efforts in preventing malaria, cases dropped from 600,000 in 2002 to 200,000 in 2004. Health care cuba and the caribbean a university of miami. 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. The world health organization who ranked the health systems of its 191 member states in its world health report 2000. Kennedy once stated, children are the worlds most valuable resource and its best hope for the future. Identify the reasons behind the renewal of the primary health 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.
But then neither is healthcare provision anywhere in the world. Universal health care is free, and everyone has a family physician and nurse. The six health system building blocks the world health organization recommends supporting and strengthening a health system based on the below framework figure 2. Describe cubas primary health care model and its main experiences 4. There is one aspect of cuba s health care system that seems to produce results. 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. Describe cuba s primary health care model and its main experiences 4. 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. Pdf overview of the cuban health system julie m feinsilver.
I am writing to protest the egregious misrepresentation of the cuban health care system presented by p. However, the original principles of the health care system are not under question. Primary health care in cuba consortium of universities. 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. Comparative analysis of three different health systems. Cuba provides a unique opportunity to study the cv epidemic in the nonindustrialized world because of its robust public health data system. 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.
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. During the cuban health systems transformation which began in 2011 as the health. 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. Cuba s health system is strongly focused on prevention.
Get a printable copy pdf file of the complete article 321k, or click on a page image below to browse page by page. 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. Precastro cuba american experience official site pbs. The basis for the entire cuban healthcare system is preventive care and the primary healthcare phc model. Health care should be managed and provided by the state. This may be a testament to health care based on social principles rather than gdp 1. Absent such reforms, the cuban nation will continue to decline in all spheres. Education is a priority, and there is almost universal literacy. The cuban health care system and factors currently. There is one aspect of cubas health care system that seems to produce results. One must remember that healthcare in cuba is very good when bearing in mind the economic constraints.
Switzerlands health care is universal and health insurance is required for all persons living in switzerland. Sources download a pdf with sources for this report here. The most serious flaw in the policy forum is its unquestioning faith in the legitimacy of cuban government health data. Cubans citizens receive free medical care through a national health service. 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. The cuban health system is recognized worldwide for its excellence and its efficiency. Enthusiasm around the cuban health system often stems from an exclusive attention to one indicator, infant mortality. 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.
In contrast, cuba only spent 10% of its gdp, putting it on par with norway, sweden, the united kingdom. Cubas health system was transformed as a result of the 1959 revolution led by fidel castro. The public is responsible for participating in the development and functioning of the health system. The cuban constitution defines the country as an independent, sovereign, democratic, and socialist state. Everyone has a family physician, everything is fre. Characterize primary health care phc as the base of a health care system 2. Previously, it ran a dual privatepublic health system with around 6,000 physicians, two. Cubas health care system proved to be as vibrant as the view, leading my ideas of public health and medicine down new pathways. Jan 17, 2017 cubas health system is strongly focused on prevention. Cuba s health care system is based on preventive medicine and the results achieved are outstanding. In a 2014 visit to cuba, the director general of the world health organization, margaret chan, declared cuba s healthcare system a. 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. Although cuba has limited economic resources, its health care system has solved some problems that the u.
Introduction this article first introduces the community health care network of cuba, mainly focusing on the threelevel setup of the cuban community healthcare system. General practitioners became the central focus of the health care system 3 1 lambie, g. Health in cuba international journal of epidemiology. A close look at cubas health care system cuba and the. Neither health care nor education reached those rural cubans at. Introduction health care delivery system hcds is a societal response to the determinants of health. The system is also far more equitable than ours in the us because everyone is guaranteed access to the same quality hea.
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