Cuban Healthcare Paradox
1
The Cuban Healthcare Paradox -- How do they deliver quality, world-class healthcare at the lowest cost per capita? The fortress of Havana “Guantanamera” – the unofficial anthem of Cuba Additional WHO health statistics for Cuba: Infant mortality M/F = 5/6 /1000 (2006) Healthy life expectancy at birth M/F = 67/69 (2006) Child mortality M/F = 8/7 /1000 (2005) Total health expenditures per capita = $503 (2009) Life expectancy at birth M/F = 76/80 (2006) Total health expenditures as % of GDP = 11.8% (2009) # physicians = 70,594 (2007) physician density/ 10,000 = 63 (2007) Adult literacy rate = 97% (2004) physician ratio/patient = 1:175 (2001) Total education expenditures as % of GNP = 10% (2010) (US = 2%) VIVA LA REVOLUTION! Public Health = National Health Care The Cuban healthcare system is an international success story. After the Revolution, the government assumed full responsi- bility for the health and educational needs of all its citizens. The Revolution declared universal healthcare and education a human right and government social responsibility and priority. Because Cuba has so few financial resources, it must depend on prevention as the only affordable means of keeping the population healthy. Although healthcare personnel are paid little compared to the US, they receive subsidized housing, utilities and a food allowance. They have such passion for their work, they are beloved by their neighbors, and the healthcare system is highly trusted. Plaza de la Revolution -- Havana Consultoria in Havana Consultoria: serves local families, approx 1500 persons Doctors/nurses generally live in building where clinic is located, know all their patients in the neighborhood. Primary care, health ed, pre-natal, mother/child care, elderly care here Approximately 99% vaccination compliance and infx dz eradication Also responsible for local vector spraying ** This system is determined to be the single most important factor in creating positive universal health – the presence of a solid community- oriented primary care network accessible to every family in Cuba Policlinica: area-wide clinic with specialties in dentistry, Traditional Medicine, chronic disease management, rehab, X-ray, labs, ultrasound, MH, etc. Provides secondary prevention care 470 in Cuba as of 2007 serving ~26,000 patients each Hospital level care – Tertiary care, including deliveries -- 248 as of 2007 Ministerio de Salud publica, including 25 Medical schools, 1 school of PH Structure of Cuban healthcare system Escuela Americana de Medicina (ELAM) (1999) Cuban medical education is 100% free and attracts students from all over the world, including from the US (~90 students). These medical graduates go back to serving in their inner-city or rural environments. Students must promise to go back to under-served areas of their native countries to practice medicine. Cuban doctors are a key component of Cuban outreach to Caribbean countries, Central and South America, and Africa. Over 29,000 Cuban doctors staff over 69 foreign medical missions. Medical diplomacy: Cuban doctors and nurses provide free medical care and services to other third-world countries after disasters. After hurricane Katrina, 1500 Cuban doctors volunteered to come to America, but US government permission was denied. The US embargo on Cuba has had a devastating effect on infrastructure improvements, procurement of medical supplies/equipment and even buying food. With the loss of Soviet patronage in the 90’s, Cuba looks to its Caribbean and Central/South American neighbors as trading partners. Cuba trades its medical expertise for Venezuelan oil. Cuba exports sugar cane, rum, nickel, tobacco and vaccines. Cuba has developed a world- class vaccine research capability (including one against a strain of bacterial meningitis B), and a new diabetes foot decubitus injection therapy that the US is interested in. On-going vaccine research continues into “neglected” diseases such as cholera, dengue, TB and leptospirosis. Prepared by: Dorothy D. Zeviar, Ed.D., LAc, MPH-c, 2012
description
Following an APHA-sponsored trip to Havana, Cuba over Christms holidays, I developed this poster to tell the story about the success of the Cuban healthcare system.
Transcript of Cuban Healthcare Paradox
The Cuban Healthcare Paradox --
How do they deliver quality, world-class healthcare
at the lowest cost per capita?
The fortress of Havana
“Guantanamera” – the unofficial anthem of Cuba
Additional WHO health statistics for Cuba:
Infant mortality M/F = 5/6 /1000 (2006) Healthy life expectancy at birth M/F = 67/69 (2006)
Child mortality M/F = 8/7 /1000 (2005) Total health expenditures per capita = $503 (2009)
Life expectancy at birth M/F = 76/80 (2006) Total health expenditures as % of GDP = 11.8% (2009)
# physicians = 70,594 (2007) physician density/ 10,000 = 63 (2007)
Adult literacy rate = 97% (2004) physician ratio/patient = 1:175 (2001)
Total education expenditures as % of GNP = 10% (2010) (US = 2%) VIVA LA REVOLUTION!
Public Health = National Health Care
The Cuban healthcare system is an international success story.
After the Revolution, the government assumed full responsi-
bility for the health and educational needs of all its citizens.
The Revolution declared universal healthcare and education
a human right and government social responsibility and priority.
Because Cuba has so few financial resources, it must depend
on prevention as the only affordable means of keeping the
population healthy.
Although healthcare personnel are paid little compared to the US,
they receive subsidized housing, utilities and a food allowance.
They have such passion for their work, they are beloved
by their neighbors, and the healthcare system is highly trusted.
Plaza de la Revolution -- Havana
Consultoria in Havana
Consultoria: serves local families, approx 1500 persons
Doctors/nurses generally live in building where clinic is located,
know all their patients in the neighborhood.
Primary care, health ed, pre-natal, mother/child care, elderly care here
Approximately 99% vaccination compliance and infx dz eradication
Also responsible for local vector spraying
** This system is determined to be the single most important factor in
creating positive universal health – the presence of a solid community-
oriented primary care network accessible to every family in Cuba
Policlinica: area-wide clinic with specialties in
dentistry, Traditional Medicine, chronic disease
management, rehab, X-ray, labs, ultrasound, MH,
etc. Provides secondary prevention care
470 in Cuba as of 2007 serving ~26,000 patients each
Hospital level care – Tertiary care,
including deliveries -- 248 as of 2007
Ministerio de
Salud publica,
including 25
Medical schools,
1 school of PH
Structure of Cuban healthcare system Escuela Americana de Medicina (ELAM) (1999)
Cuban medical education is 100% free and attracts students from all over the world, including from the US
(~90 students). These medical graduates go back to serving in their inner-city or rural environments.
Students must promise to go back to under-served areas of their native countries to practice medicine.
Cuban doctors are a key component of Cuban outreach to Caribbean countries, Central and South America,
and Africa. Over 29,000 Cuban doctors staff over 69 foreign medical missions.
Medical diplomacy: Cuban doctors and nurses provide free medical care and services to other third-world
countries after disasters. After hurricane Katrina, 1500 Cuban doctors volunteered to come to America, but
US government permission was denied.
The US embargo on Cuba has had a devastating effect on
infrastructure improvements, procurement of medical
supplies/equipment and even buying food. With the loss
of Soviet patronage in the 90’s, Cuba looks to its
Caribbean and Central/South American neighbors as
trading partners. Cuba trades its medical expertise for
Venezuelan oil. Cuba exports sugar cane, rum, nickel,
tobacco and vaccines. Cuba has developed a world-
class vaccine research capability (including one against a
strain of bacterial meningitis B), and a new diabetes
foot decubitus injection therapy that the US is interested
in. On-going vaccine research continues into “neglected”
diseases such as cholera, dengue, TB and leptospirosis.
Prepared by: Dorothy D. Zeviar, Ed.D., LAc, MPH-c, 2012
