Dr. Peter G. Bourne

UNIVERSAL

FREE

ACCESSIBLE

CUBAN HEALTH SYSTEM

INTEGRATES 5 SUBSYSTEMS

HEALTH NATIONAL SYSTEM

Information

HealthCare

Medical Education

ResearchHealthControl

CUBACUBA

HEALTH INSTITUTIONS NETWORK IN CUBA

Universities,Politechnics.

Institutes and Research Centers

Policlinics, Hospitals, Clinics

Centers and Units of Hygiene

Information Centers,Libraries

Medical Care FacilitiesCuba, 2000

Facilities 2000

Hospitals 270 Policlinic 440 Family physician's Office 20611 Dental Care Clinics 162 Research Institutions 12 Maternal Homes 258 Blood Donor Units 24 Elderly Homes 269 Disabled Homes 33

MOTHER-CHILD PROGRAMMOTHER-CHILD PROGRAMChild Mortalityunder 1 year old

Rat

e p

er 1

000

life

b

irth

s

60

9,4 6,5 7,2

0102030405060

1959 1995 1999 2000

Rat

e p

er 1

000

life

b

irth

s

.

43.8

12,58,4 9,1

0

10

20

30

40

50

1970 1995 1999 2000

Child Mortalityunder 5 years old

0

2

4

6

8

10

12

14

Maternal Mortality

1959 1995 1999 2000

Rat

e p

er 1

0 00

0 li

fe

bir

ths

12,5

2,7 3,0 3,4

VACCINATION PROGRAM RESULTVACCINATION PROGRAM RESULT

POLIO ELIMINATED SINCE 1962DIPHTHERIA ELIMINATED SINCE 1969NEWBORN TETANUS ELIMINATED SINCE 1972CONGENITAL RUBELLA ELIMINATED SINCE 1989MENINGITIS POST MUMPS ELIMINATED SINCE 1989MEASLES ELIMINATED SINCE 1993

WHOOPING COUGH TRANSMISSION INTERRUPTED SINCE 1994RUBELLA TRANSMISSION INTERRUPTED SINCE 1995MUMPS TRANSMISSION INTERRUPTED SINCE 1995

MORBIDITY

MENINGOCOCCICAL DISEASE REDUCTION 93%TYFHOID FEVER REDUCTION 75%B HEPATITIS REDUCTION 52%

LIFE EXPECTANCY. CUBALIFE EXPECTANCY. CUBA

At BIRTH 60 YEARSOLD

80 YEARSOLD

76

20.5

7.6

0

10

20

30

40

50

60

70

80YEARS

996

994

992990

980

970960

940920900

800

700

600500

100 200 400 1 000 2 000 4 000 10 000 20 000 40 000Gross National Product per Capita in US Dollars, 1995

Ch

ild

ren

su

rviv

ing

up

to

5 y

ears

of

age

per

100

0 li

ve b

irth

s, 1

995

GLOBAL HEALTH CHART VERSION SEPT. 97

177 Countries with more than 100 000 inhabitansHans rosling, Division of International Health Care ResearchDept. of Public Health Sciences. Karolinska Institute. Sweden

AFRICA

ASIA &PACIFIC

AMERICAS

EUROPEMOZAMBIQUE NIGER

INDIA

CHINA

USA

JAPON

BRASIL

MEXICO

SOUTH AFRICA

PAKISTAN

EGIPTO

VIENAM

BANGLADESH

INDONESIA

ANGOLA

SIERRA LEONANIGERIA

CUBA

RUSIATHAILANDIA

ARGENTINA

UKGERMANY

FRANCE

FINLAND SWEDEN

HONG KONG SINGAPUR

CZECH

SOUTH KOREA

JAMAICACOSTA RICA

URUGUAY

CHILE

ETHIOPIA GABON

SUDAN

CONGOTANZANIA

PANAMA

IRAN

BOLIVIA

LIBYA

SAUDI ARABIA

HAITI

ACHIEVEMENT PUBLIC HEALTH IN CUBA •HUMAN RESOURCES

(Human values)(Human values)

• POLITIC WILLINGNESS• HEALTH EDUCATION • SINGLE HEALTH SYSTEM• COMMUNITY PARTICIPATION• PREVENTIVE ATTENTION

HOW ?

HUMAN RESOURCESCUBA/2001

350 000 350 000 Health WorkersHealth Workers

Include: 105,000 profesionals 75,000 nurses 56,000 technicians

67 %67 %

MEDICAL UNIVERSITIES*MEDICAL UNIVERSITIES*OF THE HEALTH NATIONAL SYSTEMOF THE HEALTH NATIONAL SYSTEM

*

* **

*

*

**

**

- * * 4 Medical Sciencies Universities- 1 Latin American School of medicine - 21 Medicine Faculties- 4 Odontologies Faculties

- - 1 Public Health School1 Public Health School- 20 Municipality Branchs

**

* **

8373 Professors

HEALTHCOMPLEX

EDUCATION

RESEARCH

MEDICALUNIVERSITY

HEALTH POLITECNIC

HOSPITAL

POLICLINIC

ODONTOLOGYCLÍNIC

RESEARCH CENTER

MEDICAL CAREMEDICAL CARE

SYSTEM REORIENTATION TOWARD THE SYSTEM REORIENTATION TOWARD THE PRIMARY HEALTH CAREPRIMARY HEALTH CARE

IMPLEMENTATIONIMPLEMENTATION

Family Physicians 30 133National coverage 98,3 %

Family Medicine Specialists 23 294Family Medicine Residents 6 358

169Municipalities

Home medical care Social and community participation Urgency care at primary health level

2001

MEDICAL COLABORATIONMEDICAL COLABORATION

Colaboration with 6 Medicine Faculties

Professors in 25 countries

57 Countries83 Countries

1963 - 2000

WORKERS WORKERS

2001

HEALTH HUMAN RESOURCES HEALTH HUMAN RESOURCES DEVELOPMENTDEVELOPMENT

• ACCREDITATION• COMPETENCE AND PERFORMANCE

EVALUATION• ACADEMIC SYSTEM WITH CREDITS• CONTINUOUS EDUCATION

THE THE HEALTHHEALTH IN THE IN THE INFORMATION SOCIETYINFORMATION SOCIETY

THE THE HEALTHHEALTH IN THE IN THE INFORMATION SOCIETYINFORMATION SOCIETY

Health vs. Illness

Preventive medicine vs. Healing medicine

Center of Health vs. Hospital

Distance vs. Presence

Use ICT vs. Traditional care

HEALTH FOR ALL in the XXI CENTURY

PREVENTIVE SANITARY POLICY

FINANCIAL SUPPORT

KNOWLEDGE ACCESS

THE BIG CHALLENGE FOR

HEALTH

*MEDICAL TECHNOLOGY (ICT)

*PRIMARY HEALTH CARE

*SOCIAL MEDICINE *HEALING MEDICINE

TELEHEALTH

•TELE-EDUCATION•TELEMEDICINE•RESEARCH•MANAGMENT

KNOWLEDGE KNOWLEDGE NETWORKNETWORK

• HEALTH

• EDUCATION

• COMMUNICATION

INFOMED Telematic Health Network in Cuba.

La HabanaLa HabanaVilla Clara

Camagüey

Santiago de Cuba

National node3 regional nodes10 provinces nodes

http://www.sld.cu/

Cuban Health Network Connection

Municipality 80

Institutions 730

Users 20,000

Traffic daily message 34,000

Daily visits to Infomed Website 45,000

ESTRATEGIC PROJECTSESTRATEGIC PROJECTS

• HEALTH VIRTUAL UNIVERSITY

• HEALTH VIRTUAL LIBRARY

CUBA /2001CUBA /2001

TELEMATIC NETWORK IN HEALTHTELEMATIC NETWORK IN HEALTH (INFOMED)(INFOMED)

www.uvirtual.sld.cu

HEALTH VIRTUAL UNIVERSITY AND LIBRARY

-of information

-of discussion

-of consultancy

-of education

-of resources

Offered Services Interaccion Spaces:

-Virtual Clinic-Virtual Classroom-Virtual Convention Center-Scientific NetworkScientific Network

¡ TO ACEPT THE CHALLENGE !

¡ TO ACEPT THE CHALLENGE !

VIRTUAL VIRTUAL EDUCATIONEDUCATION

Health University Health University XXI CenturyXXI CenturyHealth University Health University XXI CenturyXXI Century

PRESENCE PRESENCE EDUCATIONEDUCATION

NEW INFORMATION AND NEW INFORMATION AND COMMUNICATIONS TECHNOLOGIES COMMUNICATIONS TECHNOLOGIES

DIGITAL AGE