Reply #48: World Health Organization: Cuba's primary health care revolution: 30 years on [View All]

[Judi Lynn]

Bulletin of the World Health Organization
ISSN 0042-9686 versão impressa
Bull World Health Organ v.86 n.5 Genebra maio 2008
doi: 10.1590/S0042-96862008000500006
NEWS

Cuba's primary health care revolution: 30 years on

With the community-based polyclinic as its centrepiece, the country's primary health care system has produced enviable results as it continues to adapt to new challenges. Gail Reed reports from Havana.

"We fought for the Declaration of Alma-Ata before it was official," says Dr Cristina Luna, "and its message has guided and challenged us ever since." At 43, Luna is Cuba's national director of ambulatory care, and on her shoulders rests the country's entire primary health care system, by many standards one of the world's most effective and unique.

Cuban health authorities give large credit for the country's impressive health indicators to the preventive, primary-care emphasis pursued for the last four decades. These indicators – which are close or equal to those in developed countries – speak for themselves. For example, in 2004, there were seven deaths for every 100 000 children aged less than five years – a decrease from 46 such deaths 40 years earlier, according to WHO. Meanwhile Cubans have one of the world's highest life expectancies of 77 years.

The centrepiece of this system is the community-based polyclinic, each of the 498 nationwide serving a catchment area of between 30 000 and 60 000 people. The polyclinics act also as the organizational hub for 20 to 40 neighbourhood-based family doctor-and-nurse offices, and as accredited research and teaching centres for medical, nursing and allied health sciences students. "These are the backbone of Cuba's health system," Luna says.

More:
http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862008000500006&lng=pt&nrm=iso&tlng=pt