IFGH 2010: Public Health: Why are the Cubans so successful? A case study of public health governance in Cuba

Category:
November 30, 2010

Health outcomes are closely correlated with GDP. Cuba is the classic outlier in this regard. Expenditure on health per head of population in Ireland is $4,556, UK $3867 and in Cuba $585. Life expectancy in Cuba is 78years and 80years in Ireland and the infant mortality rates in Cuba and the UK are identical 5:1000 (WHO, 2010). The aims of this study were to examine public health governance in Cuba and to develop a model which explains the reasons behind the conspicuously good health outcomes.

A case study design was used which employed a variety of research methods: participant and non-participant observation; focus group and semi structured interviews. Twenty weeks of fieldwork, was carried out in Cuba.

Ten explanatory themes emerged from the findings: Ministry of Public Health; focus on prevention and health promotion; education; integration; primary care; citizenship; equity; public system; socialism and political will. The metaphor of a repaired umbrella is used as the basis for a theoretical model to explain Cuba’s success.

Cuba teaches the importance of health policy based on systematic needs assessment; strong political commitment to public health in Cuba and the pre-eminence of the Ministry of Public Health vis á vis other ministries.

 

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