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Servicios de salud pública, un determinante esencial de salud durante la crisis. Lecciones de Cuba, 1989–2000
Author(s) -
De Vos Pol,
GarcíaFariñas Anaí,
ÁlvarezPérez Adolfo,
RodríguezSalvá Armando,
BonetGorbea Mariano,
Van der Stuyft Patrick
Publication year - 2012
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2011.02941.x
Subject(s) - life expectancy , public health , medicine , infant mortality , gross domestic product , population , health care , environmental health , health indicator , tuberculosis , demography , salary , low birth weight , economic growth , nursing , political science , pregnancy , economics , pathology , sociology , biology , law , genetics
During the 1990s, Cuba was able to overcome a severe crisis, almost without negative health impacts. This national retrospective study covering the years 1989–2000 analyses the country’s strategy through essential social, demographic, health process and health outcome indicators. Gross domestic product (GDP) diminished by 34.76% between 1989 and 1993. In 1994 slow recuperation started. During the crisis, public health expenses increased. The number of family doctors rose from 9.22 to 27.03 per 104 inhabitants between 1989 and 2000. Infant mortality rate and life expectancy exemplify a series of health indicators that continued to improve during the crisis years, whereas low birth weight and tuberculosis incidence are among the few indicators that suffered deterioration. GDP is inversely related to tuberculosis incidence, whereas the average salary is inversely related to low birth weight. Infant mortality rate has a strong negative correlation with the health expenses per inhabitant, the number of maternal homes, the number of family doctors and the proportion of pregnant women receiving care in maternal homes. Life expectancy has a strong positive correlation with health expenses, the number of nursing personnel and the number of medical contacts per inhabitant. The Cuban strategy effectively resolved health risks during the crisis. In times of serious socio‐economic constraints, a well conceptualized public health policy can play an important role in maintaining the overall well‐being of a population.