Cuban health system shows the way, British Medical Journal says

CUBA has been praised for its advances in child health, which a paper published this week in the British Medical Journal (BMJ) attributes partly to the socialist island’s empowerment of women along with other socioeconomic measures.

The article highlighting the success of the country’s healthcare system, titled Cuba’s success in child health: what can one learn? appears in the latest issue of the authoritative medical journal.

It points to World Health Organisation (WHO) figures showing a child mortality rate (U5M) of 5.5 per 1,000 lives, achieved despite an almost six-decade economic blockade.

This rate is lower than the United States, which has a child mortality rate of 6.5. Cuba has the second-lowest child mortality rate in the Americas, just behind Canada.

Free universal education means that the country has one of the world’s highest doctor-to-patient ratios and literacy stands at at 99.7 per cent, meaning that public-health campaigns are able to reach the entire population.

Primary healthcare is one of the major successes of the island’s health system with almost half of Cuban doctors working in such health facilities, according to the article’s authors, Cuban paediatrician Mauro Castello Gonzalez and Imti Choonara, emeritus professor at the University of Nottingham’s school of medicine. This brings healthcare to traditionally hard-to-reach rural communities, with each team responsible for about 300 families.

Cuba has also achieved a significant reduction in babies with a low birth weight (LBW). Just 5.5 per cent of babies are born with a weight of less than 2.5kg (5lb 8oz) compared with 8.3 per cent in the US, according to 2017 statistics.

The article notes that the “empowerment of women in civil society has been a major achievement in Cuba” and contributes to children’s health.

“First, all girls attend school. Women have the same rights as men in Cuban law and receive equal pay. Maternity leave is 12 months and the woman’s job is protected by law.

“The majority of professionals in Cuba are women. Additionally, the majority of members of parliament in Cuba are women, with Cuba having the second-highest proportion of women in parliament worldwide. This representation in parliament is a reflection of the importance of gender equality in Cuba.”

Severe malnutrition in children was declared absent in Cuba by Unicef over a decade ago and malnutrition is not considered a major problem there despite the blockade.

The main lesson is what can be achieved by governments when healthcare is recognised as a priority, even with limited resources. Advances in children’s health can be achieved if there is the political will, the authors say.

“Cuba is an example of what is possible,” they conclude.