Cuba Health Care Research Trip 2010

Vinales Panorama

A group of North American medical professional's experience studying the Cuban medical system.

History of the Cuban Healthcare System

With the departure of half the Cuban physicians after the revolution, the first step was to create more rural health centers and urban community clinics. Medical education was seen as the key – “every physician became a teacher” we were told in several interviews.  Medical schools were created and the community clinic or “polyclinic” model was adopted with responsibilities ranging from health education to prevention to environmental monitoring.  As the 1980’s began regional centers for maternal-child health, psychiatric services, infectious disease, and chronic diseases were established. 

 

Polyclinic in Havana

Later on in the 1980’s was the establishment of the Family Doctor Program. With medical schools beginning to turn out thousands of family doctors, family doctor clinics (consultorios) were started in each neighborhood. These clinics consist of a doctor-nurse team responsible for anywhere from 160 to 400 families in their neighborhood. This team is responsible for preventive health services and community education in such areas as family planning and disease vector control. Basic health services are offered at the family medicine clinics, and generally in the afternoons either the nurse or doctor will be away from the clinic making house calls or having educational meetings in the community. Usually the doctor and nurse live nearby – often upstairs or next door to the clinic.

 

While the family doctor’s office has only very basic services, the local polyclinic offers lab, x-ray, emergency room services, physical therapy, and specialty services, usually on a rotating basis. Each polyclinic may serve the patients of anywhere from 14 to 30 family doctor’s offices. It is the responsibility of the family doctor to refer the patient for specialty services and to provide a health history summary for the patient to take with them. Patients who need specialized inpatient care or specialized testing such as an MRI can be referred on to one of the region’s specialty centers. Pregnancy is managed by the family doctor/nurse team with referral as needed to the polyclinic.  This comprehensive system combined with Cuba’s nearly 100 percent literacy rate allows Cuba to post some of the best health indicator results in the world.  Data can be seen at the MEDICC website.

 

The family doctor clinics are very sparsely equipped and furnished:

 

Examination Room at family doctor clinic

 

What makes the Cuban system work is that there is one physician for every 159 people!