dr una lynch institute of governance school of law [email protected]
TRANSCRIPT
Dr Una LynchInstitute of Governance
School of [email protected]
Public Health: Why are the Cubans so successful?
IRISH FORUM FOR GLOBAL HEALTH (IFGH)BIENNIAL CONFERENCE
NUI Maynooth - 29th November 2010
• Comparative health statistics
• Research methodology
• Reasons behind Cuba’s Success
“… sentence me, it is not important, history will absolve me”
“Only death can liberate one from so much misery. In this,
however — early death —
the State is most helpful.
Ninety percent of rural children are consumed by parasites,
which filter through their bare feet from the earth.
Society is moved to compassion upon hearing of the
kidnapping or murder of one child
but they are criminally indifferent to the
mass murder of so many thousands of children
who die every year from
lack of facilities, agonizing with pain.”
Fidel Castro, 1953
http://www.gapminder.org/
Expenditure on Health
Country Total expenditure on health as
percentage of GDP
Total expenditure on health Per Capita average exchange rate US$
Bolivia 5.0 69
Cuba 10.4 585
Ghana 8.3 54
Haiti 5.3 35
Republic of Ireland 7.6 4556
United Kingdom 8.4 3867
United Stares of America 15.7 7285
Zambia 6.2 57
Source: World Health Report, (WHO, 2010)
Infant Mortality Rate
0
20
40
60
80
100
120
140
160
180
Dea
ths p
er 1
000
live
birt
hs
CountrySource WHO, 2010; *NISRA, 2007
Methods
Public health why are the Cubans so
successful?
LiteratureUnstructured
interviews
Observations(participant & non-
participant)Semi-structured
interviews
Focus Group Interviews
Documents
Public Heath: Why are the Cubans so successful?
1. Political will 2. Ministry of Public Health 3. Health promotion & prevention of ill health
4. Primary Care5. Active citizenship 6. Equity7. Public system8. Integration9. Education10. Socialism
Why a Ministry of Public Health?
“Public Health has to do with all the problems which in whatever way affect the health of the population.
If we were to view it simply as the Ministry of Health it would basically be representing the curative service.
And as the doctrine of the revolution is prevention
or rather promotion, prevention and protection of health,
if we were to call it only the Ministry of Health it would mean that most important functions would be outside of
the Ministry, and for that reason
it is public health, because the focus is prevention.”
[Dr Edwardo Zacca Peňa, Director Statistics Ministry of Public Health Cuba]
Family Doctor / Family Nurse
Needs Assessment
Education and Participation
Social Responsibility
“…to maintain infant mortality rate is
a social responsibility.
Responsibility like Beveridge
says: responsibility. A child of
one year has a right to this. I
imagine that there should not be
anything lacking that will
guarantee its protection: if you
work for this you are fulfilling your
duties, nothing more.”
(Dra Silvia Matínez Calvo)
Sláinte agus Easláinte
• TG4 three part documentary on Irish Health System. In Episode Two, Maire looks at the reforms and cutbacks being imposed on public healthcare and then compares them with a system which runs successfully for a tenth of the cost: the Cuban system. How have they managed to prevent disease and catch it early? And how can they afford so many doctors – proportionately twice as many as here?
http://www.belowtheradar.tv/SainteAgusEaslainteProg02.html