Health Services in Cuba: An Initial Appraisal

The development of the Cuban health services during the last decade reflects a commitment to minimize the striking inequalities in the availability and consumption of health resources that previously existed between social classes, between cities and rural areas, and between regions. This process of equalization has been characterized by a centralization of inpatient services, a decentralization of ambulatory services, and an increase in the use and production of paramedical and auxiliary personnel within the health-services system. The health services today are structured according to regional models aimed at providing integrated care to the whole population, with integration of preventive with curative services, social with medical services, and environmental with personal health services. The universal coverage of the population has been achieved by redistribution of old and new resources and a heavy investment in the health sector, with great priority given to the rural and poor areas and regions of the country, and to the production of personnel, primarily of physicians.