dr. peter g. bourne. universal free accessible cuban health system
TRANSCRIPT
INTEGRATES 5 SUBSYSTEMS
HEALTH NATIONAL SYSTEM
Information
HealthCare
Medical Education
ResearchHealthControl
CUBACUBA
HEALTH INSTITUTIONS NETWORK IN CUBA
Universities,Politechnics.
Institutes and Research Centers
Policlinics, Hospitals, Clinics
Centers and Units of Hygiene
Information Centers,Libraries
Medical Care FacilitiesCuba, 2000
Facilities 2000
Hospitals 270 Policlinic 440 Family physician's Office 20611 Dental Care Clinics 162 Research Institutions 12 Maternal Homes 258 Blood Donor Units 24 Elderly Homes 269 Disabled Homes 33
MOTHER-CHILD PROGRAMMOTHER-CHILD PROGRAMChild Mortalityunder 1 year old
Rat
e p
er 1
000
life
b
irth
s
60
9,4 6,5 7,2
0102030405060
1959 1995 1999 2000
Rat
e p
er 1
000
life
b
irth
s
.
43.8
12,58,4 9,1
0
10
20
30
40
50
1970 1995 1999 2000
Child Mortalityunder 5 years old
0
2
4
6
8
10
12
14
Maternal Mortality
1959 1995 1999 2000
Rat
e p
er 1
0 00
0 li
fe
bir
ths
12,5
2,7 3,0 3,4
VACCINATION PROGRAM RESULTVACCINATION PROGRAM RESULT
POLIO ELIMINATED SINCE 1962DIPHTHERIA ELIMINATED SINCE 1969NEWBORN TETANUS ELIMINATED SINCE 1972CONGENITAL RUBELLA ELIMINATED SINCE 1989MENINGITIS POST MUMPS ELIMINATED SINCE 1989MEASLES ELIMINATED SINCE 1993
WHOOPING COUGH TRANSMISSION INTERRUPTED SINCE 1994RUBELLA TRANSMISSION INTERRUPTED SINCE 1995MUMPS TRANSMISSION INTERRUPTED SINCE 1995
MORBIDITY
MENINGOCOCCICAL DISEASE REDUCTION 93%TYFHOID FEVER REDUCTION 75%B HEPATITIS REDUCTION 52%
LIFE EXPECTANCY. CUBALIFE EXPECTANCY. CUBA
At BIRTH 60 YEARSOLD
80 YEARSOLD
76
20.5
7.6
0
10
20
30
40
50
60
70
80YEARS
996
994
992990
980
970960
940920900
800
700
600500
100 200 400 1 000 2 000 4 000 10 000 20 000 40 000Gross National Product per Capita in US Dollars, 1995
Ch
ild
ren
su
rviv
ing
up
to
5 y
ears
of
age
per
100
0 li
ve b
irth
s, 1
995
GLOBAL HEALTH CHART VERSION SEPT. 97
177 Countries with more than 100 000 inhabitansHans rosling, Division of International Health Care ResearchDept. of Public Health Sciences. Karolinska Institute. Sweden
AFRICA
ASIA &PACIFIC
AMERICAS
EUROPEMOZAMBIQUE NIGER
INDIA
CHINA
USA
JAPON
BRASIL
MEXICO
SOUTH AFRICA
PAKISTAN
EGIPTO
VIENAM
BANGLADESH
INDONESIA
ANGOLA
SIERRA LEONANIGERIA
CUBA
RUSIATHAILANDIA
ARGENTINA
UKGERMANY
FRANCE
FINLAND SWEDEN
HONG KONG SINGAPUR
CZECH
SOUTH KOREA
JAMAICACOSTA RICA
URUGUAY
CHILE
ETHIOPIA GABON
SUDAN
CONGOTANZANIA
PANAMA
IRAN
BOLIVIA
LIBYA
SAUDI ARABIA
HAITI
ACHIEVEMENT PUBLIC HEALTH IN CUBA •HUMAN RESOURCES
(Human values)(Human values)
• POLITIC WILLINGNESS• HEALTH EDUCATION • SINGLE HEALTH SYSTEM• COMMUNITY PARTICIPATION• PREVENTIVE ATTENTION
HOW ?
HUMAN RESOURCESCUBA/2001
350 000 350 000 Health WorkersHealth Workers
Include: 105,000 profesionals 75,000 nurses 56,000 technicians
67 %67 %
MEDICAL UNIVERSITIES*MEDICAL UNIVERSITIES*OF THE HEALTH NATIONAL SYSTEMOF THE HEALTH NATIONAL SYSTEM
*
* **
*
*
**
**
- * * 4 Medical Sciencies Universities- 1 Latin American School of medicine - 21 Medicine Faculties- 4 Odontologies Faculties
- - 1 Public Health School1 Public Health School- 20 Municipality Branchs
**
* **
8373 Professors
HEALTHCOMPLEX
EDUCATION
RESEARCH
MEDICALUNIVERSITY
HEALTH POLITECNIC
HOSPITAL
POLICLINIC
ODONTOLOGYCLÍNIC
RESEARCH CENTER
MEDICAL CAREMEDICAL CARE
SYSTEM REORIENTATION TOWARD THE SYSTEM REORIENTATION TOWARD THE PRIMARY HEALTH CAREPRIMARY HEALTH CARE
IMPLEMENTATIONIMPLEMENTATION
Family Physicians 30 133National coverage 98,3 %
Family Medicine Specialists 23 294Family Medicine Residents 6 358
169Municipalities
Home medical care Social and community participation Urgency care at primary health level
2001
MEDICAL COLABORATIONMEDICAL COLABORATION
Colaboration with 6 Medicine Faculties
Professors in 25 countries
57 Countries83 Countries
1963 - 2000
WORKERS WORKERS
2001
HEALTH HUMAN RESOURCES HEALTH HUMAN RESOURCES DEVELOPMENTDEVELOPMENT
• ACCREDITATION• COMPETENCE AND PERFORMANCE
EVALUATION• ACADEMIC SYSTEM WITH CREDITS• CONTINUOUS EDUCATION
THE THE HEALTHHEALTH IN THE IN THE INFORMATION SOCIETYINFORMATION SOCIETY
THE THE HEALTHHEALTH IN THE IN THE INFORMATION SOCIETYINFORMATION SOCIETY
Health vs. Illness
Preventive medicine vs. Healing medicine
Center of Health vs. Hospital
Distance vs. Presence
Use ICT vs. Traditional care
THE BIG CHALLENGE FOR
HEALTH
*MEDICAL TECHNOLOGY (ICT)
*PRIMARY HEALTH CARE
*SOCIAL MEDICINE *HEALING MEDICINE
TELEHEALTH
•TELE-EDUCATION•TELEMEDICINE•RESEARCH•MANAGMENT
KNOWLEDGE KNOWLEDGE NETWORKNETWORK
• HEALTH
• EDUCATION
• COMMUNICATION
INFOMED Telematic Health Network in Cuba.
La HabanaLa HabanaVilla Clara
Camagüey
Santiago de Cuba
National node3 regional nodes10 provinces nodes
http://www.sld.cu/
Cuban Health Network Connection
Municipality 80
Institutions 730
Users 20,000
Traffic daily message 34,000
Daily visits to Infomed Website 45,000
ESTRATEGIC PROJECTSESTRATEGIC PROJECTS
• HEALTH VIRTUAL UNIVERSITY
• HEALTH VIRTUAL LIBRARY
CUBA /2001CUBA /2001
TELEMATIC NETWORK IN HEALTHTELEMATIC NETWORK IN HEALTH (INFOMED)(INFOMED)
HEALTH VIRTUAL UNIVERSITY AND LIBRARY
-of information
-of discussion
-of consultancy
-of education
-of resources
Offered Services Interaccion Spaces:
-Virtual Clinic-Virtual Classroom-Virtual Convention Center-Scientific NetworkScientific Network
¡ TO ACEPT THE CHALLENGE !
¡ TO ACEPT THE CHALLENGE !
VIRTUAL VIRTUAL EDUCATIONEDUCATION
Health University Health University XXI CenturyXXI CenturyHealth University Health University XXI CenturyXXI Century
PRESENCE PRESENCE EDUCATIONEDUCATION
NEW INFORMATION AND NEW INFORMATION AND COMMUNICATIONS TECHNOLOGIES COMMUNICATIONS TECHNOLOGIES
DIGITAL AGE