Journal of Family Medicine and Primary Care

LETTER TO EDITOR
Year
: 2020  |  Volume : 9  |  Issue : 8  |  Page : 4481--4482

Family health care model—A lesson to be learned from the Cuban health care system


Shivashankar Kengadaran1, Divvi Anusha1, Sivabalakumaran Kengadaran2, Srivalli Koyi3,  
1 Department of Public Heath Dentistry, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth, Pondicherry, Tamil Nadu, India
2 Department of Anaesthesiology, Government Chengalpattu Medical College, Chengalpattu, Tamil Nadu, India
3 Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India

Correspondence Address:
Dr. Shivashankar Kengadaran
Department of Public Heath Dentistry, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth, Pondicherry - 607402
India




How to cite this article:
Kengadaran S, Anusha D, Kengadaran S, Koyi S. Family health care model—A lesson to be learned from the Cuban health care system.J Family Med Prim Care 2020;9:4481-4482


How to cite this URL:
Kengadaran S, Anusha D, Kengadaran S, Koyi S. Family health care model—A lesson to be learned from the Cuban health care system. J Family Med Prim Care [serial online] 2020 [cited 2020 Oct 27 ];9:4481-4482
Available from: https://www.jfmpc.com/text.asp?2020/9/8/4481/293063


Full Text



Cuba is a developing country with minimal resources and facilities that had handled the recent pandemic of COVID-19 exceptionally. With most of the health systems in developed countries like America, Spain, Italy, and Britain suffered a terrible blow; Cuba surprised the world by supporting Italy with manpower to combat the pandemic.[1] While the developed countries improved and invested in tertiary health care, Cuba built strong primary health care.

The Cuban model of health comprises of three tiers. The first is the family doctor-and-nurse offices which take care of 20–40 families; located at the second level are the community-based polyclinic for every 30,000–60,000 populations and research and teaching centers for medical, nursing, and allied health sciences students.[2]

As of now, Cuba has about 33 000 family physicians and the ratio of the family physician to a person in the community was 1:2500. Almost 97% of medical graduates serve as family physicians (one year of internship and two years of residency training after they receive their degrees).[2] The family physicians along with family nurses form a team and live above their government-built family medicine offices, and are available 24 hours a day to provide services. The team monitors individual and family health by examining community and home environments, current health, and medical history and performs health diagnosis biannually using Continuous Assessment and Risk Evaluation (CARE). By this, they evaluate community risk factors to focus priorities for improving the health of the community.[2] The team also makes home visits to each family at least once a year to assess and evaluate their health holistically. Individuals with chronic illness are assessed at least once every three months. These teams' role combines the importance of focusing on both public health and clinical medicine.[3],[4]

Polyclinics are community-based clinics that are well-acquainted with the people and the communities they serve. Specialists at the polyclinic support family physicians when they are needed.[4] Each polyclinic specialist supports 20–40 family doctor-and-nurse teams. The average polyclinic in Cuba offers 22 services, which includes rehabilitation of addiction; diagnostic services like X-ray, ultrasound, optometry, endoscopy, and clinical laboratory testing; emergency services including traumatology and emergency dental services; other services include thrombolysis, family planning, maternal and child care, immunization, and diabetic and elderly care. Some polyclinics also provide specialty services which include dermatology, psychiatry, and cardiology, in addition to the family and internal medicine, pediatrics, and obstetrics and gynecology.[2] Apart from the services, they also supervise the family doctor-and-nurse offices. It was also notable that each polyclinic is unique in the way that facilities available are based on the need of the community which was assessed by family doctors.[2]

Unlike most of the countries, the complete healthcare sector is managed only by the government sector, which enables them to follow universal health coverage and a holistic approach. The lesson from Cuba teaches us how preparedness helps to combat various conditions by emphasizing more importance to primary care, without panicking which is the mantra for preventing epidemics.[5]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1World Health Organization, Regional office from Europe. WHO announces COVID-19 outbreak a pandemic. Available from: http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/news/news/2020/3/who- announces-covid-19-outbreak-a-pandemic. [Last accessed on: 2020 Jun 13].
2Keck, CW, Reed, GA. The curious case of Cuba. Am J Public Health 2012;102:e13-e22.
3Keck CW. Health for all: A dream realized in Cuba: Medical and Health Annual. Chicago, IL: Encyclopaedia Britannica Inc.; 1994. p. 357-62.
4Cuban hemispheric affairs. Cuban Medical Diplomacy: A Developmental Paradox. Available from: http://www.coha.org/cuban-medical-diplomacy-a-developmental-paradox/. [Last accessed on: 2020 Jun 13].
5Kengadaran S, Divvi A, Kengadaran S. Prepare to succeed, panic to fail: The mantra for COVID-19 prevention in India. Popul Med 2020;2:7. doi: 10.18332/popmed/120074.