Healthcare in Cuba

The book “Cuban Health Care: Utopian Dreams, Fragile Future” by Ullmann and Spooner (2014) highlights the history of Cuba’s health system and the deterioration of medical care in the country. The authors’ intended audience is healthcare officials in Cuba, the government, and the country in general. The chapter “Women and Children” points out the declining birth rates in the country, a trajectory that began in the 1950s. At the same time, stakeholders have stated that the government does not prioritise the health of children and babies under five. The low birth rates and infant mortality stem from reasons such as ineffective use of contraception and condoms. Statistics show that about 50% of Cubans do not use condoms in their first sexual encounter (Ullmann & Spooner, 2014). A considerable proportion of the youth only use condoms occasionally, including those with multiple partners. In turn, young Cubans are at a higher risk of contracting HIV-AIDS. Some cities have also reported incidents in which none of the pharmacies had high-quality condoms for some periods. In one of these instances, there was a rise in syphilis contraction and abortions.

Even though abortion rates in Cuba have declined, the country still has some of the highest rates in the world. The practice is the most preferred type of birth control among Cuban women. Hence, ineffective contraception practices are some of the issues affecting child and maternal health in the country. The pervasiveness of abortion in the country contributes to the low birth rates. Menstrual extraction is another practice that terminates pregnancy. Even though this procedure is less risky than abortions, physicians warn that both of them have adverse health effects, such as anemia, blood loss, uterine perforations, and internal genital infections (Ullmann & Spooner, 2014). Nonetheless, Cuba has formulated strategies to increase birth rates. One such solution is to incorporate women who want to have babies into the Programa Nacional de Atención Materno-Infantil Prenatal (PAMI) (Ullmann & Spooner, 2014). PAMI is the best-funded maternal health program in the country and facilitates prenatal visits for expecting mothers. The program also offers services like ultrasounds and home visits from physicians if a woman misses an appointment. While this program is a significant effort from the government to promote maternal and child care, the system faces challenges from deteriorating infrastructure. An account from a US foreign medical officer shed light on the subpar facilities afforded by PAMI. The report showed that the facility did not have a nurse on duty. There were also no computers and other devices like stethoscopes. The employees on duty were also extremely rude. At the same time, the nicest wing in the facility was reserved for foreigners.

On top of the inadequate maternal facilities in Cuba, pregnant women face other challenges like poverty and nutritional deficiencies. Women, especially those living in remote areas, face harsh conditions during pregnancy. Cuba’s nutritional problem stems from importing 70% of its food (Ullmann & Spooner, 2014). The average Cuban diet is dominated by rice, beans, and pork but lacks fruits and vegetables (Ullmann & Spooner, 2014). Another unhealthy element that affects pregnant women in Cuba is high smoking levels. Research has shown that 22% of Cuban women smoke, with the number being higher among women over forty (Ullmann & Spooner, 2014). At the same time, anti-smoking messages in the country do not have dire warnings like in other countries. This problem contributes to child health problems like low birth weight. Furthermore, smoking affects sexual potency and fertility. The healthcare problems in the country trickle down to children and babies. For instance, an evaluation of eighty infants showed that 72% had iron deficiency, 30% were deficient in calcium, and 26% lacked sufficient Vitamin C (Ullmann & Spooner, 2014). Children also suffer due to clean water shortages. Cuban children often contract intestinal ailments and parasitic infections from drinking contaminated water. A survey of 104 children found that 71% had at least one intestinal parasite (Ullmann & Spooner, 2014). Phenomena like overcrowding significantly contribute to unhygienic conditions that lead to parasitic infections and ailments.

In light of the health issues facing women and children in the country, solutions would stem from government intervention. Firstly, the government needs to invest more money in maternal health. The PAMI should be more effective in addressing nutritional deficiencies among women. The government should also pursue public education that can address unhygienic practices that put children at risk of disease. For instance, regular PSAs should emphasize the need to boil water before consumption. This education should also apply to women so that they can use the correct contraception. Regular abortions lead to low birth rates while increasing the risk of infertility. The periodic lack of high-quality condoms further affects reproductive health. Public education should address the detriments of smoking on adults and unborn children. Cuba has created an environment in which smoking unfiltered cigarettes is the norm. Overall, Cuba’s health problems stem from a lack of adequate funds, which is common in underdeveloped countries.