Economy, politics, and health status in Cuba.

An economic contraction occurred in Cuba at the beginning of the 1990s, of a magnitude greater than in any developed country in the last half century. This resulted primarily from the disappearance of the European socialist bloc and simultaneous tightening of the U.S. government's blockade at a time when Cuba was engaged in correcting its main economic problems. The economic crisis affected a number of areas of Cuban society. The state adopted a series of measures to cope with the socioeconomic situation, which have yielded positive results in the social and economic fields, as well as some undesirable results. In the health sector, the economic crisis has mainly reduced the availability of resources and has adversely affected some health determinants and some aspects of the population's health status. Despite the prevailing economic difficulties, the government is determined to preserve the country's achievements in health, and to develop them still further. The solution is not privatization or the introduction of health insurance systems or similar measures. Rather, Cuba will seek greater rationality and economic efficiency in the health sector. It has ratified the principles that the state should continue to finance the health system and maintain universal coverage and accessibility through free services.

[Coordination of public health education with service units: the Cuban experience]. / Coordinación de la enseñanza de la salud pública con las unidades de servicio: la experiencia cubana.

The authors report on education for public health personnel in Cuba: it is a broadly diversified training, given in different teaching centers in the country. The system established ensures that public health training is coordinated with the work of the health services. There are mandatory rules and methods that must be followed by all the decentralized centers and courses. The Health Development Institute is one of the health system units that trains public health personnel at the post-graduate level. Courses are given in health administration and biostatistics leading to specialized M.A. and B.A. degrees. Each stage of the courses ends with a "practical service", done in units of the health system whose staff participate as teachers. The practical work is preceded by preparation of a work proposal, which turns the practice into what is in fact applied scientific research designed to solve a specific problem of the services. This makes for close coordination between the services, teaching and research, which is of great benefit for development of the health system.

Coordinación de la enseñanza de la salud pública con las unidades de servicio: la experiencia cubana / Coordination of public health education with service units: the Cuban experience

The authors report on education for public health personnel in Cuba: it is a broadly diversified training, given in different teaching centers in the country. The system established ensures that public health training is coordinated with the work of the health services. There are mandatory rules and methods that must be followed by all the decentralized centers and courses. The Health Development Institute is one of the health system units that trains public health personnel at the post-graduate level. Courses are given in health administration and biostatistics leading to specialized M.A. and B.A. degrees. Each stage of the courses ends with a «practical service», done in units of the health system whose staff participate as teachers. The practical work is preceded by preparation of a work proposal, which turns the practice into what is in fact applied scientific research designed to solve a specific problem of the services. This makes for close coordination between the services, teaching and research, which is of great benefit for development of the health system (Au)

[Determining objectives and utilization of research applied to the health services]. / Fijación de objetivos y utilización de investigaciones aplicadas a servicios de salud.

This paper gives an account of Cuba's experiences with research work and the organization of research. The author explains the principles that govern research and the county's policies in this field. The national institution particularly responsible for health research, as well as teaching and the scientific and technical service considers that the subjects on which research is to be done include the following problems: primary health care, particularly participation of the people in the dynamics of the services, evaluation of health units and programs, productivity studies on the services, introduction of new management methods and assessments of the level of health of the population.

Fijación de objetivos y utilización de investigaciones aplicadas a servicios de salud / Determining objectives and utilization of research applied to the health services

This paper gives an account of Cuba's experiences with research work and the organization of research. The author explains the principles that govern research and the county's policies in this field. The national institution particularly responsible for health research, as well as teaching and the scientific and technical service considers that the subjects on which research is to be done include the following problems: primary health care, particularly participation of the people in the dynamics of the services, evaluation of health units and programs, productivity studies on the services, introduction of new management methods and assessments of the level of health of the population (Au)

Fijacion de objetivos y utilizacion de investigaciones aplicadas a servicios de salud. / Goal setting and use of applied research on health services

En este trabajo se da cuenta de la experiencia de Cuba en el trabajo de investigacion y en sus aspectos organizativos. Se informa de los principios que rigen esta actividad y de la politica del pais en este campo. El instituto nacional que se encarga en particular de las investigaciones en salud, a mas de las funciones docentes y de servicio cientificotecnico, contempla entre los temas a investigar, entre otros, los problemas siguientes: atencion primaria de salud, en especial la participacion de la poblacion en la dinamica de los servicios, evaluacion de unidades y programas de salud, estudios sobre productividad del trabajo en los servicios, introduccion de nuevos metodos de gestion, y apreciacion del nivel de salud de la poblacion

[Epilepsy: spidemiological study in a child population]. / La epilepsia: estudio epidemiológico en una población infantil.

The principal aims of this paper were to know the epidemiologic and clinical aspects of epilepsy in children and the use of an original methodology in the study of chronic illnesses. A survey was carried out through home calls by sampling an area in Havana City, Cuba; 14,445 children were studied. The sample was chosen at random by groups with proportional probabilities as to size, single stage. It was carried out by: --Detection of suspects by questioning. --Confirmation of suspects by means of a clinical exmination performed by specialists. Prevalence in children resulted in 7.5 epileptic children out of a thousand inhabitants. The lowest rate present was from 0 to 4 years of age (3.5) and the highest, from 10 to 14 (10). 39.4% of the cases had their first attack during the first year of lie. A highest rate was present was from 0 to 4 years of age (3.5) and the highest, from 10 to 14 (10). 39.4% of the cases had their first attack during the first year of life. A highest rate was present in the male sex (8.4 and lowest in females (6.5). Educational level was lower than the population's average; 37% did not attend classes, 87% of children showed generalized attacks, 48.1% were classified as having primary epilepsy (idiopathic) and 51.8% as organic (secondary). Some other clinical phenomena are also described, as well as aspects of medical care.

Fijación de objetivos y utilización de investigaciones aplicadas a servicios de salud / Establishment of objectives and the use of investigations applied to health services

Se expone inicialmente la vinculación existente entre el sistema social y los objetivos y utilización de las investigaciones científicas. Se identifican los principios que rigen la determinación de los objetivos de la investigación, y se anuncian -según la definición que sobre la materia se estableciera en el Primer Congreso del Partido Comunista de Cuba en su tesis y resolución sobre Política Científica Nacional- especialmente los referidos al área de la investigación en servicios de salud. En una segunda parte del trabajo se describe la organización estatal implantada para la dirección de la ejecución de las tareas de ciencia y técnica, así como las líneas de investigación adoptadas para el quinquenio 1976-1980 en el sector salud (AU)

Influencia de un estudio comparativo internacional en el conocimiento de la mortalidad perinatal / The influence of an international comparative study on the knowledge of perinatal mortality

Se plantea que en 1972 la Organización Mundial de la Salud decidió iniciar un estudio comparativo entre varios países sobre mortalidad perinatal y que la invitación a los países, entre ellos Cuba, obedeció a la posibilidad de ofrecer la información sobre el tema de estudio obtenida de los respectivos registros de estadísticas vitales durante el año 1973. En el presente artículo se comenta, la utilidad que en orden nacional e internacional hemos encontrado a dicho estudio. Después de un breve análisis de la situación nacional al momento de la investigación, se tratan sucesivamente ciertas dificultades con las defunciones, deficiencias en el certificado perinatal e inscripción de nacimientos en uso en dicho período, utilidad de estudio relacionado con el procesamiento y tabulación de los datos y repercusión en la docencia e investigación (AU)