For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
869
views
22
references
 Top references
cited by
2
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
1 collections
    0
    shares
      351
      similar
       All similar

      If you have found this article useful and you think it is important that researchers across the world have access, please consider donating, to ensure that this valuable collection remains Open Access.

      International Journal of Cuban Studies is published by Pluto Journals, an Open Access publisher. This means that everyone has free and unlimited access to the full-text of all articles from our international collection of social science journals. Furthermore Pluto Journals authors don’t pay article processing charges (APCs).

      scite_

      International Journal of Cuban Studies

      Volume 11, Issue 2
       
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Human Resources for Health and Health Outcomes in Cuba: An Analysis of Their Distributions over Time and Space

      Published
      research-article
      Bookmark

            Abstract

            Developments in Cuba's healthcare system, infant mortality rate (IMR) trends, and commitment to universal healthcare have been examined by past research. Nevertheless, reductions of spatial inequality in human resources for health (HRH) distribution and IMR have received less attention. Drawing on Cuban Ministry of Health data, we examine changes in HRH distribution by personnel type and inequality in IMRs among Cuban provinces over time, emphasising the period since 1990. We contrast these with global, OECD, and developing country HRH distributions. Our research shows declining inequality in HRH and IMR across provinces in Cuba. A longitudinal data analysis of IMR shows that IMR decreases significantly as physician density increases within provinces. Within a global context of high between and within country disparities Cuba's experience is salient given high levels of spatial inequality prior to 1959 and material resource scarcity during the ‘special period’ of the 1990s.

            Content

            Author and article information

            Contributors
            Isaac Christiansen
            David Leonard
            Journal
            Journal ID (doi): 10.2307/j50005551
            Journal ID (jcode): intejcubastud
            Title: International Journal of Cuban Studies
            Publisher: Pluto Journals
            ISSN: 1756-3461
            ISSN: 1756-347X
            Publication date (Print): 1 December 2019
            Volume: 11
            Issue: 2 ( doiID: 10.13169/intejcubastud.11.issue-2 )
            Pages: 200-227
            Affiliations
            Midwestern State University, Texas, USA
            David Leonard Statistical Consulting, Texas, USA
            Author notes
            [1]

            Isaac Christiansen is Assistant Professor in Sociology at Midwestern State University in Wichita Falls, Texas. His primary interests are Marxist theory, social, economic and health inequalities, social change and development, and the dynamics of economic crises.

            [2]

            David Leonard is the head of David Leonard Statistical Consulting, which statistical programming and advice to academic and non-profit organizations, primarily in fields of preventive and paediatric medicine.

            Article
            Publisher ID: intejcubastud.11.2.0200
            DOI: 10.13169/intejcubastud.11.2.0200
            SO-VID: 63592376-f5e6-4943-96c0-205a5359753a
            Copyright © © International Institute for the Study of Cuba
            License:

            All content is freely available without charge to users or their institutions. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles in this journal without asking prior permission of the publisher or the author. Articles published in the journal are distributed under a http://creativecommons.org/licenses/by/4.0/.

            History
            Custom metadata
            lang eng

            ScienceOpen disciplines: Literary studies,Arts,Social & Behavioral Sciences,History,Cultural studies,Economics
            Keywords: health inequality,spatial inequality,human resources for health,Cuban healthcare,physician distribution,infant mortality

            References

            1. Álvarez, Abel F. Losada. (1999) “Cuba (1898-1958). El Triunfo sobre la Mortalidad Infantil” Boletín de la Asociación de Demografía Histórica, XVII, I 131–160.

            2. Anand, Sudhir and Till Bärnighausen (2004) ‘Human Resources and Health Outcomes: Cross-country Econometric Study’, The Lancet 364(9445): 1603–9.

            3. Asamblea Nacional del Poder Popular (2003) Constitución de la República de Cuba. Havana: Ministerio de Justicia, Gaceta Oficial de la República de Cuba.

            4. Borowy, Iris (2013) ‘Degrowth and Public Health in Cuba: Lessons from the Past?‘ Journal of Cleaner Production 38: 17–26.

            5. Brenner, Philip, Marguerite Rose Jiménez, John M. Kirk and William M. LeoGrande (2008) ‘Part III: Economics’, in Philip Brenner, Marguerite Rose Jiménez, John M. Kirk and William M. LeoGrande (eds), A Contemporary Cuba Reader. Lanham, MD: Rowman and Littlefield Publishers, pp. 111–16.

            6. Brouwer, Steve (2011) Revolutionary Doctors: How Venezuela and Cuba are Changing the World's Conception of Health Care. New York: Monthly Review Press.

            7. Chaple, Enrique Beldarrain (2006) ‘La salud pública en Cuba y su experiencia internacional (1959–2005)‘, Historia, Ciencias, Saúde-Manguinhos 13(3): 709–16.

            8. Chomsky, Aviva (2000) ‘The Threat of a Good Example: Health and Revolution in Cuba’, in Jim Yong Kim, Joyce V. Millen, Alec Irwin and John Gershman (eds), Dying For Growth: Global Inequality and the Health of the Poor. Monroe, ME: Common Courage Press, pp. 331–57.

            9. Chomsky, Noam (2005) ‘Cuba and the United States: A Near-Half Century of Terror’, in Salim Lamrani (ed.), Superpower Principles: US Terrorism against Cuba. Monroe, ME: Common Courage Press, pp. 27–43.

            10. Christiansen, Isaac Zvi (2010) Improving Public Health Care: An Examination of the Nature of Cuban Government Assistance to the Ghanian Public Health Care System. Ames, IA: Iowa State University.

            11. Christiansen, Isaac Zvi (2017) ‘Commodification of Healthcare and Its Consequences’, World Review of Political Economy 8(1): 82–103.

            12. Constitución de la República de Cuba (2019) ‘Constitución de la República de Cuba’, www.granma.cu/file/pdf/gaceta/Nueva%20Constituci%C3%B3n%20240%20KB-1.pdf (accessed 13 May 2019).

            13. Corteguera, Raúl Riverón (2000) ‘Estrategía para reducir la mortalidad infantil, Cuba 1959-1999‘, Revista Cubana de Pediatría 72(3): 147–64.

            14. Corteguera, Raúl Riverón and Pedro Azcuy Henríquez (2001) ‘Mortalidad infantil en Cuba 1959-1999‘, Revista Cubana de Pediatría 73(3): 143–57.

            15. Danielson, Ross (1979) Cuban Medicine. New Brunswick, NJ: Transaction Books.

            16. Davis, Karen, Kristof Stremikis, David Squires and Cathy Schoen (2014) Mirror, Mirror on the Wall: How the Performance of the US Health Care System Compares Internationally. Commonwealth Fund. Accessed online 10/08/2019 https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_fund_report_2014_jun_1755_davis_mirror_mirror_2014.pdf

            17. De la Fuente, Alejandro (2008) ‘Race and Discrimination in Cuba's Special Period’, in Philip Brenner, Marguerite Rose Jiménez, John M. Kirk and William M. LeoGrande (eds), A Contemporary Cuban Reader. Lanham, MD: Rowman and Littlefield Publishers, pp. 316–25.

            18. Deppe, Hans-Ulrich (2009) ‘The Nature of Health Care: Commodification versus Solidarity’, in Leo Panitch and Colin Leys (eds), The Socialist Resigter 2010: Morbid Symptoms: Health under Capitalism. New York: Monthly Review Press, pp. 29–38.

            19. DHSS (1980) ‘The Black Report’, available at www.sochealth.co.uk/national-health-service/public-health-and-wellbeing/poverty-and-inequality/the-black-report-1980 (accessed 16 July 2015).

            20. Dussault, Giles and Maria Cristina Franceschini (2006) ‘Not Enough Here Too Many There: Understanding Geographical Imbalances in the Distribution of the Health Workforce’, Human Resources for Health 4(12). Accessed online 10/6/2019 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1481612/pdf/1478-4491-4-12.pdf

            21. Edith, Dixie and Ariel Terrero (2008) ‘Otra vuelta de rosca’, Bohemia, 24 March. Accessed 6/29/2015 http://www.bohemia.cu/2008/03/24/encuba/salud.html

            22. Espina, Mayra (2008) ‘Viejas y Nuevas Desigualdades en Cuba: Ambivalencias y Perspectivas de la Reestratificación Social’, Nueva Sociedad 216: 133–49.

            23. Feinsilver, Julie M. (1993) Healing the Masses: Cuban Health Politics at Home and Abroad. Berkeley, CA: University of California Press.

            24. Feinsilver, Julie (2009) ‘Cuba Health Politics at Home and Abroad’, in Leo Panicitch and Colin Leys (eds), The Socialist Register 2010: Morbid Symptoms. London: Merlin Press.

            25. Franco, Manuel, Joan Kennelly, Richard Cooper and Pedro Ordúñez Garcia (2007) ‘La Salud en Cuba y los Objetivos de Desarrollo del Milenio’, Revista Panamericana de Salud Pública/Pan American Journal of Public Health 21(4): 239–50.

            26. Frank, Marc (2013) Cuban Revelations: Behind the Scenes in Havana. Gainesville, FL: University Press of Florida.

            27. Granma (2018) ‘Reportan severos daños en la salud pública cubana a consecuencia del bloqueo de EE.UU’, Granma, 27 August. Available at www.granma.cu/cuba/2018-08-27/reportan-severos-danos-en-la-salud-publica-cubana-a-consecuencia-del-bloqueo-de-eeuu-27-08-2018-10-08-19 (accessed 3 January 2019).

            28. Hanmer, Lucia, Robert Lensink and Howard White (2003) ‘Infant and Child Mortality in Developing Countries: Analysing the Data for Robust Determinants’, The Journal of Development Studies 40(1): 101–18.

            29. Hart, Tudor (1971) ‘The Inverse Care Law’, The Lancet 297(7696): 405–12.

            30. Homedes, Núria and Antonio Ugalde (2005) ‘Human Resources: The Cinderella of Health Sector reform in Latin America’, Human Resources for Health 3(1). Accessed Online 10/8/2019 https://human-resources-health.biomedcentral.com/articles/10.1186/1478-4491-3-1

            31. Hosseinpoor, Ahmad Reza, et al. (2005) ‘Socioeconomic Inequality in Infant Mortality in Iran and across its Provinces’, Bulletin of the World Health Organization 83: 837–44.

            32. Iñiguez, Luisa (2013) ‘Overview of the Evolving Changes in Cuba's Health Services’, MEDICC Review 15(2) 45–51 (April).

            33. Jiménez Enoa, Abraham (2017) “Tu salud es gratuita pero cuesta”: las polémicas ‘facturas simbólicas’ con que Cuba busca concienciar a los enfermos” BBC Mundo. Accessed Online 10/8/2019 https://www.bbc.com/mundo/noticias-america-latina-39401797

            34. Juventud Rebelde (2012) ‘Cuba denuncia daños del bloqueo a salud y alimentación’, Juventud Rebelde, 16 October. Accessed 10/8/2019 http://www.juventudrebelde.cu/internacionales/2012-10-16/cuba-denuncia-danos-del-bloqueo-ee-uu-en-salud-y-alimentacion

            35. Marmot Review (2010) ‘Fair Society Healthy Lives: The Marmot Review’, available at www.instituteofhealthequity.org/projects/fair-society-healthy-lives-the-marmot-review (accessed 16 July 2015).

            36. McGuire, James W. and Laura B. Frankel (2005) ‘Mortality Decline in Cuba’, Latin American Research Review 40(2): 83–116.

            37. Mesa Redonda (2014) ‘Transformaciones en el sector salud y su impacto’, Mesa Redonda 3: 27. Available at www.youtube.com/watch?v=XrYEIiNGvXU.

            38. MINSAP (2011) “Anuario Estadístico De Salud 2010” Dirección Nacional de Registros Médicos y Estadísticas der Salud. La Habana

            39. MINSAP (2018) ‘Objetivos del Trabajo de Ministerio de Salud Pública para el Año 2018‘, available at http://files.sld.cu/editorhome/files/2018/01/OBJETIVOS-DE-TRABAJO-DEL-MINISTERIO-DE-SALUD-P%C3%9ABLICA-PARA-EL-A%C3%91O-2018.pdf (accessed 14 May 2010).

            40. Munga, Michael A. and Ottar Maestad (2009) ‘Measuring inequalities in the distribution of health workers: the case of Tanzania’, Human Resources for Health 7(4). Accessed online 10/7/2019 https://human-resources-health.biomedcentral.com/articles/10.1186/1478-4491-7-4

            41. Navarro, Vicente (1976) Medicine Under Capitalism. New York: Prodist.

            42. Nayari, Kamran and Cándido López-Pardo (2005) ‘Economic Crisis and Access to Care: Cuba's Health Care System since the Collapse of the Soviet Union’, International Journal of Health Services 35(4): 797–816.

            43. Ochoa, Fransisco Rojas and Elena López Serrano (2000) Revolución social y reforma sanitaria: Cuba en la década de los. Washington, DC: Pan American Health Organization.

            44. Okeke, Edward N. (2013) ‘Brain Drain: Do Economic Conditions “Push” Doctors Out of Developing Countries?‘ Social Science and Medicine 98: 169–78.

            45. Pan American Health Organization (2001) ‘Measuring Health Inequalities: Gini Coefficient and Concentration Index’, Epidemiological Bulletin (PAHO) 22(1) 3–4.

            46. Paradath, Ashnie, Charlotte Chamberlein, David McCoy, Antoniette Ntuli, Mike Rowson and Rene Loeweson (2003) Health Personnel in Southern Africa: Confronting Maldistribution and Brain Drain. Equinet Discussion Paper, Regional Network for Equity in Health in Southern Africa, Health Systems Trust and MEDACT. South Africa and UK. Accessed online 10/8/2019 http://www.tarsc.org/publications/documents/polDIS3hres.pdf

            47. Pérez, Louis A. (2011) Cuba: Between Reform and Revolution. Oxford: Oxford University Press.

            48. Petterson, Stephen M., Jr., Robert L. Phillips, Andrew W. Bazemore and Gerald T. Koinis (2013) ‘Unequal Distribution of the US Primary Care Workforce’, American Family Physician 87(11). Accessed Online 10/7/2019: https://www.aafp.org/afp/2013/0601/od1.html

            49. Pfieffer, James. 2003. “International NGOs and Primary Health Care in Mozambique: The Need for a New Model of Collaboration”. Social Science & Medicine. 56. 725–738.

            50. Piñeiro Harniker, Camila (2014) ‘Nonstate Enterprises in Cuba: Building Socialism?‘ Latin American Perspectives 41(4): 113–28.

            51. Pinheiro, J., D. Bates, S. DebRoy, D. Sarkar and R Core Team (2015) ‘nlme: Linear and Nonlinear Mixed Effects Models’, R package version 3.1-122, available at http://CRAN.R-project.org/package=nlme.

            52. R Core Team (2015) R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing.

            53. Regidor, Enrique (2004) ‘Measures of Health Inequalities: Part 1‘, Journal of Epidemiology and Community Health 58: 858–61.

            54. Robles Salguero, R. E., H. B. Serrano Mantilla, G. L. Serrano Mantilla, F. M. Gaibor Vera, G. M. Armijo Borja and A. Fernandez Lorenzo (2017) ‘Retos de la planificación estratégica en instituciones de salud’, Revista Cubana de Investigaciones Biomédicas 36(3). Accessed online 10/7/2019: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-03002017000300018

            55. Rodríguez, José Luis (2014) ‘The Frontier Change in the Cuban Economy’, Latin American Perspectives 41(4) (July): 64–73.

            56. Saney, Isaac (2004) Cuba: A Revolution in Motion. London: Fernwood Publishing and Zed Books.

            57. Schneider, Maria Cristina, Carlos Castillos-Salgado, Jorge Bacallao, Enrique Loyola, Oscar J. Mujica and Anne Roca. (2002) “Métodos de Mediación de las Desigualdades de Salud.” Revista Panamericana de Salud Pública. 12 (6) 398–415.

            58. Schoepf, B. G., C. Schoepf and J. Millen (2000) ‘Theoretical Therapies, Remote Remedies: SAPs and the Political Ecology of Poverty and Health in Africa’, in Dying for Growth: Global Inequality and the Health of the Poor. Edited by Jim Yong Kim, Joyce V. Miller, Alec Irwin and John Gershman, Monroe, ME: Common Courage Press, pp. 91–125.

            59. Sixth Congress of the Communist Party of Cuba (2011) Resolution on the Guidelines of the Economic and Social Policy of the Party and of the Revolution. Havana: Communist Party of Cuba.

            60. Souers, Joanna Mae (2012) ‘Cuba Leads the World in Lowest Patient per Doctor Ratio: How Do They To It?‘, The Social Medicine Portal 7: 30.

            61. Tandi, Tinyami Erick, et al. (2015) ‘Cameroon Public Health Sector: Shortage and Inequalities in Geographic Distribution of Health Personnel’, International Journal for Equity in Health 14(43). Accessed online 10/08/2019 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4440287/

            62. Uriarte, Mirén (2008) ‘Social Impact of Economic Measures’, in Philip Brenner, Marguerite Rose Jiménez, John M. Kirk and William M. LeoGrande (eds), A Contemporary Cuban Reader. Lanham, MD: Rowman and Littlefield.

            63. Whiteford, Linda M. and Laurence G. Branch (2008) Primary Health Care in Cuba: The Other Revolution. Lanham, MD: Rowman and Littlefield.

            64. WHO (2015) ‘WHO Validates Elimination of Mother-to-Child Transmission of HIV and Syphilis in Cuba’, available at www.who.int/mediacentre/news/releases/2015/mtcthiv-cuba/en/ (accessed July 21, 2015).

            65. WHO (2011) ‘Global Health Observatory’, available at https://www.who.int/gho/en/ (data accessed 7 November 2013).

            66. WHO (2006) Working Together for Health: The World Health Report 2006. Geneva: World Health Organization.

            67. Wilkinson, Richard G. and Kate Pickett (2006) ‘Income Inequality and Population Health: A Review and Explanation of the Evidence’, Social Science and Medicine 62: 1768–84.

            Comments

            Comment on this article