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Cuba Hits Record Low in Infant Mortality

By Conner Gorry

Once again, Cuba has recorded a drop in infant mortality, posting a nationwide rate of 5.8 deaths per 1000 live births for 2004. Down from 6.3 in 2003, this is the lowest infant mortality rate in the country's history and places the small island nation just behind Canada for the lowest rate in the hemisphere (see Table 1 for a country-by-country comparison).

Despite Draconian economic measures imposed by the US embargo - which has direct consequences for the health and well-being of the Cuban population - it's no secret how Cuba has achieved such low mortality rates in children under 12 months. According to officials from the Ministry of Public Health (MINSAP) and representatives of UNICEF, Cuba's high standard of newborn health is attributable to the level of education among expectant mothers and the free, universal access to health care afforded all Cubans, with the latter translating into better lifelong health. This is true nationwide, both in the cities and countryside.

Table 1: Infant Mortality Rates - Western Hemisphere

The quality of primary health care, coupled with the specialized attention extended to mothers and their unborn children through the Mother-Child Program and maternal homes, are integral to this success. On average, pregnant women receive 12 pre-natal check-ups and consultations, during which pregnancy-related risks including diabetes, hypertension and vaginal infections are discussed, diagnosed and monitored, plus any genetic conditions the mother may have. Consultations with genetic specialists become a priority if these conditions are detected; such attention is more accessible than ever thanks to the Master's Degree in Genetics Counseling now being offered (see More Graduates for Genetics Counseling Master's Degree, this issue. Professional care at the moment of birth is also a factor: according to the report “Health Situation in Cuba: Basic Indicators 2003,” 99.9% of live births that year were in-hospital.

When things do go wrong, perinotologists, neonatal, intensive care and other specialists are called in to ensure the lives of the baby and mother. In this area, Cuba is also making strides. In Sanctí Spíritus province for example, only 4.2% of newborns registered low birth weight; among those, there were six who weighed under one kilogram ( 2.2 pounds), all of whom lived. The nationwide program that vaccinates all children free of charge against 13 infectious diseases also plays a role in this success; see Spotlight: Cuba's National Immunization Program in MEDICC Review's October issue for an in-depth discussion. The Children's Heart Network is at the forefront of an aggressive program that has reduced mortality among children born with congenital heart problems (see Spotlight: Treating Children with Congenital Heart Problems: It Takes a Network, this issue). Taken together, these programs have registered extraordinary results over the past four decades (see Table 2 for mortality rates for that period).

Perinatal conditions and congenital malformations are the leading causes of death among those babies who die in the first 12 months of life.

Table 2: Infant Mortality Rates in Cuba 1960-2004