Credits - Back Issue
ISSN 1527-3172
ISSN 1527-3172 Cuba Registers 6.4 Infant Mortality: Lowest Ever
by José de la Osa and Gail Reed
UBA REGISTERED AN ALL-TIME low infant mortality
of 6.4/1,000 live births for 1999. The news was announed by the
Ministry of Public Health on January 1. Infant mortality has continued
its decline during the last decade, despite the sharp economic crisis,
which has affected the standard of living of virtually every Cuban citizen.
The 1999 low birthweight rate (6.5%) and under-five mortality (below 8.5)
were also below previous years. Widely credited with the improved indicators is Cuba's family
doctor program, which places primary care and preventive medicine within
a few blocks of 98% of the Cuban population. The 17,810 family doctor-and-nurse
teams serving neighborhoods throughout the island are backed up by 444 community
polyclinics, where services are complemented by specialists in such fields
as ob-gyn, pediatrics, and internal medicine. Another 12,037 family doctors
provide care at the neighborhood level, but in institutions such as child
care centers, grade schools and workplaces.
The total number of births for 1999 was 150,675, and the
number of infant deaths 966 (as compared to 1,070 for 1998, when infant
mortality stood at 7.1/1,000 live births). One of the most significant aspects
of this achievement, according to public health officials, is that the decline
in infant mortality is relatively even throughout the country, with no major
differences between urban and rural populations, between regions of more
or less abundant economic resources, or between areas of the country with
different ethnic/racial composition. Six provinces registered mortality
of six or under: Matanzas, Villa Clara, Cienfuegos, Sancti Spiritus,
Granma and Santiago de Cuba. (See Table I) The provinces
with the highest infant mortality were City of Havana Province (the nation's
capital and most populous province), Ciego de Avila Province (an agricultural
region dedicated primarily to sugar cane), and Camagüey Province (another
agricultural province). But even so, the highest infant mortality rate among
these was just 7.6. (The other higher rate was registered in the Isle
of Youth, a special municipality (9.5), where the rate has tended to fluctuate
widely from one year to the next, because of its very small population.)
Table I
INFANT MORTALITY IN CUBA BY PROVINCES, 1989-99 Province 1989 1995 1996 1997 1998 1999 Pinar del Río 11,2 10,2 8,4 6,2 7,7 6,5 La Habana 9,7 9,8 9,7 5,6 8,6 6,7 Ciudad Habana 10,4 9,7 7,9 7,2 7,5 7,1 Matanzas 10,7 9,0 5,9 6,5 7,9 5,3 Villa Clara 9,2 7,1 5,9 5,4 5,5 4,8 Cienfuegos 8,2 6,5 8,0 7,1 7,5 5,9 Sancti Spíritus 12,6 8,5 9,7 5,7 5,5 5,3 Ciego de Avila 12,6 9,2 7,6 6,0 7,3 7,1 Camagüey 10,6 9,2 5,5 8,7 5,5 7,6 Las Tunas 13,2 9,9 9,0 10,0 7,3 6,4 Holguín 11,6 8,7 9,2 7,8 6,6 6,8 Granma 11,9 11,0 7,6 8,4 7,0 5,7 S. de Cuba 11,8 10,2 7,7 6,6 7,8 6,0 Guantánamo 12,0 10,1 9,3 8,5 6,5 6,5 Isle of Youth Special Municipality 10,9 10,7 10,3 12,0 5,2 9,5 NATIONALLY 11,1 9,4 7,9 7,2 7,1 6,4 Source:
National Statistics Division, Ministry of Public Health, Havana, 1999. Preliminary Data.
This
Cuban public health achievement is considerable over the longer term as well:
in 1962, 3,000 infants under one year old died from diarrheal diseases alone.
Table II indicates the behavior of infant mortality in Cuba over the
past 30 years.
Table II
INFANT MORTALITY IN CUBA, 1970-99 1970 38,7 1980 19,6 1990 10,7 1971 36,1 1981 18,5 1991 10,7 1972 28,7 1982 17,3 1992 10,2 1973 29,6 1983 16,8 1993 9,4 1974 29,3 1984 15,0 1994 9,9 1975 27,5 1985 16,5 1995 9,4 1976 23,3 1986 13,6 1996 7,9 1977 24,9 1987 13,3 1997 7,2 1978 22,4 1988 11,9 1998 7,1 1979 19,4 1989 11,1 1999 6,4 Source: National Statistics Division, Ministry of Public Health, Havana.
Comparatively
speaking, Cuba leads Latin America, with the lowest infant mortality rate
in the region. Table III
INFANT MORTALITY IN LATIN AMERICA Haiti 91 Mexico 28 Bolivia 66 Paraguay 27 Dominican Republic 43 Colombia 25 Peru 43 Venezuela 21 Guatemala 41 Argentina 19 Nicaragua 39 Panama 18 Brazil 36 Uruguay 16 Honduras 33 Costa Rica 14 El Salvador 30 Chile 11 Ecuador 30
The
family doctor-and-nurse model has made it possible for 95% of all pregnant
women to come under a doctor's care within the first trimester of pregnancy.
During pregnancy, a woman may be scheduled for as many as 11 visits to the
doctor, as part of her regular care, and the average number is eight. Blood
testing for STD's, genetic testing and other related lab tests are regularly
performed.
Newborns are immediately tested for hypothyroidism, hepatitis
B, and fenilcetonuria. During their first year of life, infants are
immunized against nine diseases: tuberculosis, hepatitis B, meningitis B
and C, haemophilus influenza, polio, dyphtheria, tetanus and whooping cough.
By the time they are 18 months old, they have been fully incorporated into
the national immunization program against 13 childhood diseases (including
measles, rubella, mumps and typhoid fever, this last when the risk is present).
In addition, through the UNICEF-certified "Mother
and Baby-Friendly Hospital" program. 95% of Cuba's new mothers are now leaving
the maternity hospitals nursing their infants, as a sole form of nourishment.
80% of them offer exclusively breast milk through the fourth month of life,
giving further protection to these babies against infection.
Public health officials cite Cuban maternity homes as one
more key to reduced infant mortality: these homes, scattered throughout
the island, but particularly important in remote areas, offer shelter, nourishing
meals, classes, and round-the-clock medical attention to women with especially
risky pregnancies. Today, the women who spend at least part of their
pregnancies in a maternity home are most often remitted because of deficiencies
in their diet or excessive stress at home. The Association of Small Farmers
(ANAP) regularly complements the diets of women in the homes with fresh
produce.
More indicators of interest...
Under-five
mortality was reduced to an all-time low in 1999 as well: at 8.3 per
1,000 live births, compared to 9.2 in 1998. Preschool mortality (one
to four years) was down from 5.2 per 10,000 inhabitants in 1998 to 4.7 in
1999; and school-age mortality (from five to 14 years) declined, reaching
3 per 100,000 inhabitants in 1999. The main cause of death for children
from one to 14 years in Cuba is accidents. Maternal mortality was
kept under 3, for the fourth consecutive year.
AND THE CARIBBEAN
Source: State of the World's Children, 2000. UNICEF.
