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Title: Public health: why are the Cubans so successful: a case study of public health governance in Cuba
Author: Lynch, U. B.
Awarding Body: Queen's University Belfast
Current Institution: Queen's University Belfast
Date of Award: 2008
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Abstract:
Key words: public health, equity, integration, citizenship Health outcomes: infant mortality and life expectancy are closely correlated with GOP. Countries with higher GOP generally have better health outcomes. Cuba is, the classic outlier in this regard. Economically a third world country, life expectancy in Cuba is equivalent to the Republic of Ireland, and infant mortality rates are comparable with all of the high income countries. A case study research design is used to examine pUblic health in Cuba, in order to identify the reasons behind the conspicuously good health outcomes. Twenty weeks of fieldwork, divided into two phases, was carried out in Cuba. The literature review sets the context and rationale for the study. It highlights critical junctures in modern Cuban history and analyses public health in Cuba. The case study design employed a variety of methods: participant and non-participant observation, reflective diary, focus group interviews and semi structured interviews. The factors in the study which facilitated access to the 'elites' in Cuban public health are identified. Triangulation and analysis of data is described. Ten themes emerged form the findings: Ministry of Public Health; focus on prevention and health promotion; education; integration; primary care; citizenship; equity; public system; socialism and political will. The metaphor of a repaired umbrella is used as the basis for a theoretical model to explain Cuba's success. The key to success is identified as being the strong political commitment to public health in Cuba and the pre-eminence of the Ministry of Public Health vis avis other ministries. The study concludes that Cuba is successful in public health because health has become emblematic of the revolution and that political will is central to this achievement. Recommendations distilled from the study include: development of health policy based on systematic needs assessment; that the UK learns from Cuba's experience in preparing large numbers of high quality professional and further research using the Cuban model of Public Health as a tool for a comparative study of public health governance in the UK.
Supervisor: Not available Sponsor: Not available
Qualification Name: D. Gov.--Queen's University Belfast, 2008 Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.484977  DOI: Not available
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