TY - JOUR T1 - Cuba’s success in child health: what can one learn? JF - BMJ Paediatrics Open JO - BMJ Paediatrics Open DO - 10.1136/bmjpo-2019-000573 VL - 3 IS - 1 SP - e000573 AU - Mauro Castelló González AU - Imti Choonara Y1 - 2019/10/01 UR - http://bmjpaedsopen.bmj.com/content/3/1/e000573.abstract N2 - Cuba has excellent child health as illustrated by its low child mortality rates. Child mortality rates (under 5 years, infant and neonatal) in Cuba have all been lower than in the USA for many years. WHO figures for 2016 for under 5 child mortality (U5M) show that Cuba has a U5M rate of 5.5 per 1000 live births, whereas the USA has a U5M rate of 6.5 and Costa Rica has a rate of 9.7.1 Cuba has the second-lowest U5M in the Americas behind Canada with a rate of 4.9. U5M is considered to be an excellent indicator of child health by UNICEF.2 Cuba is a middle-income country with considerable economic problems exacerbated by the blockade imposed by the USA. How then has it achieved such good child health outcomes?Cuba’s achievements in child health are due to a combination of factors.2 3 Cuba has an integrated healthcare system with all sections cooperating fully. Universal healthcare and universal education are the basis for good health. Literacy is at 99.7% and this enables public health campaigns to reach the entire population. Free universal education has resulted in Cuba having one of the highest doctor-to-population ratios. Programmes, such as ‘Educa a tu hijo’ (educate your child), are in place to prepare young children for school.4 This non-institutional-based programme was developed in rural areas, and subsequently extended throughout the country, as it was recognised that early child development is essential for child well-being.Primary healthcare is a key feature of healthcare in Cuba. Almost half of all Cuban doctors work in primary healthcare. Primary healthcare exists both in urban and remote rural areas. The presence of health facilities even in remote … ER -