0139

STRATEGIES TO REDUCE U5MR IN CUBA 1959-1999

Raul L. Riveron Corteguera, MD

Children’s University Hospital of Centro Habana, Cuba

We describes the strategies used by the Ministry of Public Health in the different stages of the Maternal Infant Health Care Program, in order to reduce mortality in children under the age of 5 years in Cuba form 1959 to 1999. For the sake of a better understanding of the matter we have divided the period in four decades. We make reference herein to the different measures taken since the creation of the National Health Care System; the training of human resources and the development of medical education; the building of Medicine Schools and postgraduate training; the increase on the number of hospitals and beds and the implementation of immunization programs, of programs against gastroenteritis and to diminish the incidence of low weight at birth; the creation of kindergartens elementary schools; the rational use of antimicrobic products; the presence of the “accompanying mother” and implementation of the use of oral rehydration salts (ORS) to prevent and treat dehydration caused by diarrheic disease; the development of the Primary Health Care Program; the Advance Technology programs for the detection of congenital anomalies; the National Program for the Prevention of Accident in children; the promotion of Breastfeeding; the classification by UNICEF of the “Friends of the Mother and the Child” Hospitals; the development of research works that laid the basis for the Maternal-Infant Program; the building of intensive care therapy units with state-of-the-art equipment both in pediatrics and neonatology; as well as many other elements put into practice, during these 40 years. All these aspects have contributed to make mortality, in spite of and increase of 17.8% in the first decade (1959-1969), steadily decrease in a 44.6% in the second decade (1969-1979); 46.5% for the period (1980-1989) and 37.1% for the fourth decade (1990-1999). The article goes on stating the main strategies that contributed to reduce the U5MR in the last years of this century.