Opt for Cuban Model of Healthcare

Of all the problems facing India, none needs greater attention than inadequate healthcare and child malnutrition. The article ‘Speeding Up Reduction in Maternal Mortality: Chasing a Mirage’ (January 20, 2007) by Ashish Bose points to the high maternal mortality rate (MMR) and infant mortality rate (IMR) as an important manifestation of faulty healthcare in India. The MMR (per 1,00,000 births) and IMR (per 1,000 live births) in India are 540 and 64, respectively. The Indian MMR is approximately 10 times that of China, 20 times that of Cuba and 100 times that of Canada. IMR is two times that of China, 10 times that of Cuba and 12 times that of Canada. The Chinese figures are more relevant to India because both have comparable population and, unlike Canada, nearly 60 per cent of the population is rural based in both countries. Indeed the Indian MMR and IMR are disproportionately higher than can be accounted for by the poverty levels.

We suggest a framework for healthcare infrastructure, which in our opinion should be similar to that in Cuba. We visited Cuba a few years ago and spent most of our time studying the Cuban healthcare system. For example, a doctor and a nurse stay in a building that houses a clinic and they are responsible not only for the health problems of the sick but are required to monitor the health of the entire population within their jurisdiction. The doctor is expected to follow the course of all pregnancies and all high risk cases (maternal hypertension, diabetes, infection, abnormal foetal presentation) are referred to a hospital facility equipped to deal with them. The doctor is answerable to the government in the event of any maternal or infant mortality and has to face punitive measures in accordance with Cuban law in case the mortality was due to negligence.