Kerala - Thiruvananthapuram   

Cuban model health project

Thiruvananthapuram:

The Health Department is planning to revive the concept of family doctor in the State, modelled on the health care system in Cuba.

The Cuban system of health care, which is free, universal and de-centralised, is firmly founded on community-based primary care, delivered by a Family Doctor-Nurse team. The model has been replicated in several Latin American countries like Brazil and Argentina with successful results.

As a first step, the department has decided to start an experimental project on similar lines at Vattiyoorkavu primary health centre (PHC). With assistance from the National Rural Health Mission (NRHM), the PHC is being equipped to offer round-the-clock primary health care services by a doctor-nurse team who will be given residential quarters at the PHC itself.

The construction work of the residential quarters for the doctor-nurse team has already commenced on the PHC premises. In addition, NRHM is renovating the existing building. The doctor-nurse team and other support staff will also be provided through NRHM.

This experiment with the Cuban model of health comes following the visit of a high-level delegation from the State,

including the Health Minister, Health Secretary and the NRHM State Mission Director, to Cuba last November.

“Cuba, despite a low per capita expenditure on health, has the best health indices among third world nations. The `Family Doctor-Nurse Units’ are the mainstay of the Cuban health system and there is one such unit for every 500 to 600 population in a locality,” a senior Health Department official said.

The family doctor is the first contact point for a patient in the community. The doctor and nurse reside near the clinic itself and offer personal care to every patient. Cases which need a higher level of medical care are referred to appropriate medical centres. Apart from offering first-level of medical care, the main function of the doctor-nurse team would be to generate health awareness, promote health and hygienic practices among the community and encourage preventive measures to check infectious diseases. House visits to patients are also encouraged.

From the public health point, the key achievement of such a small doctor-nurse unit would be the generation of valuable baseline health data from the community, which will go a long way in helping health planners and policy makers in devising and executing health projects.

“A clinical registry of every person in the locality served by this 24 x 7 PHC will be developed with the help of our Accredited Social Health Activists (ASHAs) and maintained in the clinic itself. This will help in monitoring, early diagnosis and treatment of lifestyle diseases,” an official said.

In Cuba, the system of family doctor has resulted in promotion of preventive health care as a closer attention can be paid to patients with chronic lifestyle diseases like diabetes and hypertension. This has also resulted in reduced hospital admissions.

“The State’s achievements in the health front have been the result of the social commitment of our government doctors and field-level health workers in promoting health education and immunisation programmes. Today, access to equitable health care delivery is one of the major challenges faced by the State. The revival of the family doctor concept is thus a step in the right direction,” he added.

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