Editorial

A necessary triad for the development and sustainability of the Cuban national health system

0000-0002-9519-8923Liuba Díaz Valdés^{1  *}  , 0000-0002-5847-0924Sunieska Mayor Walton¹ 

¹Dirección Provincial de Salud, Sancti Spíritus, Cuba.

Scientific health societies, national groups of specialties and Cuban medical universities constitute indispensable structures for the improvement of the National Health System in Cuba; achieving their integration is a priority task that will allow responding to the challenges of global public health and the demands of the contemporary era. September 10, 2020 marks the XL anniversary of the creation of the National Council of Scientific Health Societies; organization that strengthens the development and sustainability of the National Health System and keeps Cuban professionals committed to people´s health and well-being.

The National Health System operates under the premises of improving population health indicators, the quality of medical care, satisfaction of services and efficiency in the use of resources to guarantee the sustainability of the system and its relationship with universal health.

Scientific Societies constitute a driving force for the development of science, its human capital and the generalization of knowledge, becoming the ideal environment for the exchange and frequent discussion of the experiences of groups of scientists from diverse fields and the dissemination of their research through specialized publication.

The National Council of Scientific Societies is the organization in charge of coordinating and advising the activities of scientific societies related to the health sector and linked to plans related to medical care, epidemiology, teaching and research, as well as other economic, legal, social and political activities that derive from its performance in Cuban society. ¹

The Provincial Councils of Scientific Societies constitute the coordinating and advisory unit for scientific and/or other activities related to the provincial section and the health sector in their territory and are subordinated to the Provincial Health Direction. The Plenary of the Provincial Council of Scientific Societies is integrated by the director, the secretary and the presidents of the sections of the scientific societies existing in the province. ¹

The national and provincial groups of the specialties are work groups integrated by high-level scientific and academic professionals designated by the Ministry of Public Health and the Provincial Health Direction, to carry out advisory work at these levels. ²

In both cases, the Ministry of Public Health establishes two organizational structures for its attention: the National Council of Scientific Health Societies for the care of scientific associations and the Specialties Section for national groups; it happens similarly in the provincial health directions, with officials who attend the provincial groups of specialties and the Provincial Councils of Scientific Societies who coordinate the work of the provincial sections of these societies. ²

It is a necessity today that societies and groups of specialties work together with the Ministry of Public Health in the implementation of the Guidelines of the Economic and Social Policy of the Party and the Revolution approved in the VII Congress of the Communist Party of Cuba, especially in primary health care, in strengthening hygiene, epidemiology and microbiology to decrease the rate of infestation of the Aedes aegypti mosquito, avoid the transmission of arbovirosis, in the improvement of educational work for undergraduate and graduate students, in strengthening preparation and the performance of the teachers´ assembly which has an impact on the training of students and residents, as well as increasing political-ideological and ethical work with teachers and students. ²

The current scenarios and the context of development of public health need an improvement with a strategic, organized and comprehensive vision of the specialties of Cuban Medical Sciences for the period 2020-2025; task that should be carried out by national groups, together with scientific societies, in order to raise the quality of services, throughout the training of more prepared and competent specialists, in correspondence with the health of the Cuban population.

In fulfilling the challenges, objectives and priorities of the health system, the role of medical universities and teaching scenarios as knowledge management and research centers is also decisive; academic improvement and training of doctors of science; the accreditation of health institutions and their importance in providing quality healthcare. ⁴ It is also necessary to promote the selection of medical specialties in Medicine students, to activate the Student Assistants Movement and to encourage vertical boarding.

It is also essential that scientific health societies and national groups of specialties, together with medical universities, stimulate the strengthening of science activity through scientific research, as a response to the health picture of the population, the achievement of technological innovations and the generalization of scientific results; that are linked to the comprehensive quality strategy. ²

In addition, the cooperation of this triad is urgent for the execution of the program for economic efficiency and to decrease the cost of resources, developing actions to recover what is recoverable and reusable, for the planning of medicines, equipment, reagents, expendable, spare parts and others, the execution of the investment program, of repair, maintenance and conservation of what has been recovered, with the application of internal control measures, combats indiscipline, illegalities and corruption. ²

At the near of the XL anniversary of the creation of the National Council of Scientific Health Societies, it is necessary to highlight that the 54 societies that comprise it have an intense ideological political activity within Cuban civil society by belonging to the Cuban Association of the United Nations (ACNU), which brings together all the country's non-government organizations and civil associations, carrying out political, economic and social activities of the so-called Cuban civil society. ³

In the ACNU there is a health commission, which carries out multiple scientific updating activities commemorating dates established by the UN to celebrate various days and day´s anniversaries; and the National Council of Scientific Health Societies, representing health societies, is a full member of the board of directors of that organism. ³

Cuban civil society, integrated by more than 2,200 organizations and represented in the different sectors of Cuban society, plays a main role in the implementation of the 2030 Agenda. Its actions in favor of the goals set out contribute substantially to the implementation and efforts of the Cuban State and Government to achieve compliance with the commitments made with the Sustainable Development Goals. ⁴

The Cuban health system presents particularities that promote quality fulfillment of the Millennium Development Goals. It is an integrated, state, free health system based on the Primary Health Care strategy. The current, unique and equitable system is within everyone's opportunities without limitations of any kind, scientifically supported, open to popular and solidarity participation nationally and internationally.

However, there are still goals that, from the development perspective, are subject to improvement. In this sense, the transformations of the health system unfold in response to the reorganization of the economic social model and the international context, where Cuban scientific health societies, national groups of specialties and medical universities play a decisive role.

Scientific health research, innovation and generalization of its results are essential elements in raising the quality of medical care and economic efficiency, as a fundamental condition for the advancement of the health system. ⁴

Based on new international conceptions and the experience accumulated so far, in Cuba a model of health surveillance has been resized and developed which responds to the needs of the health system, in accordance with the changes in the epidemiological pattern, the transformations performed in the health conditions of the population, the introduction of new technologies and equipment, the development of health services and programs, border surveillance, of medicines, vaccines, in primary, secondary and tertiary care, among others. Health surveillance has been developed in the country and its results have a decisive impact in improving the management of health indicators at all levels of care. ⁴

To achieve the Sustainable Development Goals, it is essential to guarantee a healthy life. In our province the spirituan section of the scientific health societies, the provincial groups of medical specialties and the University of Medical Sciences are called to promote the development of science and technology in the field of health sciences, with the common goal of raising the health level of the population, so immediate actions must be developed to integrate them into its work.

The reasons given before allow us to understand that to contribute to the development and sustainability of the National Health System, the greatest challenge is integration, that is why it is necessary to change behaviors, work styles, train, demand responsibilities, motivate, increase leadership and control. Furthermore, each action must be a systemic and systematic process to contribute to the implementation of the 2030 Agenda and the fulfillment of the objectives for sustainable development.

REFERENCIAS BIBLIOGRÁFICAS

1.  Resolución Ministerial No. 84. Reglamento del Consejo Nacional de Sociedades Científicas de la Salud. Gaceta Oficial de la República de Cuba, n.^o1.  12, (febrero-19-2015) [Internet] [citado 2020 Mar 19] Disponible en: Disponible en: https://www.gacetaoficial.gob.cu/es/resolucion-84-de-2015-de-ministerio-de-salud-publica 1.

2.  Véliz Martínez PL. Sociedades científicas y los Grupos nacionales de las especialidades médicas “palancas para el desarrollo” de la salud. INFODIR [Internet]. 2017 [citado 12 Mar 2020];25(julio-diciembre):3-6. Disponible en: Disponible en: http://www.revinfodir.sld.cu/index.php/infodir/article/view/427 2.

3.  Véliz Martínez PL. Papel de las Sociedades Científicas cubanas de la salud en la actualidad. En: Convención Internacional de Salud. La Habana: Editorial de Ciencias Médicas; 2015 [Internet]. [citado 2020 Mar 19]. Disponible en: Disponible en: http://www.convencionsalud2015.sld.cu/index.php/convencionsalud/2015/paper/view/924/747 3.

4.  Cuba. Informe nacional sobre la implementación de la Agenda 2030. Informe voluntario de Cuba. 2019[citado 2020 Mar 19] Disponible en: Disponible en: https://foroalc2030.cepal.org/2019/sites/foro2019/files/informe_nacional_voluntario_de_cuba_sobre_implementacion_de_la_agenda_2030.pdf 4.

Received: April 01, 2020; Accepted: May 07, 2020

^*Autor para la correspondencia. Correo electrónico: [e-mail]

Los autores declaran no tener conflicto de interés en esta investigación.