Resumen

El sistema de salud en Cuba: Desafíos hacia el año 2000 . Rev Cubana Salud Pública [online]. 1997, vol.23, n.1-2, pp.5-16. ISSN 0864-3466.

From 1989 up to now, Cuba has suffered a severe economic crisis caused mainly by external factors that make the country go through one of the most difficult times of its history as an independent nation. The crisis influenced on practically every sphere of the Cuban life and brought about affectations in the health services and in less degree in the health status, where there have been important achievements during the revolutionary period. The impact of the crisis on the health services is a serious challenge for a country with a universal and free health system, a population accostumed to use these services widely, induding those of advanced technology, and a reality in which the access to foreing credits, on one hand, and to markets of drugs, goods and medical equipment, on the other hand, is increasingly difficult as a result of the blockade, which limits their acquisition and makes it more expensive. In the face of this situation, the authorities of the Ministry of Public Health have defined the foundations for a new-stage of reforms within the permanent process of reforms that started in 1960. This time, the main purpose is to consolidate the achievements attained in the health field, to adjust the development of the system to the new national reality, and to advance towards higher levels as regards the population's health. For this, it is neccesary to obtain a greater effectiveness and efficiency in the health management, to improve the quality of services, to guarantee the equity and sustenance of the system, and to maintain its public and universal character without making it private. According to the behaviour of the main health indicators, the impact on the health status has been very low taking into account the depth of the crisis. Since 1995 it has been observed a positive trend similar to that of the previous decades. Some of the reason explaining this fact are the following: the great social investment made in the country during 30 years, the high equity attained, and the strenght of the Cuban health system. Cuba reemerges from the crisis among new and hard conditions in spite of the positive signs observed in the economy. The economic blockade, reinforced with the Helms-Burton law, is a major factor that hiders and restricts the recovery rythm and conditions.

Palabras clave : HEALTH SYSTEM [trends]; HEALTH SYSTEM [economics]; CUBA.