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Published in: International Journal of Public Health 1/2012

Open Access 01-02-2012 | Original Article

Intersectoral action for health at a municipal level in Cuba

Authors: Jerry Spiegel, Milagros Alegret, Veronic Clair, Nino Pagliccia, Barbara Martinez, Mariano Bonet, Annalee Yassi

Published in: International Journal of Public Health | Issue 1/2012

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Abstract

Objective

To consider how Cuba’s acknowledged achievement of excellent health outcomes may relate to how health determinants are addressed intersectorally.

Methods

Our team of Canadian and Cuban researchers and health policy practitioners undertook a study to consider the organization and practices involved in addressing health determinants in 2 municipalities (1 urban and 1 rural). The study included a questionnaire of municipal Health Council members and others involved in health and non-health sectors, key informant interviews of policy makers, focus groups in each municipality and examination of three common case scenarios.

Results

Regular engagement of different sectors and other agencies in addressing health determinants was quite systematic and comparable in both municipalities. Specific policies and organizational structures in support of intersectoral actions were frequently cited and illustrated in case scenarios that demonstrate how maintenance of regular linkages facilitates regular pursuit of intersectoral approaches.

Conclusions

The study demonstrates the feasibility of examining processes of intersectoral action for health processes and suggests that further examination in evaluating factors such as training, particular practices, etc., can be a fruitful direction to pursue comparatively and with analytical designs.
Literature
go back to reference Alegret M, Spiegel JM, Yassi A (2004) Importance of stratification and territorial ordering in prospection. Prediction and surveillance in public health. Presented at 4th annual meeting of the Canadian Coalition for Global Health Research, CCGHR, Ottawa Alegret M, Spiegel JM, Yassi A (2004) Importance of stratification and territorial ordering in prospection. Prediction and surveillance in public health. Presented at 4th annual meeting of the Canadian Coalition for Global Health Research, CCGHR, Ottawa
go back to reference Alegret M, Grau R, Rodríguez M (2008) La clasificación multivariante de áreas geográficas como una alternativa útil a la investigación salubrista [Multivariate classification of geographic areas as a useful alternative for public health research]. Rev Cub Salud Pública 34 Alegret M, Grau R, Rodríguez M (2008) La clasificación multivariante de áreas geográficas como una alternativa útil a la investigación salubrista [Multivariate classification of geographic areas as a useful alternative for public health research]. Rev Cub Salud Pública 34
go back to reference Bonet M, Spiegel J, Ibarra A, Kouri G, Pintre A, Yassi A (2007) An integrated ecosystem approach for sustainable prevention and control of dengue in Central Havana. Int J Occup Environ Health 13:188–194PubMed Bonet M, Spiegel J, Ibarra A, Kouri G, Pintre A, Yassi A (2007) An integrated ecosystem approach for sustainable prevention and control of dengue in Central Havana. Int J Occup Environ Health 13:188–194PubMed
go back to reference Castell-Florit Serrate P (2007a) Comprensión conceptual y factores que intervienen en el desarrollo de la intersectorialidad. Rev Cub Salud Pública 33 Castell-Florit Serrate P (2007a) Comprensión conceptual y factores que intervienen en el desarrollo de la intersectorialidad. Rev Cub Salud Pública 33
go back to reference Castell-Florit Serrate P (2007b) La obra de Abelardo Ramírez Márquez: paradigma de la salud pública cubana. Rev Cub Salud Pública 33 Castell-Florit Serrate P (2007b) La obra de Abelardo Ramírez Márquez: paradigma de la salud pública cubana. Rev Cub Salud Pública 33
go back to reference Castell-Florit Serrate P (2010) Intersectoral health strategies: from discourse to action. MEDICC Rev 12:48 Castell-Florit Serrate P (2010) Intersectoral health strategies: from discourse to action. MEDICC Rev 12:48
go back to reference Castell-Florit Serrate, Carnota O, Mirabal M, Santana C, Hadda J, Cabrera T (2007) Study on intersector practices in health in Cuba. Document complementing the report to the Pan American Health Organization Castell-Florit Serrate, Carnota O, Mirabal M, Santana C, Hadda J, Cabrera T (2007) Study on intersector practices in health in Cuba. Document complementing the report to the Pan American Health Organization
go back to reference Frankish CJ, Moulton GE, Quantz D, Carson AJ, Casebeer AL, Eyles JD et al (2007) Addressing the non-medical determinants of health. Can J Pub Health 98:41–47 Frankish CJ, Moulton GE, Quantz D, Carson AJ, Casebeer AL, Eyles JD et al (2007) Addressing the non-medical determinants of health. Can J Pub Health 98:41–47
go back to reference Galobardes B (2010) Closing the gap in a generation: what more research do we need? Int J Public Health 55:453–455PubMedCrossRef Galobardes B (2010) Closing the gap in a generation: what more research do we need? Int J Public Health 55:453–455PubMedCrossRef
go back to reference Health Systems Knowledge Network (2007) Challenging inequity through health systems—final report of the Health Systems Knowledge Network Health Systems Knowledge Network (2007) Challenging inequity through health systems—final report of the Health Systems Knowledge Network
go back to reference Kath E (2010) Social relations and the Cuban health miracle. Transaction Press, New Brunswick Kath E (2010) Social relations and the Cuban health miracle. Transaction Press, New Brunswick
go back to reference Lapsley I (2009) New public management: the Cruellist invention of the human spirit? Abacus 45:1–21CrossRef Lapsley I (2009) New public management: the Cruellist invention of the human spirit? Abacus 45:1–21CrossRef
go back to reference Lawn JE, Rohde J, Rifkin S, Were M, Paul VK, Chopra M (2008) Alma-Ata 30 years on: revolutionary, relevant, and time to revitalise. Lancet 372:917–927PubMedCrossRef Lawn JE, Rohde J, Rifkin S, Were M, Paul VK, Chopra M (2008) Alma-Ata 30 years on: revolutionary, relevant, and time to revitalise. Lancet 372:917–927PubMedCrossRef
go back to reference Macintyre KCE, Hadad J (2002) Cuba. In: Fried BJ, Gaydos LM (eds) World health systems: challenges and perspectives. Health Administration Press, Chicago Macintyre KCE, Hadad J (2002) Cuba. In: Fried BJ, Gaydos LM (eds) World health systems: challenges and perspectives. Health Administration Press, Chicago
go back to reference Ministry of Public Health Cuba (1991) Objectives, aims, and guidelines for improving the health of the Cuban population 1992–2000 Ministry of Public Health Cuba (1991) Objectives, aims, and guidelines for improving the health of the Cuban population 1992–2000
go back to reference O’Neill M, Lemieux V, Groleau G, Fortin J, Lamarche P (1997) Coalition theory as a framework for understanding and implementing intersectoral health-related interventions. Health Promot Int 12:79–87CrossRef O’Neill M, Lemieux V, Groleau G, Fortin J, Lamarche P (1997) Coalition theory as a framework for understanding and implementing intersectoral health-related interventions. Health Promot Int 12:79–87CrossRef
go back to reference Ochoa FR, Visbal LA (2007) Civil society and health system in Cuba. Case study commissioned by the Health Systems Knowledge Network of the WHO Commission on the Social Determinants of Health Ochoa FR, Visbal LA (2007) Civil society and health system in Cuba. Case study commissioned by the Health Systems Knowledge Network of the WHO Commission on the Social Determinants of Health
go back to reference Pagliccia N, Spiegel J, Alegret M, Bonet M, Martinez A, Yassi A (2010) Network analysis as a tool to assess the intersectoral management of health determinants at the local level: a report from an exploratory study of two Cuban municipalities. Soc Sci Med 71:394–399PubMedCrossRef Pagliccia N, Spiegel J, Alegret M, Bonet M, Martinez A, Yassi A (2010) Network analysis as a tool to assess the intersectoral management of health determinants at the local level: a report from an exploratory study of two Cuban municipalities. Soc Sci Med 71:394–399PubMedCrossRef
go back to reference Pan American Health Organisation (2007) Study on intersector practices in health in Cuba. In: Castell-Florit Serrate P, Lauzán OC, Jean-Claude MM, Espinosa CS, Hadda JH, González TC (eds) Report to the Pan American Health Organization, Washington, pp 11 Pan American Health Organisation (2007) Study on intersector practices in health in Cuba. In: Castell-Florit Serrate P, Lauzán OC, Jean-Claude MM, Espinosa CS, Hadda JH, González TC (eds) Report to the Pan American Health Organization, Washington, pp 11
go back to reference Potvin L (2009) Yes! More research is needed; but not just any research. Int J Public Health 54:127–128PubMedCrossRef Potvin L (2009) Yes! More research is needed; but not just any research. Int J Public Health 54:127–128PubMedCrossRef
go back to reference Public Health Agency of Canada (2007) Crossing sectors. PHAC, Ottawa Public Health Agency of Canada (2007) Crossing sectors. PHAC, Ottawa
go back to reference Public Health Agency of Canada (2008) Health equity through intersectoral action: an analysis of 18 country case studies. In: Public Health Agency of Canada Ministry of Health (ed) Public Health Agency of Canada (2008) Health equity through intersectoral action: an analysis of 18 country case studies. In: Public Health Agency of Canada Ministry of Health (ed)
go back to reference Sindall C (1997) Intersectoral collaboration: the best of times, the worst of times. Health Promot Int 12:5–7CrossRef Sindall C (1997) Intersectoral collaboration: the best of times, the worst of times. Health Promot Int 12:5–7CrossRef
go back to reference Spiegel J (2009) Beyond health services: channeling capacity to manage health determinants. In: Mason S, Strug D, Beder J (eds) Community health care in Cuba. Lyceum Press, Chicago, pp 108–129 Spiegel J (2009) Beyond health services: channeling capacity to manage health determinants. In: Mason S, Strug D, Beder J (eds) Community health care in Cuba. Lyceum Press, Chicago, pp 108–129
go back to reference Spiegel JM, Yassi A (2004) Lessons from the margins of globalization: appreciating the Cuban health paradox. J Public Health Pol 25:96–121CrossRef Spiegel JM, Yassi A (2004) Lessons from the margins of globalization: appreciating the Cuban health paradox. J Public Health Pol 25:96–121CrossRef
go back to reference Spiegel J, Garcia M, Bonet M, Yassi A (2006) Learning together: a Canada-Cuba research collaboration to improve the sustainable management of environmental health risks. Can J Public Health 97:50–55PubMed Spiegel J, Garcia M, Bonet M, Yassi A (2006) Learning together: a Canada-Cuba research collaboration to improve the sustainable management of environmental health risks. Can J Public Health 97:50–55PubMed
go back to reference Whiteford L, Branch L (2007) Primary health care in Cuba: the other revolution. Rowman & Littlefield, Lanham Whiteford L, Branch L (2007) Primary health care in Cuba: the other revolution. Rowman & Littlefield, Lanham
go back to reference World Health Organization (WHO) (1997) Intersectoral action for health: A cornerstone for health-for-all in the twenty-first century. Report on an international conference held in Halifax, 20–23 April 1997 World Health Organization (WHO) (1997) Intersectoral action for health: A cornerstone for health-for-all in the twenty-first century. Report on an international conference held in Halifax, 20–23 April 1997
Metadata
Title
Intersectoral action for health at a municipal level in Cuba
Authors
Jerry Spiegel
Milagros Alegret
Veronic Clair
Nino Pagliccia
Barbara Martinez
Mariano Bonet
Annalee Yassi
Publication date
01-02-2012
Publisher
SP Birkhäuser Verlag Basel
Published in
International Journal of Public Health / Issue 1/2012
Print ISSN: 1661-8556
Electronic ISSN: 1661-8564
DOI
https://doi.org/10.1007/s00038-011-0279-z

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