Human Resources for Health and Health Outcomes in Cuba: An Analysis of Their Distributions over Time and Space

Developments in Cuba's healthcare system, infant mortality rate (IMR) trends, and commitment to universal healthcare have been examined by past research. Nevertheless, reductions of spatial inequality in human resources for health (HRH) distribution and IMR have received less attention. Drawing on Cuban Ministry of Health data, we examine changes in HRH distribution by personnel type and inequality in IMRs among Cuban provinces over time, emphasising the period since 1990. We contrast these with global, OECD, and developing country HRH distributions. Our research shows declining inequality in HRH and IMR across provinces in Cuba. A longitudinal data analysis of IMR shows that IMR decreases significantly as physician density increases within provinces. Within a global context of high between and within country disparities Cuba's experience is salient given high levels of spatial inequality prior to 1959 and material resource scarcity during the ‘special period’ of the 1990s.