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Country Profile: Cuba - American Memory - Library of Congress

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<strong>Library</strong> <strong>of</strong> <strong>Congress</strong> – Federal Research Division <strong>Country</strong> <strong>Pr<strong>of</strong>ile</strong>: <strong>Cuba</strong>, September 2006<br />

Education and Literacy: Public education in <strong>Cuba</strong> is universal and free through the university<br />

level. It is based on Marxist-Leninist principles and combines study with manual labor. Day<br />

nurseries are available for all children after their forty-fifth day, and national schools at the<br />

preprimary level are operated by the state for children <strong>of</strong> five years <strong>of</strong> age. Primary education<br />

from six to 11 years <strong>of</strong> age—or until the ninth grade—is compulsory, and secondary education<br />

lasts from 12 to 17 years <strong>of</strong> age, comprising two cycles <strong>of</strong> three years each. All elementary and<br />

secondary school students receive obligatory ideological indoctrination. During the 2004–5<br />

school year, primary-school enrollment totaled 99.4 percent and secondary-school enrollment,<br />

93.1 percent. In 2002–3 an estimated 192,000 students were enrolled in higher education.<br />

Workers attending university courses receive a state subsidy to provide for their dependents.<br />

Courses at intermediate and higher levels emphasize technology, agriculture, and teacher<br />

training. In 2002 budgetary expenditures on education represented 16.4 percent <strong>of</strong> total<br />

government spending. Education spending increased to more than 11 percent <strong>of</strong> gross domestic<br />

product (GDP) in 2004, up from 6.3 percent <strong>of</strong> GDP in 1998. By the 2004–5 educational year,<br />

there were 23 education pr<strong>of</strong>essionals per 1,000 inhabitants, up from 20 in 2001–2.<br />

Health: <strong>Cuba</strong> has a single, unified National Health System (Sistema Nacional de Salud—SNS).<br />

For the most part, the SNS is administered locally through an aggressive neighborhood health<br />

promotion program that makes heavy use <strong>of</strong> a network <strong>of</strong> easy-access institutions <strong>of</strong>fering<br />

primary and secondary health-care services. At the national level, the Ministry <strong>of</strong> Public Health<br />

provides oversight. In 2004, 6.8 percent <strong>of</strong> <strong>Cuba</strong>n medical facilities, including five hospitals and<br />

several dozen institutes, were subordinate to the Ministry <strong>of</strong> Public Health; most <strong>of</strong> <strong>Cuba</strong>’s<br />

medical facilities (93.2 percent), including 279 hospitals, 436 polyclinics, and many other<br />

medical facilities, were subordinate to provincial and municipal administrative councils. The<br />

total amount spent on public health increased 59 percent between 1994 and 2000, an average<br />

annual increase <strong>of</strong> 9.6 percent. In 2004 <strong>Cuba</strong> spent a total <strong>of</strong> 6.2 percent <strong>of</strong> gross domestic<br />

product on health care. The total per capita expenditure on health at an average exchange rate in<br />

2002 was US$197. In 2004 <strong>Cuba</strong> had 69,713 doctors, theoretically giving the country a ratio <strong>of</strong><br />

about one doctor per 161 residents, as compared with one doctor per 188 residents in the United<br />

States; in theory, family doctors covered 99.4 percent <strong>of</strong> the population.<br />

The health pr<strong>of</strong>ile <strong>of</strong> the <strong>Cuba</strong>n population is more like that <strong>of</strong> a developed country than a<br />

developing one, with low infant mortality, low fertility, low rates <strong>of</strong> infectious disease, and high<br />

cancer and cardiovascular disease rates. Despite <strong>Cuba</strong>’s relatively meager resources, the primary<br />

health care system is still able to provide almost universal coverage and to ensure the<br />

continuance <strong>of</strong> low mortality among those less than 65 years <strong>of</strong> age even in the face <strong>of</strong> rising<br />

health threats. More than 95 percent <strong>of</strong> pregnant women receive prenatal care, and 98 to 99<br />

percent <strong>of</strong> newborns are delivered in hospitals, factors that contribute to low infant and maternal<br />

mortality. <strong>Cuba</strong> also has high vaccination rates for childhood diseases, plus children up to age<br />

seven receive additional food rations through the ration card system.<br />

The leading causes <strong>of</strong> death in 2000 were chronic noncommunicable diseases. Diseases <strong>of</strong> the<br />

heart, malignant neoplasms, and cerebrovascular diseases accounted for 60 percent <strong>of</strong> all deaths.<br />

In 2000 the most frequent communicable diseases were acute diarrheal diseases and acute<br />

respiratory infections. Dengue fever is also prevalent. Between 1986 and 2000, 3,231 individuals<br />

tested positive for human immunodeficiency virus (HIV)/acquired immune deficiency syndrome<br />

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