Social Relations and the Cuban Health Miracle (Hardback)
  • Social Relations and the Cuban Health Miracle (Hardback)
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Social Relations and the Cuban Health Miracle (Hardback)

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£80.99
Hardback 216 Pages / Published: 15/07/2010
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For Cuba's supporters, health is the most commonly cited evidence of the socialist system's success. Even critics often concede that this is the country's saving grace. Cuba's health statistics are indeed extraordinary. This small island outperforms virtually all of its neighboring countries and all countries of the same level of economic development. Some of its health statistics rival wealthy industrialized countries. Moreover, these health outcomes have resulted against all odds.

Setting out to unravel this puzzle, the author finds that Cuba possesses an unusually high level of popular participation and cooperation in the implementation of health policy. This has been achieved with the help of a longstanding government that prioritizes public health, and has enough political influence to compel the rest of the community to do the same. On the other hand, popular participation in decision-making regarding health policy is minimal, which contrasts with the image of popular participation often promoted. Political elites design and impose health policy, allowing little room for other health sector groups to meaningfully contribute to or protest official decisions. This is a problem because aspects of health care that are important to those who use the system or work within it can be neglected if they do not fit within official priorities.

The author remains, overall, supportive of health achievement in Cuba. The country's preventive arrangements, its collective prioritization of key health areas, the improvements in public access to health services through the expansion of health facilities and the provision of free universal care are among the accomplishments that set it apart. The sustainability and progress of these achievements, however, must involve open recognition and public discussion of weaker aspects of the health system.

Publisher: Taylor & Francis Inc
ISBN: 9781412814171
Number of pages: 216
Weight: 454 g
Dimensions: 229 x 152 x 20 mm


MEDIA REVIEWS

"[Elizabeth Kath] has made a remarkably original contribution to social science research on contemporary Cuba, and I am certain this work will be useful for generations of future researchers interested in this topic. This work is based on long term research in a country that has historically been quite inaccessible to outsiders. Kath's ability to circumvent the numerous barriers (bureaucratic, cultural, ideological, economic) that typically segregate foreign visitors from ordinary Cubans suggests she is a researcher with a good deal of finesse and determination, and these traits reverberate throughout the book... At no time is the work strident or unbalanced: the author is able to navigate this highly volatile political terrain with uncompromising intellectual honesty, astute analysis and literary grace....It is a richly detailed and intellectually sophisticated analysis of health in contemporary Cuba and an outstanding contribution to the literature." -- Katherine Hirschfeld, Associate Professor of Anthropology, University of Oklahoma, and author of Health, Politics, and Revolution in Cuba Since 1898.

"Elizabeth Kath explores the profound contradiction in Cuban health care between political intentions and goals on the one hand and the complicated workings of practice on the other. She examines the official picture, often presented through statistics and quoted in many studies, which stresses the achievements of Cuban health care. The most interesting contribution of the book, however, is her scrutiny of the complexities of everyday health care practices. Kath shows that state paternalism, which is one of the reasons for its success, also becomes the very obstacle to health care quality, as fear of not fulfilling the goals set up by the state impede real participation and creativity and counteracts the positive cooperation between medical staff and patients." -- Mona Rosendahl, Director of the Institute of Latin American Studies, Stockholm University (Sweden) a


"[Elizabeth Kath] has made a remarkably original contribution to social science research on contemporary Cuba, and I am certain this work will be useful for generations of future researchers interested in this topic. This work is based on long term research in a country that has historically been quite inaccessible to outsiders. Kath's ability to circumvent the numerous barriers (bureaucratic, cultural, ideological, economic) that typically segregate foreign visitors from ordinary Cubans suggests she is a researcher with a good deal of finesse and determination, and these traits reverberate throughout the book... At no time is the work strident or unbalanced: the author is able to navigate this highly volatile political terrain with uncompromising intellectual honesty, astute analysis and literary grace....It is a richly detailed and intellectually sophisticated analysis of health in contemporary Cuba and an outstanding contribution to the literature."

--Katherine Hirschfeld, Associate Professor of Anthropology, University of Oklahoma, and author of Health, Politics, and Revolution in Cuba Since 1898.

"Elizabeth Kath explores the profound contradiction in Cuban health care between political intentions and goals on the one hand and the complicated workings of practice on the other. She examines the official picture, often presented through statistics and quoted in many studies, which stresses the achievements of Cuban health care. The most interesting contribution of the book, however, is her scrutiny of the complexities of everyday health care practices. Kath shows that state paternalism, which is one of the reasons for its success, also becomes the very obstacle to health care quality, as fear of not fulfilling the goals set up by the state impede real participation and creativity and counteracts the positive cooperation between medical staff and patients."

--Mona Rosendahl, Director of the Institute of Latin American Studies, Stockholm University (Sweden) and author of Inside the Revolution: Everyday Life in Socialist Cuba.

"In this astute and unflinching examination of Cuba's health care system, Elizabeth Kath pulls back the curtain on the island's "medical miracle" to reveal how its top-down approach limits the ability of the Cuban people to influence their own medical care. Filled with insights based on extensive field research, this book illuminates the paradoxes of the Cuban model and reveals important lessons for everyone concerned about improving health care outcomes in the developing world."

--Daniel P. Erikson, Senior Associate for U.S. policy at the Inter-American Dialogue and author of The Cuba Wars: Fidel Castro, the United States, and the Next Revolution.

"This well written and engaging book was a pleasure to read... It examines the institutional arrangements of the Cuban health sector and examines them in light of contemporary theories of the state and of a particularly insightful critique and development of the concept of social capital, [which] provides some real depth and meaning to the term 'capital' and its various dimensions. Rarely is the concept scrutinized to the extent offered in this book, which reveals problems with not only what is being measured, but with the underlying mechanisms that can explain why social capital makes a difference."

--Maria Zadoroznyj, Associate Professor of Sociology, School of Social Science, The University of Queensland, Australia.

"Outstanding contribution to understanding healthcare in Cuba... Dispels most of the mythologies about Cuba's healthcare."

--Jaime Suchlicki, Director of University of Miami Institute for Cuban and Cuban-American Studies.

"This book intriguingly explores the little-spoken aspects of the Cuban health care success story. Kath carefully examines both the strengths and the weaknesses of the Cuban health care system, employing various ethnographic sources as well as personal in-depth data collection conducted in Havana. [These methods] bring her account closer to the daily realities of the Cuban people than is typical for many political scientific accounts. In doing so, the book appeals to a wider audience than just experts in the field of political science or healthcare. Particularly appreciated is Kath's thorough description of the state measures surrounding pregnancy and childbirth, as well as the wider range of institutional aspects of the Cuban healthcare system; information that is notoriously difficult to gain access to."

--Heidi HArkOnen - PhD researcher working on kinship, gender, lifecycle and the state in Cuba. Social and Cultural Anthropology, University of Helsinki, Finland.

"With extreme evenhandedness, Kath skillfully deconstructs Cuba's healthcare mythology. While giving credit where she believes is due (especially regarding pre-natal and infant care), she punches holes in the government's propagandistic balloon, uncovering contradictory dark sides of Cuba's regimented medicine system. The author candidly concludes that Cuba's health policies cannot keep up with the population's needs due to the top-down nature of the rigid political power structure, therein the expansion of an underground medical-care informal network that fosters black market and that, ironically, depends on generous care-packages from the much demonized Cubans in diaspora. Kath's revealing findings -- based on field research in the island -- challenge those authors who have uncritically parroted Havana's official discourse vis-A-vis presumed medical achievements."

--Prof. Roland Armando Alum, anthropologist; Trustee, DeVry University, New Jersey, and former Chair, U.S. Census' Hispanic Advisory Committee.

"Ethnography conducted in 2003/2004. Focus on social and economic forces within Cuba relating to MCH."

--Family Medicine


"[Elizabeth Kath] has made a remarkably original contribution to social science research on contemporary Cuba, and I am certain this work will be useful for generations of future researchers interested in this topic. This work is based on long term research in a country that has historically been quite inaccessible to outsiders. Kath's ability to circumvent the numerous barriers (bureaucratic, cultural, ideological, economic) that typically segregate foreign visitors from ordinary Cubans suggests she is a researcher with a good deal of finesse and determination, and these traits reverberate throughout the book... At no time is the work strident or unbalanced: the author is able to navigate this highly volatile political terrain with uncompromising intellectual honesty, astute analysis and literary grace....It is a richly detailed and intellectually sophisticated analysis of health in contemporary Cuba and an outstanding contribution to the literature."

--Katherine Hirschfeld, Associate Professor of Anthropology, University of Oklahoma, and author of Health, Politics, and Revolution in Cuba Since 1898.

"Elizabeth Kath explores the profound contradiction in Cuban health care between political intentions and goals on the one hand and the complicated workings of practice on the other. She examines the official picture, often presented through statistics and quoted in many studies, which stresses the achievements of Cuban health care. The most interesting contribution of the book, however, is her scrutiny of the complexities of everyday health care practices. Kath shows that state paternalism, which is one of the reasons for its success, also becomes the very obstacle to health care quality, as fear of not fulfilling the goals set up by the state impede real participation and creativity and counteracts the positive cooperation between medical staff and patients."

--Mona Rosendahl, Director of the Institute of Latin American Studies, Stockholm University (Sweden) and author of Inside the Revolution: Everyday Life in Socialist Cuba.

"In this astute and unflinching examination of Cuba's health care system, Elizabeth Kath pulls back the curtain on the island's "medical miracle" to reveal how its top-down approach limits the ability of the Cuban people to influence their own medical care. Filled with insights based on extensive field research, this book illuminates the paradoxes of the Cuban model and reveals important lessons for everyone concerned about improving health care outcomes in the developing world."

--Daniel P. Erikson, Senior Associate for U.S. policy at the Inter-American Dialogue and author of The Cuba Wars: Fidel Castro, the United States, and the Next Revolution.

"This well written and engaging book was a pleasure to read... It examines the institutional arrangements of the Cuban health sector and examines them in light of contemporary theories of the state and of a particularly insightful critique and development of the concept of social capital, [which] provides some real depth and meaning to the term 'capital' and its various dimensions. Rarely is the concept scrutinized to the extent offered in this book, which reveals problems with not only what is being measured, but with the underlying mechanisms that can explain why social capital makes a difference."

--Maria Zadoroznyj, Associate Professor of Sociology, School of Social Science, The University of Queensland, Australia.

"Outstanding contribution to understanding healthcare in Cuba... Dispels most of the mythologies about Cuba's healthcare."

--Jaime Suchlicki, Director of University of Miami Institute for Cuban and Cuban-American Studies.

"This book intriguingly explores the little-spoken aspects of the Cuban health care success story. Kath carefully examines both the strengths and the weaknesses of the Cuban health care system, employing various ethnographic sources as well as personal in-depth data collection conducted in Havana. [These methods] bring her account closer to the daily realities of the Cuban people than is typical for many political scientific accounts. In doing so, the book appeals to a wider audience than just experts in the field of political science or healthcare. Particularly appreciated is Kath's thorough description of the state measures surrounding pregnancy and childbirth, as well as the wider range of institutional aspects of the Cuban healthcare system; information that is notoriously difficult to gain access to."

--Heidi HArkOnen - PhD researcher working on kinship, gender, lifecycle and the state in Cuba. Social and Cultural Anthropology, University of Helsinki, Finland.

"With extreme evenhandedness, Kath skillfully deconstructs Cuba's healthcare mythology. While giving credit where she believes is due (especially regarding pre-natal and infant care), she punches holes in the government's propagandistic balloon, uncovering contradictory dark sides of Cuba's regimented medicine system. The author candidly concludes that Cuba's health policies cannot keep up with the population's needs due to the top-down nature of the rigid political power structure, therein the expansion of an underground medical-care informal network that fosters black market and that, ironically, depends on generous care-packages from the much demonized Cubans in diaspora. Kath's revealing findings -- based on field research in the island -- challenge those authors who have uncritically parroted Havana's official discourse vis-A-vis presumed medical achievements."

--Prof. Roland Armando Alum, anthropologist; Trustee, DeVry University, New Jersey, and former Chair, U.S. Census' Hispanic Advisory Committee.

"Ethnography conducted in 2003/2004. Focus on social and economic forces within Cuba relating to MCH."

--Family Medicine


-[Elizabeth Kath] has made a remarkably original contribution to social science research on contemporary Cuba, and I am certain this work will be useful for generations of future researchers interested in this topic. This work is based on long term research in a country that has historically been quite inaccessible to outsiders. Kath's ability to circumvent the numerous barriers (bureaucratic, cultural, ideological, economic) that typically segregate foreign visitors from ordinary Cubans suggests she is a researcher with a good deal of finesse and determination, and these traits reverberate throughout the book... At no time is the work strident or unbalanced: the author is able to navigate this highly volatile political terrain with uncompromising intellectual honesty, astute analysis and literary grace....It is a richly detailed and intellectually sophisticated analysis of health in contemporary Cuba and an outstanding contribution to the literature.-

--Katherine Hirschfeld, Associate Professor of Anthropology, University of Oklahoma, and author of Health, Politics, and Revolution in Cuba Since 1898.

-Elizabeth Kath explores the profound contradiction in Cuban health care between political intentions and goals on the one hand and the complicated workings of practice on the other. She examines the official picture, often presented through statistics and quoted in many studies, which stresses the achievements of Cuban health care. The most interesting contribution of the book, however, is her scrutiny of the complexities of everyday health care practices. Kath shows that state paternalism, which is one of the reasons for its success, also becomes the very obstacle to health care quality, as fear of not fulfilling the goals set up by the state impede real participation and creativity and counteracts the positive cooperation between medical staff and patients-.

--Mona Rosendahl, Director of the Institute of Latin American Studies, Stockholm University (Sweden) and author of Inside the Revolution: Everyday Life in Socialist Cuba.

-In this astute and unflinching examination of Cuba's health care system, Elizabeth Kath pulls back the curtain on the island's -medical miracle- to reveal how its top-down approach limits the ability of the Cuban people to influence their own medical care. Filled with insights based on extensive field research, this book illuminates the paradoxes of the Cuban model and reveals important lessons for everyone concerned about improving health care outcomes in the developing world.-

--Daniel P. Erikson, Senior Associate for U.S. policy at the Inter-American Dialogue and author of The Cuba Wars: Fidel Castro, the United States, and the Next Revolution.

-This well written and engaging book was a pleasure to read... It examines the institutional arrangements of the Cuban health sector and examines them in light of contemporary theories of the state and of a particularly insightful critique and development of the concept of social capital, [which] provides some real depth and meaning to the term 'capital' and its various dimensions. Rarely is the concept scrutinized to the extent offered in this book, which reveals problems with not only what is being measured, but with the underlying mechanisms that can explain why social capital makes a difference.-

--Maria Zadoroznyj, Associate Professor of Sociology, School of Social Science, The University of Queensland, Australia.

-Outstanding contribution to understanding healthcare in Cuba... Dispels most of the mythologies about Cuba's healthcare.-

--Jaime Suchlicki, Director of University of Miami Institute for Cuban and Cuban-American Studies.

-This book intriguingly explores the little-spoken aspects of the Cuban health care success story. Kath carefully examines both the strengths and the weaknesses of the Cuban health care system, employing various ethnographic sources as well as personal in-depth data collection conducted in Havana. [These methods] bring her account closer to the daily realities of the Cuban people than is typical for many political scientific accounts. In doing so, the book appeals to a wider audience than just experts in the field of political science or healthcare. Particularly appreciated is Kath's thorough description of the state measures surrounding pregnancy and childbirth, as well as the wider range of institutional aspects of the Cuban healthcare system; information that is notoriously difficult to gain access to.-

--Heidi HArkOnen - PhD researcher working on kinship, gender, lifecycle and the state in Cuba. Social and Cultural Anthropology, University of Helsinki, Finland.

-With extreme evenhandedness, Kath skillfully deconstructs Cuba's healthcare mythology. While giving credit where she believes is due (especially regarding pre-natal and infant care), she punches holes in the government's propagandistic balloon, uncovering contradictory dark sides of Cuba's regimented medicine system. The author candidly concludes that Cuba's health policies cannot keep up with the population's needs due to the top-down nature of the rigid political power structure, therein the expansion of an underground medical-care informal network that fosters black market and that, ironically, depends on generous care-packages from the much demonized Cubans in diaspora. Kath's revealing findings -- based on field research in the island -- challenge those authors who have uncritically parroted Havana's official discourse vis-A-vis presumed medical achievements.-

--Prof. Roland Armando Alum, anthropologist; Trustee, DeVry University, New Jersey, and former Chair, U.S. Census' Hispanic Advisory Committee.

-Ethnography conducted in 2003/2004. Focus on social and economic forces within Cuba relating to MCH.-

--Family Medicine

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