14ymedio, Madrid, 15 December 2021 — Infant deaths doubled in Ciego de Ávila in 2021 compared to the previous year, going from 23 to 45 babies, up to 12 months, who died so far this year. The effect is also noticeable in the mortality rate, which jumped from 6.4 to 13.8 per thousand, as revealed by the newspaper Invasor in an article that tries to analyze the causes of a problem that goes beyond the pandemic.
Although the tragic jump in the figures that occurred last year can be partially explained by the impact of covid-19 on the overload on the National Health System, professionals confirm that the causes are varied and extend over time. The province has had one of the highest infant mortality rates on the island for years, exceeding the second worst province, Guantánamo, which reached 6.8 last year. The average is also high compared to the island as a whole, which last year closed with a rate of 4.9 per thousand.
“Low birth weight and prematurity have an impact on morbidity and mortality in the territory, fundamentally associated with arterial hypertension, delayed intrauterine growth and teenage pregnancy. Many babies arrive at the Neonatology service with extremely low weights (less than 1,500 and 1,000 grams [3.3 to 4.4 pounds]), threatening their lives and extending their hospital stays,” according to Luis Carmenate Martinez, head of the field of gynecology and obstetrics in the province and an official of the Program Mother and Child (PAMI), speaking to Invasor.
According to the reporting in the provincial newspaper, the main failures occur in primary care, where adequate monitoring is sometimes not received, this year in part because staff were displaced to the red zones due to covid, or consultations were suspended, but also due to lack of investment.
Ernesto René, who worked for 34 years at PAMI, says that 20 years ago the inter-sectoral work of the program began to be dismantled, which, he categorically affirms, does not work today. The doctor has expressed his opinion in a comment to the article, in which he denounces the lack of a health promotion and education system that, in his opinion, has been dismantled. In addition, he adds, the working groups are not complete and there is a lack of support from the sector.
“Professionals with experience in PAMI have been lost due to policies and decisions of its directors in the province in a totally wrong way, and lacking in science and experience,” he adds.
René also warns of the lack of motivation among health personnel, who end up dropping out. “Professionals of value such as obstetricians, pediatricians or clinical nurses have not been cared for in primary and secondary care and I believe that the motivations and barriers faced by the personnel who work in this sensitive area should be reviewed.”
The doctor, who describes the program as beautiful and loving, believes that it has lost so much that the province returns to mortality levels typical of the last century, which also leads to secondary problems such as depression among the families of those who lose a baby or mother. In Ciego de Ávila, 11 women also died in childbirth, compared to 2 in 2020.
“The maternal mortality rate involves analysis and technical and administrative decision-making in agile and dynamic ways,” judges the professor, who also warns of the risk of adolescent pregnancies in Ciego de Ávila, a leader on the Island of this situation.
The Invasor text highlights another serious problem, although it hardly gives details: infections in hospitals. “The physical conditions of the delivery and caesarean section rooms, and other structures in the Doctor Antonio Luaces Iraola Provincial General Teaching Hospital, has led to an increase in infections associated with health services and the prognoses are not good,” explains Carmenate Martínez .
The article also analyzes the fall in the birth rate, which in recent years has been remarkable, going from more than 4,000 births in 2015 to fewer than 3,300 this year. The problem is of great concern to the authorities, who at the end of 2020 warned that, with 105,038 births registered, versus 112,439 deaths, there is a decrease in the population regardless of migration.
The difficult vital circumstances and the lack of a future that young Cubans face has had a direct impact on the decline in births in Cuba and the aging of the population, something that portends imminent problems due to the lack of generational replacement.
In 2019, Cuba already exhibited a strong growth in infant mortality, increasing by 26% (a rate of 3.9 per thousand) compared to 2018. Despite this, the data continues to be good compared to other countries in the region which have very high rates in infant mortality, being much lower than the rate of 21 in Venezuela or even the rate of 11 in Mexico and 12 in El Salvador.
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