Abstract
In her report, 1 Bloomfield concluded that the holistic perspective of infectious disease prevention, such as understanding how the family perceives hygiene in the household, is imperative for national public health initiatives. By emphasising this holistic approach in healthcare systems, healthcare providers can encourage patients to take responsibility towards reducing infectious pathogens at home.
For decades, the Cuban healthcare system has prioritised community health through community polyclinics and family doctor–nurse consults – consultorios – strengthening the delivery of preventive healthcare services to families during medical consultations and home visits. It has evolved to meet community health needs and provide accessible, gratuitous, integral, localised and universal healthcare to all citizens. Historically, the national reform movement towards social medicine aimed to meet community health needs by expanding medical services to rural areas (1960s), focusing on the primary healthcare model through community polyclinics (1970s) and increasing the number of medical specialities and doctor–nurse consults (1980s). 2
Three strategies have reinforced the Cuban holistic approach and delivery of health messages to families. First, health promoters constantly disseminate health messages through creative modalities, like large digital educational posters – gigantografías – which fill wall spaces of waiting rooms at neighbourhood polyclinics. This valuable health investment aims to empower community members in choosing healthy lifestyle behaviours.
Second, disease surveillance records are carefully recorded at municipal and provincial levels, allowing timely assessments of community health needs and disparities. Multidisciplinary clinical teams – basic work groups – evaluate community needs for prompt interventions.
Third, through community participation, individuals and organisations are motivated to be active leaders in their families and communities in disease prevention programmes. Community groups, such as the Committee for the Defense of the Revolution (CDR) or Federation of Cuban Women (FMC), have organised regular exercise classes in parks and increased compliance rates to vaccinations and sexual and reproductive health screenings. 3
With emerging threats of novel pathogens and antibiotic resistance, all nations should prioritise cost-effective, community-based prevention programmes that aim to minimise threats of infectious pathogens at home. High population literacy and patient compliance rates, coupled with strong doctor–patient relationships, are advantageous in building community engagement towards a collective vision of healthy families.