Is there anything to learn from the Cuban child protection system?

We believe that the Cuban child protection system anchored in a strong community-based health care system, relying on the use of informal services for parents, and a strong neighborhood-based support system for families offers... [ view full abstract ]

We believe that the Cuban child protection system anchored in a strong community-based health care system, relying on the use of informal services for parents, and a strong neighborhood-based support system for families offers an example of a community-wide approach to early recognition and prevention of child maltreatment.

A group of eight professionals representing different disciplines traveled to La Havana, Cuba and met with physicians and representatives of different organizations involved in child protection. Our meetings consisted mostly of presentations led by the Cuban organizations and visits to facilities, such as the Centro/Casa de Protección a Niñas, Niños y Adolescentes (CPNNA), the Academic Committee for the Prevention of Child Maltreatment, and the Association for Family Law and Civil Rights of the Union of Cuban Jurists, amongst others.

We observed that even though a formal child protection agency does not exist, Cuba’s child protection model has a unifying theme, the community. After its Revolution, Cuba developed a unique system of family –medicine teams connecting polyclinics to hospitals, schools, and community centers so that risk factors, such as depression, drug use, or family violence can be identified at weekly meetings and services provided. The social cohesion and the community participation to projects reducing youth unemployment were impressive. According to 2014 data provided by UNICEF, 28% of children one to 14 years of age were victims of mild corporal punishment, during the last month and 21% were victims of emotional abuse.

Based on our observations, the Cuban child protection system gives us an example of a practice and a strategy recommended by the U.S. Advisory Board on Child Abuse and Neglect in 1993. Learning the ingredients of this successful community-wide approach to child maltreatment prevention may be timely as the current US health care reform focuses on the social determinants of health.