Ciego de Ávila concluded 2022 with an infant mortality of 6.2 per 1,000 live births and, although it is not a notable result on the national scene, it did behave below the country's average, since eight other provinces showed this indicator more deteriorated. The municipality of Primero de Enero was the only one in the province that had no deaths.

The infant mortality rate in Ciego de Ávila, even when it did not meet the aspiration of being below four —the country's goal for the year that ended, also unfulfilled—, did halve the indicator, compared to 2021, when it rose to 13.8 per 1,000 live births, the highest in the country.

The indicator returns to the parameters it was before COVID-19: 2019 and 2020 ended with 6.1 per 1,000 live births, but at that time it was the highest rate in the country. Now, with 6.2, the province ranks eighth and is below the national average of 7.5 per 1,000 live births.

“Despite the efforts of health personnel, the Maternal and Child Care Program (PAMI) did not achieve the desired results. At the end of the year, the Directorate of Medical Records and Statistics of the Ministry of Public Health (MINSAP) refers, as preliminary data, that 95,402 live births were reported on the Island, 3,694 less than the previous year, and a rate of infant mortality of 7.5 per 1,000 live births, with 39 fewer deaths than in 2021, when a rate of 7.6 was reported”, according to a note published on the MINSAP website.

The territories with the best rates were Cienfuegos with 4.3; Holguin with 4.5; Sancti Spiritus with 4.7; Matanzas with 5.0; Artemis with 5.4; Pinar del Río with 5.9 and the special municipality of Isla de la Juventud with 2.6. The rest of the provinces had higher numbers: Ciego de Ávila with 6.2; Granma with 6.6; Las Tunas with 7.0; Villa Clara with 7.3; Camagüey with 9.1; Havana with 9.5; Guantánamo with 9.7; Santiago de Cuba with 9.9 and Mayabeque with 12.2.

According to Dr. Noemí Causa Palma, national head of PAMI, the main causes of infant mortality in children under one year of age were perinatal conditions, mainly related to low birth weight, prematurity and intrauterine growth retardation, in addition to of congenital malformations and sepsis.

In the last seven years, the directive specified, the mother-to-child transmission rate of HIV has been equal to or less than 2 percent and the conditions that accredited Cuba as the first country that eliminated mother-to-child transmission of HIV-AIDS and syphilis in the region.

How did infant mortality due to birth defects behave?

Infant mortality due to congenital defects registered a rate of 0.96 per 1,000 live births and at the end of 2022, it went from being the second to the fourth cause of death in children under one year of age. In turn, the percentage of deaths with respect to the total number of deaths under one year of age continues to be below 13 percent.

Causa Palma pointed out that the integrated work of the national network of medical genetic centers, laboratories and services, from Primary Health Care to the tertiary level, was consolidated and distinguishes Cuba internationally.

Maternal Mortality, what was the behavior in relation to previous years?

During 2021, there was a disproportionate increase in maternal mortality, which was affected by the COVID-19 pandemic, and a rate of 176.6 per 100,000 live births was recorded. Based on this result, a reorganization was carried out in the strategies for the control of this important indicator.When comparing the absolute numbers of the year that ended in relation to 2020, there were three fewer maternal deaths (39 vs. 42) and compared to 2019, two fewer maternal deaths (39 vs. 41).

When analyzing it with respect to 2021, there were 136 fewer deaths (39 vs. 175), direct deaths decreased by 19 (26 vs. 45) and indirect non-COVID-19 deaths by 23 (13 vs. 36). While the total maternal mortality rate was 40.9 per 100,000 live births and Matanzas, Cienfuegos and the special municipality of Isla de la Juventud had no deaths in 2022.

Doctor of Science Danilo Nápoles Méndez, professor and head of the National Group of Gynecology and Obstetrics, explained that the actions developed to reduce maternal mortality were mainly aimed at preparing and updating professionals.

PAMI in 2023: for greater health and happiness for Cuban families

In order to improve the PAMI indicators, Dr. Julio Guerra Izquierdo, National Director of Medical Care, said that by 2023 the measures to improve the Family Doctor and Nurse Program will continue, the plans for development of specialties related to the Program and the committees for the prevention and control of infections associated with health care in maternity wards and pediatric hospitals will be strengthened.

Similarly, the updating of system professionals involved in maternal and child care processes will be guaranteed, and it is planned to create a national reference center for autoimmune diseases in pregnant women, taking into account the impact of these conditions on the component of maternal morbidity and mortality, the doctor noted.