Maternal and child health care in Cuba: achievements and challenges/ Atencion a la salud maternoinfantil en Cuba: logros y desafios/ Cuidados de saude materno-infantil em Cuba: conquistas e desafios

In Cuba, maternal and child health care is based on the priority granted by the State, the implementation of the National Maternal and Child Health Program and the guarantee of equitable access to health services. This article describes the Cuban experience in this field, as well as its main achievements, challenges, and lessons learned. Among the most relevant results up to 2015 are the reduction of infant mortality rate and under-five mortality rate to 4.3 and 5.7 deaths per 1 000 live births, respectively; 5-year survival of 99.4%; more than 10 prenatal check-ups per delivery; 5.3% of low birth weight; 99.9% of institutional births; and being the first country to validate the elimination of mother-to-child transmission of HIV/AIDS and congenital syphilis. The main challenges are to increase the rate of exclusive breastfeeding; to reduce anemia due to iron deficiency in children and pregnant women; to reduce overweight in children; to prevent accidents; and to reduce maternal mortality, adolescent fertility rate, and voluntary abortion. Among the lessons learned are the priority given by the State to health, the programmatic management of maternal and child care, the guarantee of universal coverage, the systematic collection of information for decision-making, the integration of sectors and social participation in health. Sustaining and improving the results achieved will contribute to the fulfillment of the Sustainable Development Agenda for 2030. Keywords Maternal health; child health; maternal mortality; infant mortality; Millennium Development Goals; Sustainable Development Goals; Cuba. En Cuba, la atencion a la salud maternoinfantil se sustenta en la prioridad que le otorga el Estado, la ejecucion del Programa Nacional de Atencion Materno Infantil y la garantia de acceso equitativo a los servicios de salud. Este articulo describe la experiencia cubana en este campo, asi como sus principales logros, desafios y lecciones aprendidas. Entre los resultados mas relevantes hasta el 2015 se encuentran la reduccion de la mortalidad infantil y del menor de 5 anos a 4,3 y 5,7 fallecidos por 1 000 nacidos vivos, respectivamente; supervivencia a los 5 anos de 99,4%; mas de 10 controles prenatales por parto; 5,3% de peso bajo al nacer; 99,9% de partos institucionales; y ser el primer pais en validar la eliminacion de la transmision vertical del VIH y la sifilis congenita. Los principales desafios son aumentar la tasa de lactancia materna exclusiva; reducir la ane