Paper short abstract:

In Cuba, the healthcare system emphasizes community involvement. This paper explores how the pandemic shifted the healthcare system's approach to community participation, by analyzing how the Cuban state assigned unprecedent caregiving roles to diverse groups, extending beyond medical personnel.

Paper long abstract:

In Cuba, Primary Health Care (PHC) is the foundation of the nationally organized state health system. Since 1984, PHC has been implemented through a network of polyclinics and neighborhood health posts (consultorios), focusing on prevention, primary care, community services, and active citizen participation.

During the pandemic, PHC played a crucial role in the national strategy for pandemic control, functioning as a key filter to contain the spread, within a context already marked by a severe economic crisis, increasing vulnerabilities, and deepening socio-economic inequalities.

To support the healthcare system in its fight against COVID-19, efforts extended beyond medical personnel. Leveraging its historical mobilization capacity, the state called upon a broad range of community actors and socio-professional categories, such as students, public workers, etc., assigning unprecedented caregiving responsibilities to the population.

This contribution, grounded in the political anthropology of health, aims to account for local organizational forms, community dynamics, and their integration with health services in managing the effects of the pandemic. Based on a post-COVID-19 ethnography of three health districts (areas de salud) in La Habana and Cienfuegos, it addresses the following question: How did COVID-19 shift the lines in how the healthcare system incorporates community participation?

This paper can contribute to the panel debate on public care policies and crisis responses by presenting a case study of an alternative model of state response to the pandemic, where community participation was considered one of the key measures. It will contextualize this approach, and discuss its contributions and the risks it entails.