Low birth weight outcomes: why better in Cuba than Alabama?

Reducing the incidence of low birth weight (LBW), a major predictor of infant mortality and morbidity in developed and developing countries, is an important worldwide goal, yet interventions to reduce this incidence have been disappointingly unsuccessful. Despite its low per capita income, Cuba has managed to significantly reduce the prevalence of LBW in recent decades. To date, minimal research has been conducted to comparatively evaluate risk factors associated with birth weight outcomes between countries with significantly differing rates of LBW. For this reason, we traveled to Havana to study the Cuban model of prenatal care and compare risk factors associated with LBW in Cuba, the United States, and, in particular, Alabama. This article describes the community-based approaches to prenatal care provided within the Cuban healthcare system and their influence on rates of LBW. As a result of these successfully integrated health services, the Cuban healthcare model will be used to evaluate and compare Alabama's current prenatal care system, in particular the implementation of strategies such as community-based clinics and maternity homes for high-risk pregnancies.