In adverse circumstances, marked by the incidence of arboviruses, especially chikungunya, Las Tunas closes the year with an infant mortality rate of 8.7 per thousand live births, which, although below the national average, is far from the goal of a sector that continues to defend the improved functioning of the Maternal and Child Care Program (PAMI in Spanish) as one of its crown jewels.

Dr. Ariel Guevara Bringa, Health director-general in the Balcón de Oriente (Eastern Cuban Balcony), talks to 26 about the main causes that led to higher than expected morbidity and mortality rates, a situation in which many factors demand more optimal courses of action.

“We are not at all satisfied with the figures, even though we rank sixth in the country, because a single incidence means a life that could have been saved,” the doctor points out. We also had only 3,149 births, 297 fewer live births than in 2024, which further complicates the situation in Las Tunas in terms of birth rates.

"We know that we are dealing with a difficult social environment, with specific situations that exist in society today, including communicable diseases and arboviruses, issues that increase morbidity and have an impact on PAMI. However, the mother-baby binomial remains a priority for Health."

"And although the indicator is high, we worked intensively during the 12 months, sometimes with a high percentage of our professionals also sick and incapacitated by viruses. 2026 should be a year with better results because a coherent work system has been implemented, which has finally managed to address the fundamental problems of previous periods."

"At the end of 2024, we had one of the highest rates of low birth weight in Cuba. This aspect is directly proportional to the infant mortality rate, and we knew that to maintain or reduce the numbers, it was essential to improve it. And we succeeded. We ended the year with about 100 fewer cases."

"This is not a cause for celebration, because more than 200 underweight babies were born during the period, and it continues to be a significant phenomenon that poses a threat to life, but we remain convinced that we are on the right track. This index has been kept under control thanks to many intersectoral actions."

"We have addressed high blood pressure as one of the primary causes of preterm pregnancy, which is the leading cause of low birth weight here. Women give birth prematurely, and because their babies have not gained the necessary weight, we have births below 2,500 grams."

"We are committed to reversing this. We all work together to treat hypertension. We provide medication and prenatal care, and in this way, we have managed to reduce the number of preterm births and signs of low birth weight."

"Meanwhile, there has been an intersectoral focus in the communities, starting with the popular councils, on weight gain for pregnant women who need it. The Ministry of Economy and Planning centrally allocates some resources to improve its food options. We know we have to keep improving in this area. Anemia has also been treated in a differentiated manner."

Regarding teenage pregnancy, the director assures us that this is one of the areas where the most arduous work has been done and which is now yielding positive results. "Although a year ago we were one of the provinces with the highest rates, this is no longer the case. It has taken a lot of work, focused on a multisectoral approach, and there is still more to be done," he argues.

Guevara Bringa emphasizes that this scourge has been recognized as one of the main health problems, especially because almost 30 pregnant minors were admitted to intensive care with complications in 2025. To address this, efforts have been reinforced in primary care, the community, the family, and schools.

“Although the availability of contraceptive methods in pharmacies is not sufficient, we have been prioritized with resources to protect girls and boys who begin sexual relations at an early age. We want to carry out more health education activities in schools and neighborhoods.”

Infant mortality rate in Las Tunas, from 1989 to 2025.

SADNESS IN THE LENS

During 2025, maternity wards faced around 176 serious morbidities, with patients in intensive care and multidisciplinary teams battling for days and weeks for their lives. The Director General of Health talks about the fact that this has prompted a whole institutional response to safeguard life.

"The death of a mother has been a source of great dissatisfaction for us, especially because the cause was an unregulated abortion. I take this opportunity to urge families to reflect, reason, and prevent women from taking herbs, concoctions, pills... Illegal abortion methods are very dangerous."

“In 2026, we will make menstrual regulation services available in municipalities, and the curettage team will continue to perform its characteristic function. We must say that a high percentage of patients arrived during this period in serious condition due to illegal abortions.”

Guevara Bringa praises the quality of the critical maternal care team, describing it as “well-cohesive, timely, and efficient.” “Whether in Amancio, Jobabo, Manatí, or Puerto Padre, we provide timely rescue and centralized care in the provincial commission, which is recognized by the sector's leadership in the territory and the entire public health community in Las Tunas.”

Another alarming factor had a considerable impact on the balance sheet for the year just ended. Five infants died in accidents at home, setting off alarm bells in a province that had never before faced such a sad toll of accidents.

"Nothing like this has ever happened before, and five is a high number when it comes to issues that could have been prevented. This calls on us to be closer to families, to promote health more to prevent bronchoaspiration, so that safe breastfeeding can be achieved."

“We have already devised an action plan for this, because it has caused a lot of helplessness and a lot of pain.”
Likewise, survival in Pediatric Therapy, which had had no deaths for two years, showed a different reality in 2025, regardless of the excellent team of professionals working there.

"It is up to us to alert parents that they cannot underestimate their children's illnesses and must seek timely medical attention so that the conditions do not become complicated by infections."

“As for Neonatology, although it has historically controlled its indicator, it must focus on increasing survival rates in infants weighing less than 1,500 grams, those extremely premature babies born between 26 and 29 weeks. That is where we are headed.”

NEW KEY POINTS

The PAMI canvas closes in 2025 with complex nuances, in keeping with the scenario that surrounds us, marked by crisis and an amalgam of shortcomings that leave their mark on every Cuban's purpose.

In this context, Dr. Ariel Guevara Bringa praises the proven value of the health sector, its experience in providing services, its compliance with protocols, the youth who also demand leadership, and the paths identified that must be followed to achieve better results in the calendar that is already imposed.

"Although it has not been everything that families want, nor what we want either, we are closing a stage with favorable results, because we have managed to control several indicators that can guarantee us a safer year.

“We are going to change the way we work, with a different approach. The goal is to directly address the causes that marked the cycle that is coming to an end. We will be in the communities, in the municipalities, with the closeness that the people require and deserve.”

On his desk, beyond the figures and numbers in the red, lies the responsibility of achieving benefits that are a total guarantee, essential support to be able to celebrate life from its very beginnings.