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Scaling Up Poverty Reduction Case Study A ccess to Social Services in Cuba Carmelo Mesa-Lago (Presented by Mr. Jorge Lopez) March 2004. Outline. 1. Estimates of poverty in Cuba 2. Implementation process in access to social services (education, health care, pensions, social assistance)

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  1. Scaling Up Poverty ReductionCase StudyAccess to Social Services in CubaCarmelo Mesa-Lago(Presented by Mr. Jorge Lopez) March 2004

  2. Outline 1. Estimates of poverty in Cuba 2. Implementation process in access to social services (education, health care, pensions, social assistance) 3. Impact analysis 4. Driving (implementation) factors 5. Lessons learned

  3. 1. Estimates of Poverty in Cuba • No official statistics • Official position: no poverty in Cuba; free social services; subsidized food and rent • 1997 study: 14.7% of urban population “at risk of not covering essential needs” (food) • 1995 study: Sen Index of Severity of Poverty: poverty incidence: 61% to 67%; severity of poverty: 40% to 42%. (With economic crisis, may be higher now.)

  4. 2. Implementation Process in Access to Social Services, 1959-1989 • Cuba well placed in 1958. Distribution uneven; urban-rural differentials in access • Strong expansion of social services in 1959-89; universal access • Education • Health care • Pension • Social assistance

  5. 3. Impact of Crisis on Social Services, 1990+ • Severe economic crisis in 1990s: “special period in time of peace” • Effect on access and quality of social services • Education • Health care • Pensions • Social assistance • Comparisons with FCSC and LAC

  6. 4. Driving (Implementing) Factors Commitment and political economy of change • State control over resources • Access to social services generated political support (“logros de la revolución”) Institutional innovation • Many innovations--literacy campaign, schools in the countryside,family doctor program • Difficult to manage during crisis (rising inequality)

  7. 4. Driving (Implementing) Factors Learning and experimentation • Excessive centralization; decision making from above • No participation from civil society External catalysts • Soviet aid large positive factor (1960-90) • Loss of Soviet aid since 1990 a negative combined with lack of access to markets, IFIs.

  8. 5. Lessons Learned—Positive • Universal access to social services--political commitment to universal access to education, public health, pensions • Single, equal and free public system--no need to target groups • Setting priorities to achieve goals--mostly sound and well sequenced • Social safety net

  9. 5. Lessons Learned--Negative • Unsustainable social service system • State-owned, -managed and -funded system • Inefficient allocation of resources • Generous entitlements and costly separate schemes • Poor targeting and social assistance

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