Translated from the Spanish and reprinted with permission from the Revista Cubana de Salud Pública, [online] Vol. 38, No. 1, Jan–Mar 2012.
Original available at: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-34662012000100011&lng=es&nrm=iso&tlng=es

This paper describes the evolution of basic indicators of health services, human resources, and infrastructure, starting with a general account of processes under way since the mid-1990s aimed at health sector recovery and focused on improving quality of service, system efficiency and effectiveness, while maintaining equity. Using this background, a description is provided of objectives and essential elements of transformations currently under way in the national health system, based on processes of reorganization, consolidation and regionalization of services. Finally, implications of territorial redistribution for health system reform are discussed, focusing on tensions between rationalization and equity in real or perceived access.

KEYWORDS Health services, transformations, Cuba