Cuba's Maternity Homes, 1962-2017: History, Evolution, Challenges.

Cuba's maternity homes were founded in 1962 as part of the gen-eral movement to extend health services to the whole population in the context of the post-1959 social transformations. The over-arching goal of the homes was to improve the health of pregnant women, mothers and newborns. Hence, in the beginning when there were few hospitals in Cuba's rural areas, their initial pur-pose was to increase institutional births by providing pregnant women a homelike environment closer to hospitals. There, they lived during the final weeks before delivery, where they received medical care, room and board free of charge. Over time, and with expanded access to community and hospital health facilities across Cuba, the numbers, activities, modalities and criteria for admission also changed. In particular, in addition to geographi-cal considerations, expectant mothers with defined risk factors were prioritized. For example, during the 1990s economic crisis, the maternity homes' role in healthy nutrition became paramount. The purpose of this essay is to provide a historical perspective of this process, describe the changes and results during the 55 years examined, and take a critical look at the challenges to suc-cessful implementation of this model, a mainstay at the primary healthcare level of the public health system's Maternal-Child Health Program. KEYWORDS Maternal health, maternal-child health, obstetrics, pregnancy, Cuba.