Evaluating the effectiveness of a multi-component intervention to improve health in an inner-city Havana community

The ecosystem approach to human health was applied to guide an evaluation of the effectiveness of a multi-component intervention to improve quality of life and health in an inner-city Havana community. A pre- versus post-intervention analysis was carried out in the study community of Cayo Hueso, and Colon, a concurrent comparison community. A household survey of 1,703 individuals was conducted in 30 neighborhoods, equally divided between the two areas. Greater improvements in housing, local infrastructure, and exposure to risk were perceived to have occurred in the targeted community, more so from the perspective of benefit to the community rather than with regard to the residents' own households. Improvements in some lifestyle-related risk factors and self-rated health in the most vulnerable subgroups (elderly and adolescents) were also achieved. Overall, the Cayo Hueso Plan was considered highly successful in improving the quality of life amid difficult circumstances. Its lessons are being embraced by other communities.