Documenting the Implementation Experience of the Cuban Doctors Project in Kenya: Lessons from LMICs

Background: The success of any country in achieving its health goals largely depends on the training, motivation, and deployment of adequate and adequately skilled human resources for health (HRH)1. However, many countries globally face chronic HRH shortages, with more severe shortages in low- and low-middle-income countries (LMICs)2,3. Additionally, most healthcare workers work in urban areas leaving large populations in rural areas with limited access to healthcare services. These shortages in HRH and skewed distribution between those working in urban and rural areas exacerbate inequalities in healthcare access and hinder progress towards attaining Universal Health Coverage (UHC). Several studies have also shown that the emergence and resurgence of infectious diseases, including HIV/AIDs, tuberculosis, malaria and more recently COVID-19, have put additional strain on the health workforce in many countries, where there are HRH shortages amidst growing demand for healthcare services. Different countries have put various HRH interventions aimed at addressing public sector HRH challenges including the importation of healthcare workers. Globally, the importation and exportation of healthcare workers is increasing and many countries are increasingly depending on imported healthcare workers to fill in existing HRH gaps. While majority of the countries that import healthcare workers are primarily high-income countries in the global north, there are increasing patterns of healthcare workers importation programs to LMICs4,5. Cuba, maintains one of the largest healthcare workers export programs to different countries globally6. Cuba has invested heavily in medical training ensuring a steady supply and producing a surplus of healthcare workers. This enables Cuba to export healthcare workers to other countries. The Cuban healthcare system, is one of the best globally yet it’s a low-resource setting, centered on preventive and promotive care, which provides a good benchmark for other LMICs 7. The design and implementation of HRH interventions play a crucial role in their success. Therefore, it is essential to analyze how these interventions are developed and delivered and to gather lessons from the implementation experiences. This review will focus on examining the implementation experiences of Cuban health cooperation programs in LMICs. To analyse the emergence and goals, the implementation design, utility and draw lessons. Methods: This scoping review will map out literature on the design and implementation processes of Cuban health cooperation programs in LMICs, using the Joanna Briggs Institute (JBI) guidelines for a scoping review. In this review, we will include the goals and the emergence of Cuban medical internationalism in different countries, the design and implementation processes, and the implications and lessons learned. We will review published literature from studied published in English language, between 2000 and 2024. The databases to be searched include PubMed, Google Scholar Web of Science and Scopus. Two independent reviewers will conduct searches, study selection, and data extraction using Covidence. The findings will be analyzed using the thematic content analysis approach and the results presented narratively and graphically. Discussion: We anticipate finding relevant information on the design implementation processes and experiences of health cooperation programs between Cuba and LMICs and drawing lessons that can better inform similar HRH interventions in the future.