Good health and equitable health service delivery have a positive impact on human development and economic growth. Better access to health care improves a population’s well-being, increases productivity, and reduces poverty. Making health care systems work for all involves targeting those ever-present inequities in many national health systems.
Measuring health and health care systems inequalities is particularly important in a region such as Latin America and the Caribbean (LAC) with wide income disparities. Despite improvements in poverty levels in the Region, 36.5 percent of the population still lives in poverty, while those living in extreme poverty account for 13.4 percent, and 125 million people lack access to basic health services.
The macroeconomic reforms of the 1980s and 1990s introduced a series of changes to several Latin American and Caribbean health systems, aimed to improve effectiveness, guarantee financial sustainability, promote decentralization, and assign a larger role to the private sector. Several countries also implemented policies and programs to improve the health status of the poor and ensure more equitable access to health care services. The outcomes of these reforms vary widely, in terms of equity and efficiency, and remain present in today’s health systems’ structures and performance.
While poverty is still one of the major determinants of inequity, recent studies have shown that health inequities exist even in the absence of poverty and in countries offering universal coverage to their population. Evidence on why these socioeconomic inequalities persist in countries with policies that target the removal of barriers to access in health care remains limited. More needs to be known about the countries that have been successful in reducing or eliminating inequities in their health systems and how the different approaches to the organization and financing of health systems affects their performance in terms of equity.
Since the characteristics of health systems may work to promote or hinder development, it becomes essential to measure the overall performance of health systems and identify the key sources of failure and success. A better understanding of the sources of health inequalities will lead us closer to achieving health equity and improved health outcomes, by providing policy makers with evidence and actionable information to implement better policies.
The EquiLAC II project calls for the systematic assessment of health system inequalities in the Latin America and Caribbean region. The background for this work is based on prior case studies performed during the late 1990s on the measurement of health and health systems inequalities in the Region.
The project is divided into three phases:
The main goal of the project is to increase understanding and knowledge of health systems inequalities in the region of the Americas by producing evidence to support policy development, monitoring, and evaluation.
The audience for these studies includes ministries of health, economic development agencies, national and international organizations, policy makers, researchers and health agencies in the Americas. The studies will be widely disseminated with the hope of fostering future policy dialogue in the area of health equity research.
The specific objectives of the project encompass the following:
Regional Office for the Americas of the World Health Organization