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On October 22 - 23th, 2012 will be held in Barbados the Senior Policy Seminar "The Universal Health Coverage Agenda in the Caribbean: Challenges and Options", as one of the diverse events to promote UHC in the Americas and to disseminate the findings of the WHR 2010. Participants will be  policy makers in the health sector, government policy makers in charge of social policy, senior managers of national health insurance funds, and experts involved in health system reform in the Caribbean.

The main expected outcome of this meeting should become a Caribbean Universal Health Coverage Action Plan, which will summarize the meeting findings as well as propose way forward for strengthening health systems and services to benefit the peoples of the Sub-region.  

Information in the Newspaper  Barbados Advocate. (October 23, 2012)

Activity Brief


In May 2005, the World Health Assembly (WHA) endorsed Resolution WHA58.331 urging Member States to work towards universal coverage and to ensure that their populations have access to needed health interventions without the risk of financial catastrophe. This goal was defined as “universal health coverage” (UHC).

The World Health Report (WHR) 2010 highlighted that financing for UHC requires that Financing systems need to be specifically designed to:

  • Provide all people with access to needed health services (including prevention, promotion, treatment and rehabilitation) of sufficient quality to be effective;
  • Ensure that the use of these services does not expose the user to financial hardship.

The WHR 2010 based on new research and lessons learnt from experience outlined how countries can modify their financing systems to move more quickly towards universal health coverage and to sustain those achievements. (World Health Organization, 2010)

Main barriers countries face to achieve UHC identified are:  i) availability of resources; ii) reliance on direct payments to finance services which may conduct the less well-off to impoverishment and financial hardship; ii) the inefficient and inequitable use of resources. But, “every country regardless of their level of development can do something to improve their position toward UHC in at least one of those three key areas.” 

The Caribbean region faces important challenges related to future health costs based on the population aging and an increasing prevalence of non-communicable diseases (NCDs) that make these efforts even harder challenging the governments’ ability to respond. NCDs are responsible for six of the top ten leading causes of death in the region, represent a growing portion of health spending, and impose a large economic burden at the societal, community, and household level. (The World Bank, 2011)

A document by the International Monetary Fund analyzing the options for universal health coverage for the Eastern Caribbean Currency Union (ECCU) countries concludes that the best financing option for UHC is country-specific―depending on a country’s economic, cultural, institutional, demographic and epidemiological characteristics, as well as political economy considerations. It proposes however that health system reforms towards UHC should largely be based on taxation, since high indebtedness levels prevent these countries to use external sources of funding1 .

The concept of UHC is not new to the Caribbean region. Several countries of the region have been emphasizing a need for universal coverage and health for all in their national health plans over last 20 years. With a reference to social protection, the CARICOM’s Caribbean Cooperation for Health (2010-2015) has an objective to develop “mechanisms to assess or develop health financing policies, strategies and programs to increase efficiencies and measure performance”, which is also recognized in the PAHO/WHO Caribbean  Sub-regional Cooperation Strategy (2010-2015) among the most important priorities.  The promotion of the Caribbean Single Market and Economy (CSME) as well strategies pursued by several governments in regard to medical tourism present both challenges and opportunities for this region and call for economies of scale in delivering cooperation for health.

Diverse events to promote UHC in the Americas and to disseminate the findings of the WHR 2010 have taken place since its publication2.  Moving the discussion to the Caribbean Sub-Region is a priority now for the Pan American Health Organization (PAHO) considering the increasing interest by countries in the Sub-Region related to health systems financing reviews toward UHC.


To promote policy dialogue on policy options and best practices in developing health financing systems that support moving towards UHC in the Caribbean and identify main challenges and way forward to guarantee its sustainability.

In particular:

To promote health financing system reviews as an essential step in the process of shaping national health financing systems and strategies towards achieving UHC and social health protection under the NCDs challenge.

To promote research on feasible measures for tracking progress on all UHC objectives: financial risk protection (catastrophic and impoverishing expenditure), access (reduce gap between need and utilization) and quality.

The main expected outcome of this meeting should become a Caribbean UHC Action Plan, which will summarize the meeting findings as well as propose way forward for strengthening health systems and services to benefit the peoples of the Sub-region.

The Meeting was  transmited at the same time live the sessions.   

This page


icon Activity Brief 

icon Agenda

icon Opening Ceremony. October 22-23, 2012 

icon List of participants



icon David B Evans. Universal Health Coverage: Concepts and Principles (1.78 MB)

icon Trinidad and Tobago Experience. (750.02 kB)

icon Michael Coombs. Universal Coverage in Jamaica (414.32 kB)

icon C. James Hospedales. Burden of the NCD Epidemic in the Caribbean. Implications for Universal Health Coverage (3.52 MB)

icon David Mayer-Foulkes. Economic and development dimensins of NCDs. (890.69 kB)

icon Stanley Lalta. Financing Universal Health Coverage in (831.86 kB)

icon Don Ferguson. Building a Sustainable Workforce in the Caribbean (2012-2017) (967.93 kB)

icon Irad Potter. National Health Insurance The Virgin Islands Experience (1006.8 kB)

icon Federico Dorin. Measuring total health expenditure – Using indicators of National Accounts / Health Satellite Accounts (403.13 kB)

icon Peter Allen. National Health Insurance. The Belize Experience (302.49 kB)

icon Gisele Almeida. EquiLAC

icon Raphael D. Barrett. The Role of Regional Health Insurance in CARICOM on the path to Universal Health Covarage (586.43 kB)

List of Background Documents

Introduction – Sub regional documents and events:

Caribbean Cooperation in Health Phase III (CCH III). Regional Health Framework 2010 – 2015

Report of the Caribbean Commission on Health and Development

An Assessment of the Economic Impact of Climate Change on the Macroeconomy in the Caribbean. ECLAC
Available at:

6th Caribbean Conference o health financing initiatives
Debriefing Notes

Session I

World Health Report 2010. Health Systems Financing. The path to universal coverage. WHO

Background Papers

Health for All: Can it be financed?  Fiscal Space and the Financing of Universal Health Care Systems: Issues and Policies. PAHO
Available at:

Anything goes on the path to universal health coverage? No. WHO
Available at:

Universal Health Coverage. The Lancet
Available at:

Transitions in Health Financing and Policies for Universal Health Coverage: Final Report of the Transitions in Health Financing Project. Results for Development Institute

Session II

Integrated health service delivery networks. Concepts, options and a road map for implementation in the Americas. PAHO.

Declaration of Port-of Spain: Uniting to stop the epidemic of chronic NCDs

Economic Development and Non communicable Chronic Diseases. GEJ
(To be published soon)

The growing burden of non-communicable disease in the Eastern Caribbean. The World Bank.

Non-communicable diseases in Jamaica: Moving from prescription to prevention. The World Bank.

Session III

The Economics of Public Health Care Reform in Advanced and Emerging Economies (Excerpt)

Economic survey of Latin America and the Caribbean 2012. Policies for an adverse international economy. ECLAC

Rethinking Policy to Address Low Growth and High Debt in the Caribbean  - Press release
Regional Economic Outlook Update: Western Hemisphere. Latin America and the Caribbean

Universal Health Care 101: Lessons for the Eastern Caribbean and Beyond. IMF

Road Map on Human Resources for Health in the Caribbean, 2012-2017

Session IV

Sub-Regional Workshop on Health Accounts and Health Financing in the Caribbean: Barbados, Trinidad & Tobago and OECS Member States. PAHO

Analyzing Health Equity Using Household Survey Data. A guide to techniques and their implementation. The World Bank

Structural Change for Equality: An Integrated Approach to Development. ECLAC

Measuring and monitoring country progress toward UHC: Concepts, indicators and experiences. Abt Associates Inc.

Indicators for measuring Universal Health Coverage: Five Country Analysis. Abt Associates Inc.

Session V

Feasibility of Regional Health Insurance in CARICOM. Presentation of the Report.


The Crane Residential Resort
St. Philip, Barbados
Tel: (+246) 423-6220
Fax: (+246) 423-5343


Newspaper  The Barbados Advocate. October 23, 2012


This page:

Activity Coordinator

Claudia Pescetto
Advisor, Health Economics and Financing
Health Systems Based on Primary Health Care
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Tel: +1 (202) 974-3019

Administrative Support

Omarys Nieves
Administrative Assistant
Health Systems Based on Primary Health Care
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Tel:  +1 (202) 974-3115


icon Barbados. Logistics Information. October 2012 (300.75 kB)


(1) Tsounta, E. (2009) Universal Health Care 101: Lessons for the Eastern Caribbean and Beyond. Working Paper WP/09/61. Washington DC. International Monetary Fund.

(2) “Ministerial Forum on Universal Health Coverage” on April 2012. Available at:
“Seminario internacional de la financiación de los sistemas de salud. El camino hacia la cobertura universal” Buenos Aires, Argentina 2011.  Available at:

Last Updated on Wednesday, 16 January 2013 15:49

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