Toward Universal Health Coverage in LAC: Measuring results of programs to extend financial protection and access to health care for the poor.
Presenter Tania Dmytraczenko Senior Economist, LCSHH
Co-Author Gisele Almeida Advisor in Analysis of Health Systems and Services, Pan American Health Organization
Discussant Adam Wagstaff Research Manager, DECHD Chair Joana Godinho Sector Manager, LCSHH
Synopsis
Since the publication of the 2010 World Health Report the momentum towards expansion of universal healthcare coverage has been building. Despite this growing consensus, there is less clarity about how to measure the effectiveness of universal coverage programs in reaching their stated objectives. The World Bank and the Pan American Health Organization have jointly undertaken an effort to review the different approaches taken to expand universal healthcare coverage and assess progress in reducing socioeconomic inequalities in health in nine countries in Latin America and the Caribbean that have implemented reforms aimed at expanding equitable access to services and financial protection, dating as far back as the late 1980s. Each country case study applies a common metric to: 1) examine the magnitude of inequities in health outcomes, utilization of services and financial protection; and 2) review how these inequities have changed over time. Time series data from nationally representative living standards measurement type surveys spanning approximately 10 years is used in the analyses. Results indicated a narrowing gap in health status and utilization of health services across socio-economic strata as well as reductions in catastrophic expenditures and impoverishment. Nonetheless substantial socioeconomic inequalities remain.
About the Presenter
Tania Dmytraczenko, Senior Economist, has over 15 years of experience as a researcher and technical advisor on health policy and planning, health care financing and health systems strengthening. Currently, she leads the preparation of the Regional Study on Universal Health Coverage in Latin America and the Caribbean; supports implementation of the federal Family Health Project in Brazil; and leads the preparation of Development Policy Lending operations at the subnational level also in Brazil. Previously, she supported the Government of Bangladesh in the implementation of the Health Nutrition and Population Sector Program, the world's largest health program being implemented as a sector wide approach. Prior to joining the Bank, she worked at Abt Associates on USAID, WHO, UNFPA and UNAIDS-funded projects at the global and country level; and she had a joint appointment with the Department of Economics and the Center for Latin American Studies at Tulane University. Tania has a Ph.D in Economics from the University of North Carolina at Chapel Hill, and a Certificat en Relations Internationales from the Université d'Aix-Marseille III. She has published in books and peer-reviewed journals.
Gisele Almeida provides technical cooperation to countries for the use of evidence in public policies and assessment of health systems performance. She is currently directing a multi-country study on the evolution of equity in health systems and their implications to public policy in the Region. She has extensive expertise in health systems research, health services management tools, evaluation methods, and project management. Before joining PAHO, she worked for the U.S. Department of Agriculture and the Brazilian Agricultural Research Corporation. She received a Doctor of Public Health with specialization in Health Policy and a Master of Science in Information Management for Health Sciences from the George Washington University. She has published in books and peer-reviewed journals. ________________________________________
