Progress toward Universal Health Coverage in Latin America and the Caribbean: Outcomes, Utilization, and Financial Protection

TANIA DMYTRACZENKO; GISELE ALMEIDA; HEITOR WERNECK; JAMES CERCONE; YADIRA DÍAZ; DANIEL MACEIRA; SILVIA MOLINA; GUILLERMO PARAJE; FERNANDO RUIZ; FLÁVIA MORI SARTI; EWAN SCOTT; JOHN SCOTT; MARTÍN VALDIVIA

Toward Universal Health Coverage and Equity in Latin America and the Caribbean Evidence from Selected Countries

World Bank

Año: 2015; p. 81 - 147

The region has made considerable progress implementing schemes aimed at expanding universal health coverage in the past quarter-century. Measureable improvements in equity have been identified during the same period. Socioeconomic gradients are clearly present in health status, with the poor having worse observed health outcomes than the rich, but disparities have narrowed, particularly for early stages of the life course. Countries have reached high levels of coverage for maternal and child health services but, despite narrowing inequality, services remain pro-rich. Coverage of noncommunicable disease interventions is not as high as maternal and child health services and service utilization is skewed toward the better off, though these disparities continue to narrow as well. Primary care services are in general more equally distributed across income groups than is specialized care. Prevalence of noncommunicable diseases has not declined as expected given drops in mortality across these groups. Greater access to services, and hence diagnosis, among wealthier individuals may be masking differences in actual prevalence between income groups. Catastrophic health expenditures have declined in most countries, though the picture regarding equity is mixed due to measurement limitations.