Over the past three decades, many countries of Latin America and the Caribbean have recognized health as a human right. Since the early 2000s, 46 million more people in the countries studied are covered by health programs with explicit guarantees of affordable care. Reforms have been accompanied by a rise in public spending for health, financed largely from general revenues that prioritized or explicitly target the population without capacity to pay. Political commitment has generally translated into larger budgets as well as passage of legislation that ring-fenced funding for health. Most countries have prioritized cost-effective primary care and adopted purchasing methods that incentivize efficiency and accountability for results, and that give stewards of the health sector greater leverage to steer providers to deliver on public health priorities. Evidence from the analysis of 54 household surveys corroborates that investments in extending coverage are yielding results. Though the poor still have worse health outcomes than the rich, disparities have narrowed considerably - particularly in the early stage of the life course. Countries have reached high levels of coverage and equity in utilization of maternal and child health services; coverage of noncommunicable disease interventions is not as high and service utilization is still skewed toward the better off. Catastrophic health expenditures have declined in most countries; the picture regarding equity, however, is mixed. While the rate of impoverishment owing to health-care expenditures is low and generally declining, 2-4 million people in the countries studied still fall below the poverty line after health spending. Efforts to systematically monitor quality of care in the region are still in their infancy. Nonetheless, a review of the literature reveals important shortcomings in quality of care, as well as substantial differences across subsystems. Improving quality of care and ensuring sustainability of investments in health remain an unfinished agenda.

'Beyond Survival' breaks new ground in the ongoing debate about health finance and financial protection from the costs of health care. The evidence and discussion support the need to consider financial protection, in addition to health status, as a policy objective when setting priorities for health systems. This book reviews the Latin American experience with health reform in the last 20 years and the fundamentals of health system financing, using new evidence to show the magnitude and mechanisms that determine the impoverishing effects of health events (diseases, accidents, and those of the life cycle). It provides options for policy makers on how to protect, and help household to protect themselves,against this impoverishment. The authors use empirical evidence from six case studies commissioned for this report, on Argentina, Chile, Colombia, Ecuador, Honduras, and Mexico. This book provides policy makers with a solid conceptual basis for decisions on the contents of mandatory health insurance benefit packages, choices of financing mechanisms, and the roles of public policy in this field. 'Beyond Survival' provides an in-depth analysis of, and organizational alternatives for, risk pooling and health insurance for financial protection. It analyzes the urgent need to extend risk pooling to the informal sector, the challenges for current social insurance arrangements, and options for policy makers to effectively extend risk pooling to the informal sector.

Explora las posibilidades de lograr cambios favorables en los sistemas de atencion a la salud de America Latina y el Caribe y de alcanzar una Salud para Todos en el siglo XXI. Contenido: Futuros de la salud : herramientas para una mejor toma de decisiones; Desarrollo economico y social y Salud para Todos; La revolucion informativa y la atencion a la salud en Chile; El futuro de terapeutica; Tendencias futuras de la vacunologia; La genomica: promesas y las precauciones a tomar en la aceleracion de la calidad de la prevencion; el diagnostico, el tratamiento y la curacion; El futuro de los farmacos y de su regulacion en America Latina; Los sistemas de salud latinoamericanos en transicion: una vision para el futuro; El futuro de la atencion gerenciada en America Latina; Salud para Todos en las Americas: el escenario preferido; +Que significa todo esto? El sector privado, el sector publico y Salud para Todos(AU).

This book provides a clear, broad, and provocative synthesis of the history of Latin American medicine.

The health workforce is the foundation of care and affects quality and outcomes; human resources for health(HRH) constitutes the largest portion of the health care budget of most countries. Latin America and theCaribbean has been challenged by imbalances in workforce composition, distribution, and skill mix, as wellas by variations in productivity and quality.The Health Workforce in Latin America and the Caribbean: An Analysis of Colombia, Costa Rica, Jamaica, Panama,Peru, and Uruguay provides an update on HRH in these six countries. The discussion is structured around fivekey areas of the workforce: financing, organization, management, regulation, and performance.** Financing: The authors present the variety of contracting mechanisms, salary levels, and financialincentives, and their roles in attracting and retaining health workers.** Organization: The countries have made progress toward achieving HRH targets and making educationmore accessible. However, the absorption capacity remains limited for graduates, the primary health carefocus of training programs needs to be strengthened, and the strategies to encourage rural service havenot effectively addressed the distribution gap of health workers.** Management: All six countries have adopted the World Health Organization's Global Code of Practice onthe International Recruitment of Health Personnel to recognize foreign-trained professionals to helpaddress shortages and fill gaps in rural and remote areas. However, the countries continue to strugglewith implementing self-sufficiency policies to build the capacity to meet needs. Such policies includepromotion plans, nonmonetary incentives, and personnel for recruitment and eventual placement.** Regulation: The countries are working to reduce precarious and unprotected employment, introducesafety policies to decrease occupational diseases and workplace accidents, and enact legislation toresolve disputes.** Performance: Mixed results have been achieved in health outcomes, access and availability, quality ofcare and patient satisfaction, professional practice, and productivity and efficiency.

This book examines the health and economic impact of noncommunicable diseases in Latin America and the Caribbean and the governance challenges in designing and implementating multisectoral interventions to prevent these conditions, including policies to improve diet, increase physical activity, and reduce tobacco use and alcohol abuse.