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.

This forward-looking book provides an in-depth analysis of the major transformations of the right to health in Latin America over the past decades, marked by the turn towards the pharmaceuticalisation of health care. Everaldo Lamprea-Montealegre investigates how health-based litigation has deepened inequalities in the global South, exploring the practices of key actors that are reclaiming the right to health in the region.

In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.

This book is about 24 developing countries that have embarked on the journey towards universal health coverage (UHC) following a bottom-up approach, with a special focus on the poor and vulnerable, through a systematic data collection that provides practical insights to policymakers and practitioners. Each of the UHC programs analyzed in this book is seeking to overcome the legacy of inequality by tackling both a “financing gap†? and a “provision gap†?: the financing gap (or lower per capita spending on the poor) by spending additional resources in a pro-poor way; the provision gap (or underperformance of service delivery for the poor) by expanding supply and changing incentives in a variety of ways. The prevailing view seems to indicate that UHC require not just more money, but also a focus on changing the rules of the game for spending health system resources. The book does not attempt to identify best practices, but rather aims to help policy makers understand the options they face, and help develop a new operational research agenda. The main chapters are focused on providing a granular understanding of policy design, while the appendixes offer a systematic review of the literature attempting to evaluate UHC program impact on access to services, on financial protection, and on health outcomes.

The last fifteen years have seen a tremendous growth in the number of health rights cases focusing on issues such as access to health services and essential medications. This volume examines the potential of litigation as a strategy to advance the right to health by holding governments accountable for these obligations. It includes case studies from Costa Rica, South Africa, India, Brazil, Argentina and Colombia, as well as chapters that address cross-cutting themes. The authors analyze what types of services and interventions have been the subject of successful litigation and what remedies have been ordered by courts. Different chapters address the systemic impact of health litigation efforts, taking into account who benefits both directly and indirectly—and what the overall impacts on health equity are.

Reshaping Health Care in Latin America: A Comparative Analysis of Health Care Reform in Argentina, Brazil, and Mexico

A muchos pacientes se les niega el acceso a los servicios de salud y a los medicamentos en América Latina, por lo que los jueces tienen que intervenir. Esta tendencia de judicialización se ha acelerado durante la última década. En un sentido similar, la literatura existente sobre la justiciabilidad y judicialización del derecho a la salud se ocupa de la cuestión de si los jueces deben intervenir o no en la protección del derecho a la salud. Objetivo: Evaluar los desafíos derivados del litigio del Derecho a la Salud en Colombia, Argentina, Brasil y México. Metodología: Marco analítico y metodológico cualitativo, descriptivo y comparativo. Incluye una revisión bibliográfica y 37 entrevistas semiestructuradas a jueces, académicos y funcionarios gubernamentales. Además, se realizó un análisis jurisprudencial de la jurisprudencia más reciente en los 4 países mediante análisis de contenido. Resultados: En los cuatro países estudiados persiste un enfoque moderado orientado a las repercusiones en el litigio y, preocupado por las consecuencias del proceso de judicialización. Esto supone, en primer lugar, la incorporación de algunos límites y condiciones en el reconocimiento del derecho a la salud por parte de los Tribunales y, en segundo lugar, en términos generales, que las sentencias no están teniendo en cuenta las causas estructurales que afectan a la litigiosidad. Conclusiones: Los tribunales deberían avanzar hacia un equilibrio intencional en el reconocimiento, los remedios, la supervisión y la evaluación de las sentencias. Esto implica ser más reflexivos y estratégicos que reactivos y pasivos. En otras palabras, cuanto más inmaduro sea el sistema sanitario y más causas estructurales se perciban, más reflexivos y estratégicos deberían ser los Tribunales y más se debería promover el reconocimiento, la protección, la supervisión y la evaluación. Los Estados también deben adoptar medidas contundentes contra las causas estructurales y deben hacer operativo un enfoque de la salud más práctico y basado en los derechos, de manera tangible.

"The World Health Report: research for universal health coverage" focuses on the importance of research in advancing progress towards universal health coverage. In addition, it identifies the benefits of increased investment in health research by low- and middle-income countries using case studies from around the world, and proposes ways to further strengthen this type of research.