Reducing the equity gap in child health care and health system reforms in Latin America
Fil: Brumana, Luisa. Regional Health Advisor, UNICEF Regional Office for Latin America and the Caribbean; Panamá.
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2023
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| Acceso en línea: | http://repositorio.cedes.org/handle/123456789/4727 |
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I61-R167-123456789-47272023-07-04T04:25:10Z Reducing the equity gap in child health care and health system reforms in Latin America Reducción de la brecha de equidad en la atención de la salud infantil y reformas de los sistemas de salud en América Latina Brumana, Luisa Maceira, Daniel Aleman, Joaquín González Mortalidad infantil Disparidades en el Estado de Salud Factores Socioeconómicos Salud del Niño América Latina Fil: Brumana, Luisa. Regional Health Advisor, UNICEF Regional Office for Latin America and the Caribbean; Panamá. Fil: Maceira, Daniel. CEDES. Centro de Estudio de Estado y Sociedad. Área de Economía; Argentina. Fil: Aleman, Joaquín González. Regional Health Advisor, UNICEF Regional Office for Latin America and the Caribbean; Panamá. Background: During the first decade of the current century, Latin American countries have shown high and consistent economic growth rates, increasing per capita GDP and reducing poverty. Social indicators improved in even the poorest and least equitable countries in the region. In terms of health care results, marked advances were made in infant mortality rates. Objective: The aim of this paper is to identify if decreasing poverty rates in Latin America and the Caribbean during the first decade of the century have had an effect on health inequality, specifically by reducing the health care equity gap and, if so, whether that trend and its effects were distributed evenly at the sub-national level. Methods: Basic statistical tools were applied to national and sub-national administrative data for eleven Latin American countries (Argentina, Belize, Bolivia, Brazil, Colombia, Dominican Republic, El Salvador, Mexico, Nicaragua, Peru, and Uruguay) to compare the evolution of a set of social determinants with a classic health care outcome, such infant mortality) during the period 1995-2012. This document proposes a set of indicators to analyze relative evolution of results and convergence to equity, and to discuss general trends in health care reforms across the region. Results: The document shows a correspondence between poverty reduction, and improvement of health care indicators at a regional level, though national differences persist. In some cases, like Brazil and Peru, the reduction in infant mortality rates is coupled with significant movements towards health equity. This trend is different in Bolivia, where the drop in poverty is not followed by better outcomes in poor departments. At the same, results are not necessarily linked to health systems organization and/or specific reforms. For instance, both Brazil and Peru pursue in applying decentralized solutions, although the incentive mechanisms are quite different: the former has a supply side structure at the public provision level while the latter has implemented mixed payment systems. Conclusion: While some of the same instruments and measures of effectiveness in health care reforms appear across the region, specific impact evaluations should be performed. To reduce the equity gap in Latin America requires not only major improvements in social determinants but also the design and implementation of sound institutional policy and more robust regulatory frameworks (institutional determinants) so that more resources yield better practices. 2023-07-03T14:56:05Z 2023-07-03T14:56:05Z 2022-02-23 info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article info:ar-repo/semantics/artículo Maceira D, Brumana L, Aleman JG. Reducing the equity gap in child health care and health system reforms in Latin America. Int J Equity Health. 2022 Feb 23;21(1):29. doi: 10.1186/s12939-021-01617-w. Disponible en: http://repositorio.cedes.org/handle/123456789/4727. 1475-9276 http://repositorio.cedes.org/handle/123456789/4727 10.1186/s12939-021-01617-w 35197074 eng info:eu-repo/semantics/openAccess https://creativecommons.org/licenses/by/4.0/ application/pdf Int J Equity Health. 2022 Feb 23;21(1):29. |
| institution |
Centro de Estudios de Estado y Sociedad (CEDES) |
| institution_str |
I-61 |
| repository_str |
R-167 |
| collection |
Respositorio Digital CRIS del CEDES - Centro de Estudios de Estado y Sociedad |
| language |
Inglés |
| topic |
Mortalidad infantil Disparidades en el Estado de Salud Factores Socioeconómicos Salud del Niño América Latina |
| spellingShingle |
Mortalidad infantil Disparidades en el Estado de Salud Factores Socioeconómicos Salud del Niño América Latina Brumana, Luisa Maceira, Daniel Aleman, Joaquín González Reducing the equity gap in child health care and health system reforms in Latin America |
| topic_facet |
Mortalidad infantil Disparidades en el Estado de Salud Factores Socioeconómicos Salud del Niño América Latina |
| description |
Fil: Brumana, Luisa. Regional Health Advisor, UNICEF Regional Office for Latin America and the Caribbean; Panamá. |
| format |
publishedVersion Artículo Artículo |
| author |
Brumana, Luisa Maceira, Daniel Aleman, Joaquín González |
| author_facet |
Brumana, Luisa Maceira, Daniel Aleman, Joaquín González |
| author_sort |
Brumana, Luisa |
| title |
Reducing the equity gap in child health care and health system reforms in Latin America |
| title_short |
Reducing the equity gap in child health care and health system reforms in Latin America |
| title_full |
Reducing the equity gap in child health care and health system reforms in Latin America |
| title_fullStr |
Reducing the equity gap in child health care and health system reforms in Latin America |
| title_full_unstemmed |
Reducing the equity gap in child health care and health system reforms in Latin America |
| title_sort |
reducing the equity gap in child health care and health system reforms in latin america |
| publishDate |
2023 |
| url |
http://repositorio.cedes.org/handle/123456789/4727 |
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