The Demand For Health Care In Latin America

Spanish summary. The full report examines the public policies of 8 high-performing Asian economies (HPAEs) from 1965 to 1990. It seeks to uncover the role those policies played in the dramatic economic growth, improved human welfare, and more equitable income distribution in Hong Kong, Indonesia, Japan, Malaysia, the Republic of Korea, Singapore, Taiwan (China), and Thailand. HPAEs stabilized their economies with sound development policies that led to fast growth. They were committed to sharing the new prosperity by making income distribution more equitable. Their public policies promoted rapid capital accumulation by making banks more reliable and encouraging high levels of domestic savings. They increased the skilled labor force by providing universal primary schooling and better primary and secondary education. Agricultural policies supported productivity, while requiring only modest taxes. HPAEs kept price distortions in check and welcomed new technology and FDI. Legal and regulatory structures created a positive business environment. Cooperation between governments and private enterprises was fostered. Beyond the fundamentals of accepted macroeconomic management, HPAEs adopted policies at variance with the notion of the level playing field of open-market free enterprise. HPAEs targeted key industries for rapid development. In key areas, resource allocation was strictly managed. Trade in manufactured exports was promoted by government-established marketing institutions. Analysts disagree about the effectiveness of such interventions, but agree that without the foundation of macroeconomic stability and development of human and physical capital, the expansion would not have been so dramatic and sustainable. This report reviews the basic development policies of HPAEs that created macroeconomic stability. It explains why most countries should not use government interventions in today's changing global economy.

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

This book critically analyses the influence of international policies and guidelines on the performance of interventions aimed at reducing health inequities in Latin America, with special emphasis on health promotion and health in all policies strategies. While the implementation of these interventions plays a key role in strengthening these countries’ capacity to respond to current and future challenges, the urgency and pressures of cooperation and funding agencies to show results consistent with their own agendas not only hampers this goal, but also makes the territory invisible, hiding the real problems faced by most Latin American countries, diminishing the richness of local knowledge production, and hindering the development of relevant proposals that consider the territory’s conditions and cultural identity. Departing from this general analysis, the authors search for answers to the following questions: Why, despite the importance of the theoretical advances r egarding actions to address social and health inequities, haven’t Latin American countries been able to produce the expected results? Why do successful initiatives only take place within the framework of pilot projects? Why does the ideology of health promotion and health in all policies mainly permeate structures of the health sector, but not other sectors? Why are intersectoral actions conjunctural initiatives, which often fail to evolve into permanent practices? Based on an extensive literature review, case studies, personal experiences, and interviews with key informants in the region, Globalization and Health Inequities in Latin America presents a strategy that uses monitoring and evaluation practices for enhancing the capacity of Latin American and other low and middle-income countries to implement sustainable processes to foster inclusiveness, equity, social justice and human rights. p/pp

Conservation of biological diversity is important for sustainable development, and decentralization is a key aspect of good governance. Whether decentralization promotes conservation and if so, under what conditions, is the topic of this book. This study draws insights from field experience and traces the complex interactions among various factors involved, such as degree and type of decentralization, community participation, institutional capacity, and economic incentives. Local and international experts present case studies from experiences in Colombia, Costa Rica, India, Indonesia, Kenya, Nepal, Nigeria, the Philippines, Russia, and Zimbabwe. Subsequent chapters review 32 World Bank and Global Environment Facility projects and their impact on habitat conservation, describe a possible model of a decentralized country, and look at lessons learned from the overall study.

This book examines issues concerning how developing countries will have to prepare for demographic and epidemiologic change. Much of the current literature focuses on the prevalence of specific diseases and their economic consequences, but a need exists to consider the consequences of the epidemiological transition: the change in mortality patterns from infectious and parasitic diseases to chronic and degenerative ones. Among the topics covered are the association between the health of children and adults, the strong orientation of many international health organizations toward infant and child health, and how the public and private sectors will need to address and confront the large-scale shifts in disease and demographic characteristics of populations in developing countries.

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.

Most Latin American countries are now attempting the radical reform of their healthcare financing and delivery systems. In many cases, these reforms complement and contribute to broader neo-liberal orthodoxies of economic and social reform. Key strategies include decentralising hospital administration and the promotion of private health insurance. However, experiences across the region are quite diverse, and countries such as Cuba persist with a system of healthcare based on very different principles. This book identifies key problems facing healthcare systems in the region and evaluates the reforms that have been implemented to date. It pays particular attention to problems of implementation and the impact that changes to health policy are having on poor and vulnerable groups.