Reducing the equity gap in child health care and health system reforms in Latin America

• DOI: 10.1186/s12939-021-01617-w
• Publication Date: 2022-02-23T18:05:22Z
• Authors: Daniel Maceira; Luisa Brumana; Joaquín González ...
• Keywords: Equity; Health Services Research; Health indicator

Abstract Background During the first decade of current century, Latin American countries have shown high and consistent economic growth rates, increasing per capita GDP reducing poverty. Social indicators improved in even poorest least equitable region. In terms health care results, marked advances were made infant mortality rates. Objective The aim this paper is to identify if decreasing poverty rates America Caribbean during century had an effect on inequality, specifically by equity gap and, so, whether that trend its effects distributed evenly at sub-national level. Methods Basic statistical tools applied national administrative data for eleven (Argentina, Belize, Bolivia, Brazil, Colombia, Dominican Republic, El Salvador, Mexico, Nicaragua, Peru, Uruguay) compare evolution a set social determinants with classic outcome, such mortality) period 1995–2012. This document proposes analyze relative results convergence equity, discuss general trends reforms across Results shows correspondence between reduction, improvement regional level, though differences persist. some cases, like Brazil reduction coupled significant movements towards equity. different where drop not followed better outcomes poor departments. At same, are necessarily linked systems organization and/or specific reforms. For instance, both Peru pursue applying decentralized solutions, although incentive mechanisms quite different: former has supply side structure public provision level while latter implemented mixed payment systems. Conclusion While same instruments measures effectiveness appear region, impact evaluations should be performed. To reduce requires only major improvements but also design implementation sound institutional policy more robust regulatory frameworks (institutional determinants) so resources yield practices.