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Toward Universal Health Coverage and Equity in Latin America and the Caribbean
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 ...
Wired
Latin America and the Caribbean continues to face adverse global headwinds: high interest rates, modest G-7 growth, soft commodity prices and uncertain prospects in China will all depress growth. Well-grounded policy responses have led to largely recovering employment and income losses from the pandemic and falling rates of inflation. However, the region faces the mutually reinforcing triple challenges of low growth, limited fiscal space, and citizen dissatisfaction. Expanding digital connectivity offers a possibility to make progress on all three fronts. To maximize the social benefits of connectivity as well as to ensure that it does not exacerbate spatial, educational, gender or racial inequalities, three challenges are important to address: first, expanding coverage to the remaining unconnected areas as well as improving the quality of service; second, increasing the productive use of existing infrastructure, and; third, as with any other infrastructure "hardware," investments in "software" - such as digital and traditional skills, managerial capabilities, supportive regulatory frameworks, and deeper financial markets are critical.
The Moral Evaluation of Emergency Department Patients
In The Moral Evaluation of Emergency Department Patients: An Ethnography of Triage Work in Romania, Marius Wamsiedel examines the social categorization of patients and its consequences at two emergency departments in Romania. Based on long-term ethnographic fieldwork, this work argues that moral evaluation is an attempt on the part of triage nurses and clerks to keep the emergency service afloat in the context of high-care demand, insufficient resources, and uneven access to primary care. At the same time, Wamsiedel argues that moral evaluation is an effort to align the provision of emergency services with socially dominant values, norms, and representations. As such, the moral evaluation of...
The Changing HIV/AIDS Landscape
HIV/AIDS reverses life expectancy gains, erodes productivity, consumes savings and dilutes growth efforts, threatening the realization of the Millennium Development Goals (MDGs) in Africa.The report is the result of an extensive analytical and consultative process begun in 2006, that engaged more than 1,000 people from over 30 countries and many institutions mostly in Africa, as well as UN agencies, multilateral and bilateral donors, and foundations. The report reaffirms the Bank's commitment to combating HIV/AIDS in Africa, moving from its initial emergency response to the next phase, including the goal to provide at least US $250 million annually and to create an Africa HIV/AIDS Incentive Fund to enhance the evidence base, promote the multisectoral response and provide technical support, analysis and policy advice to countries.
Améliorer la couverture effective en matière de santé
Dans de nombreux pays à faible revenu et à revenu intermédiaire, la couverture sanitaire s’est considérablement améliorée au cours des deux dernières décennies, mais pas les résultats en matière de santé. Ainsi, la couverture effective — une mesure de la prestation de services qui répond à une norme minimale de qualité — demeure à un niveau inacceptable. Le rapport Améliorer la couverture effective en matière de santé examine une approche particulière visant à améliorer la couverture effective : les incitations financières sous la forme d’un financement basé sur la performance (FBP), une réforme globale qui comprend généralement la rémunération liée à la...
Tracking Universal Health Coverage
This report is the first of its kind to measure health service coverage and financial protection to assess countries' progress towards universal health coverage. It shows that at least 400 million people do not have access to one or more essential health services and 6% of people in low- and middle-income countries are tipped into or pushed further into extreme poverty because of health spending. Universal health coverage (UHC) means that all people receive the quality essential health services they need without being exposed to financial hardship. A significant number of countries at all levels of development are embracing the goal of UHC as the right thing to do for their citizens. It is a...
The Life of a Pest
The Life of a Pest tracks the work practices of scientists in Mexico as they study flora and fauna at scales ranging from microscopic to ecosystemic. Amid concerns about climate change, infectious disease outbreaks, and biotechnology, scientists in Mexico have expanded the focus of biopolitics and biosecurity, looking beyond threats to human life to include threats to the animal, plant, and microbial worlds. Emily Wanderer outlines how concerns about biosecurity are leading scientists to identify populations and life-forms either as worthy of saving or as “pests” in need of elimination. Moving from high security labs where scientists study infectious diseases, to offices where ecologists regulate the use of genetically modified organisms, to remote islands where conservationists eradicate invasive species, Wanderer explores how scientific research informs, and is informed by, concepts of nation.
Improving Effective Coverage in Health
In many low- and middle-income countries, health coverage has improved dramatically in the past two decades, but health outcomes have not. As such, effective coverage—a measure of service delivery that meets a minimum standard of quality—remains unacceptably low. Improving Effective Coverage in Health examines one specific policy approach to improving effective coverage: financial incentives in the form of performance-based financing (PBF), a package reform that typically includes performance pay to frontline health workers as well as facility autonomy, transparency, and community engagement. This Policy Research Report draws on a rich set of rigorous studies and new analysis. When compa...
Performance-based Contracting for Health Services in Developing Countries
Despite the existence of effective interventions, there are many developing countries which are not on track to achieve the Millennium Development Goals (MDGs) for health. In many countries the delivery of health services is inadequate and one way of improving the situation is to contract with non-state providers. Contracting is a mechanism for a financing entity to procure a defined set of services from a non-state provider. Performance-based contracting is a type of contracting with: (a) a clear set of objectives and indicators; (b) systematic efforts to collect data to judge contractor performance; and (c) some consequences for the contractor, either rewards or sanctions, based on perform...
Coalitions and Compliance
Coalitions and Compliance examines how international changes can reconfigure domestic politics. Since the late 1980s, developing countries have been subject to intense pressures regarding intellectual property rights. These pressures have been exceptionally controversial in the area of pharmaceuticals. Historically, fearing the economic and social costs of providing private property rights over knowledge, developing countries did not allow drugs to be patented. Now they must do so, an obligation with significant implications for industrial development and public health. This book analyses different forms of compliance with this new imperative in Latin America, comparing the politics of pharm...
