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FEATURE STORYSeptember 14, 2023

Unlocking Access to Health: Caribbean and Central America Forge Path to Universal Health Coverage

The World Bank and the Korea-World Bank Partnership Facility (KWPF) are providing critical support to countries in the Caribbean in their ambitious journey to expand Universal Health Coverage (UHC). UHC, an SDG 2023 target (set in 2015), is based on the principle that all individuals and communities should have access to quality essential health services across the full spectrum of care without suffering financial hardship.

Countries in the Caribbean region are mid-way through this reform agenda. Given the disruption in progress toward UHC caused by COVID-19, Caribbean countries recognize the value of cooperatively identifying strategies to accelerate UHC expansion. United by the common development challenges of small (island) states, they are sharing their national experiences and discussing areas that can be better tackled as a Caribbean block.

To help support this process and accelerate UHC expansion (especially amid shocks and in the context of increasing health care costs), the Korea-World Bank Partnership Facility (KWPF) and the World Bank contributed to the establishment of a platform for knowledge sharing and policy dialogue. Through this platform, in June 2023, government counterparts participated in a regional exchange—hosted by the World Bank in Washington—focused on sharing insights and experiences on UHC financing.  

Participants included Caribbean policymakers from ministries of health and finance, experts and researchers from regional and global development partners, and represented the following countries: Korea, Belize, Costa Rica, Grenada, Jamaica, Saint Lucia, and Saint Vincent and the Grenadines. The event was part of a larger World Bank Advisory Services & Analytics (ASA) program in the region focused on strengthening health financing, NCD care management, hospital sector performance, and leveraging digital for health. This event zoomed in on UHC financing, with focus on two overarching themes:

  • Investing in Health: Countries in the Caribbean block, vulnerable to shocks, understand that building back better requires their governments to invest in building more resilient health systems. Ministries of Health in the region have implemented reforms in service delivery, including at primary and higher levels of care, and strengthened data systems. The KWPF is supporting these efforts through technical assistance. To complement these efforts, the June event focused on reforms to finance the expansion of UHC, an area where progress has been slower.
  • Pushing the Frontiers of Health Financing Reforms: With most economies in the region facing slow growth and rising health sector costs, improving health financing is a priority, especially in the aftermath of COVID-19. The will is there: countries want to strengthen their health financing systems. The next steps, which the knowledge exchange event was designed to address, are, first, to clearly define and improve understanding of the components of resilient health financing. Second, to identify strategies for health care revenue mobilization in practice. And third, to ensure understanding of the implications of the various health financing models available. Overall, practitioners seek policy options to support the diversification of funding sources, improve risk pooling, efficiently and equitably allocate resources across regions and facilities, and offer more cost-effective solutions for health service delivery.

Through scanning the health financing landscape of the participant countries and sharing their first-hand experiences with ongoing reforms, the event aimed to help countries articulate their investment strategies and push the frontiers in UHC financing. One component contributing to the event’s success was the participation of two key players in the health care financing ecosystem: Ministries of Finance and Ministries of Health, which must work hand-in-hand to make reform implementation a reality. There are six crucial areas of cooperation between these two ministries in all countries that seek to accelerate UHC expansion:

  1. Identification of gaps in government health spending (e.g., how much to spend, on what, and how) and the development of revenue mobilization strategies, together with Ministries of Finance, based on solid diagnostics and a focus on sustainability and equity.
  2. Making the government budget the cornerstone of primary health care financing to create the foundation for effective and efficient health financing.
  3. Strengthening provider payments at the primary and hospital levels to link funding to actual outputs—pay providers for quality health services that are needed and valued by patients.
  4. Upgrade and mainstream Health Management Information Systems to provide the backbone for the flow of data on service provision and payments and enable evidence-based decision making to target scarce health care resources.
  5. When possible, test reforms and gather evidence from early implementation to devise scalable solutions. The end goal is a UHC financing architecture that is coherent and lasting.
  6. Improve the health financing literacy of policy makers, clinicians, and patients through capacity building, evidence-based dialogue, learning by doing, and targeted communication.

While much work remains to be done, the progress that the Caribbean region has made to date in expanding access to UHC is laudable.  The KWPF and the World Bank are committed to continuing to play a convening, technical assistance, and knowledge-sharing role to guide the countries’ UHC journeys and improve health care for patients in the region.


Last Updated: Sep 14, 2023

I think it’s very important to be part of this knowledge exchange because we are focusing on the implementation of UHC in Saint Lucia and for us, any opportunity to learn from our brother and sister countries across the region and indeed from countries across the world, will help us to avoid reinventing the wheel and potentially encountering the same mistakes or challenges faced by other countries during their UHC implementation processes
The Honorable Moses Jn Baptiste
Minister of Health, Wellness, Elderly Affairs of Saint Lucia
The Health Financing Event in June 2023 has validated many of the actions taken in Grenada to support health financing but has also identified gaps which need to be addressed for a more strategic and collaborative approach to health financing and service delivery.
Ms. Camille St. Louis
Chief Health Planner, Minister of Health and Wellness and Religious Affairs of Grenada


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