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publication November 15, 2017

Toward Universal Health Coverage and Equity in Latin America and the Caribbean : Evidence from Selected Countries


Latin America and Caribbean countries have made meaningful progress toward universal health coverage. On average, the region enjoys a relatively good position with people living longer and healthier lives. Despite these advances, much remains to be done to close the equity gap and address new health challenges in the region. The report analyzes nearly a quarter-century of health reforms in the region using an equity approach to measure variation over time in terms of population coverage, health outcomes, utilization of needed health services, and improvement in financial protection.


  • Programs to expand coverage occurred in the political context of redemocratization, reduced inequality, and stable economic growth;
  • An additional 46 million people in nine countries have at least nominal guarantees of affordable health care;
  • Most expansion of coverage was achieved through subsidization of those without capacity to pay;
  • Nearly universal use of reproductive, maternal and child health services;
  • Narrowing gap in health status and utilization of health services across socio-economic strata;
  • Substantial socioeconomic inequalities remain, especially in access to preventive health services;
  • Noncommunicable disease and associated risk factors have increased consistently among all socioeconomic groups, over time and across countries studied;
  • Noncommunicable diseases account for most deaths in the region. Many of these deaths could be avoided through timely access to quality care;
  • Quality of health services individuals receive depends much on where they fit in the social and/or economic order;
  • Health reforms have placed more emphasis on the first level of care;
  • Increase in public financing for health as a share of gross domestic product;
  • Reductions in catastrophic expenditures and impoverishment, although millions of people still face health-related financial hardship;
  • Expenditures on medicines remain a heavy burden on the poor;
  • Best overall results have been seen in countries that increased public spending on health, covered their whole populations and integrated their health systems.