Development Challenge
Despite expanded health coverage in Latin America and the Caribbean over the past two decades, millions in rural, indigenous, and low-income communities still lack access to quality care. A growing crisis of non-communicable diseases like cancer and diabetes requires strong primary health care systems for prevention and management. High out-of-pocket spending, which accounts for one-third of health expenditures, disproportionately burdens the poor and vulnerable, pushing them further into poverty.
WB Group Approach
The WBG is implementing a comprehensive strategy focused on strengthening primary health care (PHC) as the foundation for a resilient health system. With a portfolio of over 20 active operations across more than 15 countries, the WBG has committed over US$2 billion to this effort. The approach prioritizes results-based financing, digital health innovation, and climate-resilient infrastructure. Through the "Alliance for Primary Health Care in the Americas," the WBG collaborates with the Pan American Health Organization (PAHO) and the Inter-American Development Bank (IDB) to coordinate efforts and maximize impact. This "One-WBG" approach integrates lending from the World Bank, private investment from the IFC, and guarantees from MIGA to build a more robust and equitable health ecosystem.
Result
• Reached over 3 million people in Paraguay through the Ñemyasã’i: Salud y Familia program, increasing access to Family Health Care Centers from 32 percent to 53 percent of the population.
• Provided essential health and nutrition services to over 2 million people in Haiti, including immunizing 1 million children, despite extreme institutional fragility.
• Increased prenatal care coverage in intervention areas of Guatemala from 19 percent to 85 percent and exclusive breastfeeding from 43 percent to 71 percent through the Crecer Sano project.
• Eliminated waiting lists for pediatric heart surgery in Argentina, reducing the median time from diagnosis to surgery from four weeks to just one week.
• Expanded the use of electronic health records in Costa Rica to cover 90 percent of primary health care units, with 86 percent of patients in Paraguay now having digital records, compared to none before the program.
• Trained over 87,000 health workers across the region in critical areas such as infection prevention and primary care delivery.
Bank Group Contribution
This regional initiative directly contributes to the WBG's target of reaching 1.5 billion people with essential health services by 2030, with the LAC region aiming to cover 150 million people. The program also drives job creation; every new health job in the region generates an estimated 2.3 additional jobs in related sectors. By investing in the health workforce, where women constitute 70 percent of employees, the WBG is also promoting gender equity and formalizing the care economy.
Lessons Learned
A key lesson is the power of results-based financing (RBF) to drive performance and accountability in the public health sector, as demonstrated in Paraguay. By linking funding to the delivery of specific services, the model incentivizes efficiency and expands coverage. Another important lesson is that even in fragile and conflict-affected states like Haiti, targeted investments in primary care, combined with practical solutions like renewable energy for health clinics, can deliver life-saving results for vulnerable populations.
Moving Forward
The WBG will continue to scale up successful interventions across the region. Priorities include expanding the use of results-based financing models and accelerating the adoption of digital health and telemedicine to improve access and efficiency. The "Alliance for Primary Health Care in the Americas" with PAHO and the IDB will be deepened to enhance coordination and mobilize additional financing. The WBG will also leverage the Global Financing Facility to support countries in sustaining and expanding essential health services.