Explora las posibilidades de lograr cambios favorables en los sistemas de atencion a la salud de America Latina y el Caribe y de alcanzar una Salud para Todos en el siglo XXI. Contenido: Futuros de la salud : herramientas para una mejor toma de decisiones; Desarrollo economico y social y Salud para Todos; La revolucion informativa y la atencion a la salud en Chile; El futuro de terapeutica; Tendencias futuras de la vacunologia; La genomica: promesas y las precauciones a tomar en la aceleracion de la calidad de la prevencion; el diagnostico, el tratamiento y la curacion; El futuro de los farmacos y de su regulacion en America Latina; Los sistemas de salud latinoamericanos en transicion: una vision para el futuro; El futuro de la atencion gerenciada en America Latina; Salud para Todos en las Americas: el escenario preferido; +Que significa todo esto? El sector privado, el sector publico y Salud para Todos(AU).
This book was prepared by World Bank in collaboration with the Chinese government and leading academics. It argues that, in order to address the growing economic, social, and political pressures of the 21st Century, China will have to build solid foundations for a knowledge-based economy by updating the economic and institutional regime, upgrading education and learning, and building information infrastructure. China must also raise the technological level of the economy by diffusing new technologies actively throughout the economy, improving the research and development sytem, and exploiting global knowledge.
Illustrating the diversity of disciplines that intersect within global health studies, Healthcare in Latin America is the first volume to gather research by many of the foremost scholars working on the topic and region in fields such as history, sociology, women’s studies, political science, and cultural studies. Through this unique eclectic approach, contributors explore the development and representation of public health in countries including Argentina, Bolivia, Brazil, Chile, Colombia, Cuba, Ecuador, El Salvador, Guatemala, Mexico, Nicaragua, Puerto Rico, and the United States. They examine how national governments, whether reactionary or revolutionary, have approached healthcare as a means to political legitimacy and popular support. Several essays contrast modern biomedicine-based treatment with Indigenous healing practices. Other topics include universal health coverage, childbirth, maternal care, forced sterilization, trans and disabled individuals’ access to care, intersexuality, and healthcare disparities, many of which are discussed through depictions in films and literature. As economic and political conditions have shifted amid modernization efforts, independence movements, migrations, and continued inequities, so have the policies and practices of healthcare also developed and changed. This book offers a rich overview of how the stories of healthcare in Latin America are intertwined with the region’s political, historical, and cultural identities. Contributors: Benny J. Andrés, Jr. | Javier Barroso | Katherine E. Bliss | Eric D. Carter | David S. Dalton | Carlos S. Dimas | Sophie Esch | Renata Forste | David L. García León | Javier E. García León | Jethro Hernández Berrones | Katherine Hirschfeld | Emily J. Kirk | Gabriela León-Pérez | Manuel F. Medina | Christopher D. Mellinger | Alicia Z. Miklos | Nicole L. Pacino | Douglas J. Weatherford Publication of this work made possible by a Sustaining the Humanities through the American Rescue Plan grant from the National Endowment for the Humanities.
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 efficiency and accountability for results, and that give stewards of the health sector greater leverage to steer providers to deliver on public health priorities. Evidence from the analysis of 54 household surveys corroborates that investments in extending coverage are yielding results. Though the poor still have worse health outcomes than the rich, disparities have narrowed considerably - particularly in the early stage of the life course. Countries have reached high levels of coverage and equity in utilization of maternal and child health services; coverage of noncommunicable disease interventions is not as high and service utilization is still skewed toward the better off. Catastrophic health expenditures have declined in most countries; the picture regarding equity, however, is mixed. While the rate of impoverishment owing to health-care expenditures is low and generally declining, 2-4 million people in the countries studied still fall below the poverty line after health spending. Efforts to systematically monitor quality of care in the region are still in their infancy. Nonetheless, a review of the literature reveals important shortcomings in quality of care, as well as substantial differences across subsystems. Improving quality of care and ensuring sustainability of investments in health remain an unfinished agenda.
This report provides a status update on the human resources for health (HRH) sub-system in six Latin American and Caribbean countries: Colombia, Costa Rica, Jamaica, Panama, Peru, and Uruguay. The report structures its discussion around how the health workforce is financed, organized, managed, regulated, and performing. In the area of financing, the study presents the variety of contracting mechanisms, salary levels, and financial incentives offered across the countries and their role in being able to attract and retain health workers. On the organization of the HRH sub-system, the report looks at the skill-mix, training, and distribution of health care workers concluding that although the countries have made progress towards achieving key HRH targets and in making education more accessible, there continues to be limited absorption capacity for graduates, the Primary Health Care focus of training programs needs to be strengthened, and strategies to encourage rural service have not been able to fully address the gap in the distribution of health workers. In reviewing management strategies for HRH, the report presents how all countries have adopted the WHO Global Code of Practice on the International Recruitment of Health Personnel to recognize foreign-trained professionals to help address shortages and fill gaps of health worker presence in rural, remote areas. However, the countries continue to struggle with putting self-sufficiency policies in place to meet HRH needs such as the lack of promotion plans, limited non-monetary incentives, and the shortage of personnel for recruitment and eventual placement. In the area of regulation, the report presents the countries' efforts to reduce precarious employment and introduce HRH safety policies and legislation to regulate disputes and negotiations. On performance, the report found mixed results in the areas of access/availability to health workers and quality of care, factors discouraging dual practice, and unjustified absenteeism of health workers.
"Each experience described here has its own history, as can be seen in each one of the chapters. Yet, all of them are part of a single reform process with shared historical roots and influences ... As proved by the experiences included in this book, a great deal can be learned from mental health reforms in Latin America and the Caribbean. On the one hand, each initiative developed truly original and innovative solutions for some of the problems usually encountered in the reform processes. Obviously, many of the innovative solutions can be applied in those countries that are at a similar stage of development as the Latin American and Caribbean countries where the reported experiences took place. However, many of these innovations also can be useful to any country interested in reforming its mental health services, regardless of the country's degree of development. I also believe that the reform of mental health services in Latin America and the Caribbean--given specific aspects such as the dynamic following the Caracas Declaration and the impact of international cooperation--help us to better understand the real importance of some factors, such as social and political aspects and international cooperation, in implementing mental health service reforms."--p. iv.
This report contributes to the debate about the quality of education and returns to education investment in Latin America and the Caribbean. It aims to improve our understanding of the links from investmetn in education and training to labor market outcomes and provide a basis for policy choices that will strengthen future outcomes.
