This publication considers the final reports of three research projects that explored how investing in health can benefit economic growth, household productivity, and poverty reduction in Latin America and the Caribbean. It contains case studies of health systems and policies in a number of countries including Brazil, Jamaica, Mexico and Peru; as well as a review of experiences from other regions in the world regarding health inequalities and poverty alleviation.
From Few to Many is the first comprehensive look at Colombia's 1993 health system reforms. It describes the implementation of universal health insurance, including a subsidized system for the poor, and examines the impact of this and other reforms during a time when Colombia experienced crushing recession and internal conflict that displaced half a million people. Prior to the reforms, a quarter of the Colombian population had health insurance. Subsidies failed to reach the poor, who were vulnerable to catastrophic financial consequences of illness. Yet by 2008, 85 percent of the population benefited from health insurance. From Few to Many describes the challenges and benefits of implementing social health reforms in a developing country, exploring health care financing, institutional reform, the effects of political will on health care, and more. The reforms have provided important lessons not only for continued reform in Colombia, but also for other nations facing similar challenges.
Living Standards Measurement Study No. 113. This paper analyzes the extent to which workers in Bolivia face barriers to entry in the formal and informal sectors of the urban labor market. These barriers are most prevalent in the formal sector because of regulation. The higher wages found in the that sector are often regarded as evidence of labor market segmentation. However, wage differences between sectors may also result from compensating wage differentials, which follow from non-monetary returns to the job such as health insurance, utility associated with the workplace, and job security. The author proposes a model that allows testing for labor market segmentation between the two sectors on the basis of cross- sectional data. The methodology incorporates data on ways in which individuals search for new jobs and information about discouraged workers who have stopped searching for jobs. The proposed model accounts for all of the specific features of urban labor markets in developing countries, in particular the existence of a competitive informal sector.
International health and aid policies of the past two decades have had a major impact on the delivery of care in low and middle-income countries. This book argues that these policies have often failed to achieve their main aims, and have in fact contributed to restricted access to family medicine and hospital care. Presenting detailed evidence, and illustrated by case studies, this book describes how international health policies to date have largely resulted in expensive health care for the rich, and disjointed and ineffective services for the poor. As a result, large segments of the population world-wide continue to suffer from unnecessary casualties, pain and impoverishment. International Health and Aid Policies arms health professionals, researchers and policy makers with strategies that will enable them to bridge the gaps between public health, medicine and health policy in order to support robust, comprehensive and accessible health care systems in any political environment.
In Health in Ruins César Ernesto Abadía-Barrero chronicles the story of El Materno—Colombia’s oldest maternity and neonatal health center and teaching hospital—over several decades as it faced constant threats of government shutdown. Using team-based and collaborative ethnography to analyze the social life of neoliberal health policy, Abadía-Barrero details the everyday dynamics around teaching, learning, and working in health care before, during, and after privatization. He argues that health care privatization is not only about defunding public hospitals; it also ruins rich traditions of medical care by denying or destroying ways of practicing medicine that challenge Western medicine. Despite radical cuts in funding and a corrupt and malfunctioning privatized system, El Materno’s professors, staff, and students continued to find ways to provide innovative, high-quality, and noncommodified health care. By tracking the violences, conflicts, hopes, and uncertainties that characterized the struggles to keep El Materno open, Abadía-Barrero demonstrates that any study of medical care needs to be embedded in larger political histories.
Nursing is vital to millions of people worldwide. This book details the ebb and flow of its fascinating history and politics through case studies from Brazil, Argentina, Chile, Colombia, Mexico, Canada, and the United States. Authors from across the Americas share findings and explore new thinking about Western hemisphere-specific issues that affect nursing and health care. Using economic globalization as an overarching framework, these cross-national case studies show the strengths and contradictions in nursing, elucidating common themes and examining successes. The partnership of authors shapes a collective understanding of nursing in the Americas and forms a basis for enduring hemisphere-wide academic exchange. Thus, the book offers a new platform for understanding the struggles and obstacles of nursing in a climate of globalization, as well as for understanding nursing's richness and accomplishments. Because politics, economics, health, and nursing are inextricably linked, this volume critically explores the intersections among political economies and nursing and health care systems. The historical and contextual background allows readers to make sense of how and why nursing in the Americas has taken on its present form.
