[EQ] Challenges and Solutions in Health in Latin America

Challenges and Solutions in Health in Latin America

Paper for the Consulta de San José, sponsored by the Copenhagen Consensus Center and the Inter-American Development Bank

Philip Musgrove Deputy Editor, Health Affairs  September 2007

Health Challenges, Latin America

 

Available online [72p.] at: http://idbdocs.iadb.org/wsdocs/getdocument.aspx?docnum=1186232

 

“……..The overall challenge can be expressed in one sentence: People do not always get the health care they need. Of course to provide all the care that would ever do something to improve health, with no concern for cost, could use far more of society’s resources than would make any sense. In fact, spending too much on health care might actually worsen health outcomes, as resources were withdrawn from education, food, environmental protection or other inputs to health. So the challenge or problem can be re-phrased as, Of the interventions that society decides it can afford, people do not always get all those that they need. “Intervention” is used in the sense of Disease Control Priorities in Developing Countries, 2nd edn (Jamison et al. 2006, hereafter DCP2, chapter 15), meaning actions that are not limited to individual medical care—they include public health measures.

 

“Care” in this sense includes even the provision of information about health risks. To the extent that some people get the benefit of needed interventions more readily than others, the challenge is one of disparities. One way to decompose the challenge and look for ways to address it ascribes the problem to four causes—People don’t realize that they need care (that is, demand is lacking); They lack access to care, for financial, physical and cultural reasons (health facilities are too costly to the patient, too distant, or impose cultural barriers to their use, such as language differences—these are supply deficiencies);

When care is accessible, it is provided inefficiently (priorities are set badly or left to chance, resources are wasted through imbalances among inputs or operation at uneconomical scale, and so on); and Even when care is accessible, its quality is often substandard (so it does not protect or improve health as much as it could, because providers don’t know what to do, or don’t act on what they know)….”

 

Table of Contents

I. Defining the Challenges

I.1 Ignorance of need means lack of demand

I.2 Impediments to obtaining wanted care

I.3 Inefficient provision

I.4 Substandard quality

II. Defining the solutions

II.1 Improving access to care

II.2 Raising quality of care

II.3 Improving efficiency

II.4 Increasing public knowledge

III. Costs of improving utilization of good quality care

III.1 Cost of expanding access in Colombia

III.2 Other costs of systemic improvement in Colombia

III.3 Other cost estimates

IV. Benefits from the proposed solutions

IV.1 Prior estimates of benefits, and their limitations

IV.2 Financial protection

IV.3 Improved health access and outcomes

V. Conclusions

 

 

Challenges and Solutions in Health in Latin America. An Alternative View

Solution Papers Consulta de San José

Savedoff, William D.

This note presents an "Alternative View" to "Challenges and Solutions in Health in Latin America," prepared by Philip Musgrove for the Consulta de San José 2007 ((pdf 84kb)

 

Available online [14p.] at:

http://idbdocs.iadb.org/wsdocs/getdocument.aspx?docnum=1186218

 

 

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