International learning and lessons to move towards universal, comprehensive and sustainable health systems

Background

Health systems in Latin America suffer from a set of structural weaknesses that became evident as a result of the health crisis caused by the COVID-19 pandemic. Although the countries have made efforts to increase spending on health, it is observed that their health systems are chronically underfunded which, accompanied by high levels of fragmentation and an organization that separates them into segments that are unrelated to each other, translates into a set of problems of sufficiency in access, inefficiency, coordination difficulties, lack of solidarity and situations of inequality (ECLAC, 2022). When considering the indicators of the health systems of Latin America and the Caribbean in light of the situation of the countries of the Organization for Economic Cooperation and Development (OECD), it is observed, for example, that the expenditure on health per capita of the region is equivalent to a quarter of the value corresponding to the average of the OECD countries, which, in turn, translates into a relative scarcity of human resources in the area of ​​health and of beds available for the population (CEPAL /PAHO, 2021).

These problems have worsened during the pandemic, generating a situation of reproduction and deepening of health inequalities, in which the well-being of the population of Latin America has been significantly deteriorated. Faced with this and taking advantage of the historic opportunity that the COVID-19 pandemic offers the region to debate the centrality of the health of the population for sustainable development, ECLAC has raised the urgency of restructuring health systems and moving towards universal coverage, with timely and quality care for the entire population, through supportive and sustainable financing models. It is stated that this must be accompanied by a sustainable increase in investment in health and a more efficient organization of health services, in which the first level of care occupies a central place and is accompanied by a primary health care strategy that incorporates the social determinants of health in its actions (ECLAC, 2022).

At the international level, various models of health systems and reform experiences can be observed that allow highlighting positive practices to move towards universal, comprehensive and sustainable health systems, as well as reflect on the challenges that these reforms imply. Within the framework of the technical assistance that ECLAC is providing to the Ministry of Health of Chile in matters of health system reform that is under discussion, this hybrid International Seminar organized by ECLAC with the collaboration of the Ministry of Health of Chile and PAHO, aims to learn about the experience of countries from different regions that have more robust health systems and are characterized by their universality, comprehensiveness, and financial sustainability, providing the opportunity to reflect together with the authorities and/or specialists of each country about the main challenges they face in their management, as well as the main lessons and learning from those that have recently implemented reforms.