Gender equity and health sector reform in Colombia: mixed state-market model yields mixed results.
In 1993, Colombia carried out a sweeping health reform that sought to dramatically increase health insurance coverage and reduce state involvement in health provision by creating a unitary state-supervised health system in which private entities are the main insurers and health service providers. Using a quantitative comparison of household survey data and an analysis of the content of the reforms, we evaluate the effects of Colombia's health reforms on gender equity. We find that several aspects of these reforms hold promise for greater gender equity, such as the resulting increase in women's health insurance coverage. However, the reforms have not achieved gender equity due to the persistence of fees which discriminate against women and the introduction of a two-tier health system in which women heads of household and the poor are concentrated in a lower quality health system.
Ewig
Christina
C
Gender and Women's Studies & Political Science, University of Wisconsin, 110 Ingrahan Hall, 1155 Observatory Drive, Madison, WI 53706, USA. cewig@wisc.edu
Bello
Amparo Hernández
AH
D003105:Colombia; D005260:Female; D018166:Health Care Reform / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D012737:Sex Factors; D016387:Women's Health