title: Assessing Latin America's Progress Toward Achieving Universal Health Coverage.
abstract: Two commonly used metrics for assessing progress toward universal health coverage involve assessing citizens' rights to health care and counting the number of people who are in a financial protection scheme that safeguards them from high health care payments. On these metrics most countries in Latin America have already "reached" universal health coverage. Neither metric indicates, however, whether a country has achieved universal health coverage in the now commonly accepted sense of the term: that everyone--irrespective of their ability to pay--gets the health services they need without suffering undue financial hardship. We operationalized a framework proposed by the World Bank and the World Health Organization to monitor progress under this definition and then constructed an overall index of universal health coverage achievement. We applied the approach using data from 112 household surveys from 1990 to 2013 for all twenty Latin American countries. No country has achieved a perfect universal health coverage score, but some countries (including those with more integrated health systems) fare better than others. All countries except one improved in overall universal health coverage over the time period analyzed.
authors.affiliation: Adam Wagstaff (awagstaff@worldbank.org) is a research manager in the Development Research Group at the World Bank, in Washington, D.C.
authors.forename: Adam
authors.initials: A
authors.lastname: Wagstaff
authors.affiliation: Tania Dmytraczenko is a senior economist in the health, nutrition, and population global practice at the World Bank.
authors.forename: Tania
authors.initials: T
authors.lastname: Dmytraczenko
authors.affiliation: Gisele Almeida is an adviser at the Pan American Health Organization, in Washington, D.C.
authors.forename: Gisele
authors.initials: G
authors.lastname: Almeida
authors.affiliation: Leander Buisman is a PhD candidate at the Institute of Health Policy and Management, Erasmus University Rotterdam, in The Netherlands.
authors.forename: Leander
authors.initials: L
authors.lastname: Buisman
authors.affiliation: Patrick Hoang-Vu Eozenou is an economist in the health, nutrition, and population global practice at the World Bank.
authors.forename: Patrick
authors.initials: P
authors.lastname: Hoang-Vu Eozenou
authors.affiliation: Caryn Bredenkamp is a senior economist in the health, nutrition, and population global practice at the World Bank.
authors.forename: Caryn
authors.initials: C
authors.lastname: Bredenkamp
authors.affiliation: James A. Cercone is president of Sanigest Internacional, in San Jose, Costa Rica.
authors.forename: James A
authors.initials: JA
authors.lastname: Cercone
authors.affiliation: Yadira Diaz is a PhD candidate in the Institute for Social and Economic Research at the University of Essex, in Colchester, United Kingdom.
authors.forename: Yadira
authors.initials: Y
authors.lastname: Diaz
authors.affiliation: Daniel Maceira is a senior researcher at the Center for the Study of State and Society, in Buenos Aires, Argentina.
authors.forename: Daniel
authors.initials: D
authors.lastname: Maceira
authors.affiliation: Silvia Molina is an economic analyst at Sanigest Internacional.
authors.forename: Silvia
authors.initials: S
authors.lastname: Molina
authors.affiliation: Guillermo Paraje is an associate professor in the business school at the Univesidad Adolfo Ibáñez, in Santiago, Chile.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Paraje
authors.affiliation: Fernando Ruiz is director of Cendex, at Pontificia Universidad Javeriana, in Bogota, Colombia.
authors.forename: Fernando
authors.initials: F
authors.lastname: Ruiz
authors.affiliation: Flavia Sarti is a professor of Escola de Artes, Ciências e Humanidades, University of São Paulo, in Brazil.
authors.forename: Flavia
authors.initials: F
authors.lastname: Sarti
authors.affiliation: John Scott is a professor and researcher in the Economics Department at Centro de Investigación y Docencia Económicas, in Mexico City.
authors.forename: John
authors.initials: J
authors.lastname: Scott
authors.affiliation: Martin Valdivia is a senior researcher at Grupo de Análisis para el Desarrollo, in Lima, Peru.
authors.forename: Martin
authors.initials: M
authors.lastname: Valdivia
authors.affiliation: Heitor Werneck is an adviser at the National Regulatory Agency for Private Insurance and Plans, in Rio de Janeiro, Brazil.
authors.forename: Heitor
authors.initials: H
authors.lastname: Werneck
mesh_terms: D000328:Adult; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007843:Latin America; D008297:Male; D008427:Maternal Health Services / Q000706:statistics & numerical data; D019472:Universal Health Insurance / Q000706:statistics & numerical data*; D014944:World Health Organization
keywords: Access To Care; Developing World < International/global health studies; Disparities; Financing Health Care; Health Economics