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Multi-dimensional Review of Paraguay

Volume 3. From Analysis to Action

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Paraguay has set itself ambitious development goals for 2030. To achieve them, it will have to tackle two major challenges: buttressing sources of sustainable economic prosperity and putting the country on a more inclusive development path. Progressing towards a more inclusive society will require a broad and vigorous reform agenda. First, the country’s healthcare system requires systemic reform to widen its coverage, reduce Paraguayans’ vulnerability in the face of health risks and increase the efficiency of health service provision. Second, the social protection system needs to overcome its fragmentation and become more effective in delivering the right services and risk management tools to citizens according to their needs. In particular, the pension system requires reforms to increase its coverage and become more equitable and more sustainable. Third, the quality and the inclusiveness of its education and training system need to be strengthened to generate the skills the economy needs, and provide opportunities to all. Based on the analysis and recommendations undertaken in Volumes 1 and 2 of this Multi-dimensional country review, this report identifies key areas for action and presents targeted action plans to kick-start reform. The report also provides a dashboard of monitoring indicators to support the reform agenda in the country.

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Reforming the Paraguayan health system

The Paraguayan health system is faced with major challenges to achieve universal health coverage. To respond to the double burden of disease among the population, it needs to secure sustainable funding, ensure it is run more efficiently and strengthen its stewardship. The country has undertaken a series of reforms to modernise the system, laying the foundations for a new approach to health care based on primary care. However, it has not significantly altered the foundations of the health system and its fragmentation into multiple subsystems.The third phase of the Multi-dimensional Review aims to bridge the gap between the recommendations made in Volume 2 of the review and the implementation of those recommendations through a series of participatory activities to generate an action plan and a series of monitoring instruments. A high-level meeting with Paraguayan authorities discussed various aspects of health policy and a potential reform and identified four key areas in which work may begin: (i) securing sustainable funding for the system; (ii) reducing fragmentation by integrating service delivery and improving the system of payment to suppliers; (iii) defining a package of health benefits; and (iv) making the public procurement of medicines and medical supplies more efficient. This chapter also presents a series of conceptual tools with the objective of supporting the government for decision making and restructuring of the health system in these key areas.

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