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Chapter 1. Universal health coverage and country dashboards

Abstract

This chapter uses Universal Health Coverage as the basis to analyse a core set of indicators on health, health systems and inequalities in the Latin American and Caribbean (LAC) region. Country dashboards shed light on how LAC countries compare amongst themselves and with the OECD, across five dimensions: population health, coverage and services, financial protection, quality of care, and health inequalities. This overview provides a first glimpse on the overall situation of LAC countries and establishes linkages and dependencies between the indicators that the full report contains.

    
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Introduction

The aim of this chapter is to present a set of key indicators related to population health and Universal Health Coverage (UHC) that informs the organisation of the report and establish linkages and dependencies between the indicators it contains. Table 1.1 shows a summary of these selected indicators.

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Table 1.1. Population health and universal health coverage: summary indicators

Dimension

Indicator

Population health

(Chapters 3 and 4)

Health status

Life expectancy at birth for females and males (2017)

Survival to age 65 for females and males (2017)

Under age 5 mortality rate (2017)

Determinants of health

Smoking among persons aged 15 and above (2016)

Alcohol consumption in litres per capita among persons aged 15 and above (2016),

Prevalence of overweight among adults (2016)

Access to basic drinking water (2017)

Access to basic sanitation (2017)

Coverage and services

(Chapter 5)

Number of hospital beds per 1 000 population (latest year available)

Doctors per 1 000 population (latest year available)

Nurses per 1 000 population (latest year available)

Psychiatrists per 100 000 population (latest year available)

Mothers receiving at least four antenatal visits during pregnancy (latest year available)

Financial protection

(Chapter 6)

Total health spending per capita (2016)

Proportion of total health spending attributed to out of pocket payments (2016)

Proportion of population that are overspending in health (latest year available)

Proportion of population being pushed into the poverty line by health expenditures (latest year available)

Quality of care

(Chapter 7)

Diphtheria, tetanus toxoid and pertussis vaccination coverage (2017)

Measles vaccination coverage (2017)

Breast cancer five-year net survival indicators (2010-14)

Cervical cancer five-year net survival indicators (2010-14)

Colon cancer five-year net survival indicators (2010-14)

Health inequality

(throughout the publication)

Difference between poorest and wealthiest quintile of the population (latest year available) for:

Mortality rate, under-5 (per 1 000) (lowest)

Contraceptive prevalence, modern methods (% of females ages 15-49)

Births attended by skilled health staff (% of total)

Pregnant women receiving prenatal care of at least four visits (% of pregnant women)

Diarrhoea treatment (% of children under 5 who received ORS)

Immunisation, full (% of children ages 15-23 months)

For each dimension, a set of indicators is presented in the form of country dashboards. The indicators are selected based on their policy relevance, but also on data availability and interpretability. Indicators where coverage is highest are therefore prioritised.

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Methodology, interpretation and use

Country dashboards

In order to allow for cross-country comparisons of performance, the central tendency measures presented for all indicators are medians. The classification of countries being close to, better or worse than the LAC countries average is based on an indicator’s standard deviation (a common statistical measure of dispersion). This method is preferred to using a fixed percentage or fixed number of countries per category, since it reflects the degree of variation, i.e. how far a country is from the LAC countries average. Countries are classified as “close to the LAC average” (blue) whenever the value for an indicator is within half of a standard deviation from the LAC average for the latest year. For a typical indicator, and assuming a standard normal distribution of the data, about 38.2% of the countries (12-13 countries) will be close to the OECD average, with the remaining 61.8% performing significantly better (green) or worse (red).

This classification applies to all indicators, with a caveat for the dashboard on coverage and services: given the nature of the indicators presented, high levels cannot be classified as being clearly better or worse performance, the symbols simply imply that the values are significantly higher or lower than the median. When the number of countries that are close to the LAC average is higher (or lower), it means that cross-country variation is relatively low (or high) for that indicator.

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Universal Health Coverage

Universal health coverage (UHC) is achieved when all people, communities and social groups have access to health services they need, that these services have a high degree of quality, and that users are not vulnerable to financial hardship through the use of health services (WHO and World Bank, 2017[1]).

Despite recent progress, in 2019, at least half of the world’s population still did not have full coverage of essential health services. Lack of financial protection pushes about 100 million people into poverty worldwide as a result of health care related payments, and nearly a billion spend more than 10% of the household’s budgets in health-related expenses. UN member states have agreed to achieve UHC by 2030, as part of the Sustainable Development Goals (SDGs) (WHO and World Bank, 2017[1]).

The definition of UHC includes three related dimensions:

  • Access to health services – all people in need of health services should be able to receive care, independent of socio-economic characteristics, location, wealth or any other vulnerability.

  • Financial protection – all people should be safe from financial risk when incurring health care expenses, therefore service affordability and mechanisms that facilitate access to care should be prioritised.

  • The quality of health services should be at a standard where it is effective in providing care and improving outcomes, while it is also cost effective and sustainable. Access without quality can be considered an empty universal health coverage promise (OECD/WHO/World Bank Group, 2018[2]).

This chapter also considers an important factor that must be included in every discussion on UHC: inequalities. There are gaps in population health in all three of these UHC dimensions across different socio-economic groups.

The 200+ indicators included in this publication offer the reader a comprehensive sense of LAC health systems, and how countries compare.

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Population health

UHC has as its ultimate goal the improvement of health status and the reduction of risk factors across all population groups. Ensuring access to services, quality and financial protection are key contributors to better population health, but several other societal factors determine final health status. The following two dashboards offer an overview of health status and risk factors for health using a partial list of the indicators discussed in Chapter 3 (Health Status) and Chapter 4 (Determinants of Health).

Health Status

The five indicators presented in this dashboard offer a general view of health status based on mortality indicators. This includes life expectancy at birth for females and males (2017), survival to age 65 for females and males (2017) and under age 5 mortality rate (2017). They provide an overview of where countries stand in terms of lowering mortality (see Table 1.2).

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Table 1.2. Dashboard on health status

Country

Life expectancy at birth (F)

Life expectancy at birth (M)

Survival to age 65 (F)

Survival to age 65 (M)

Under age 5 mortality rate 

In years

In years

%

%

Per 1 000 live births

LAC31

77.4

 

71.6

83.2

 

73.8

18.6

OECD36

83.4

78.1

90.9

 

84.1

4.5

Antigua and Barbuda

78.9

⦿

74.0

85.1

⦿

78.6

7.0

Argentina

80.4

73.0

⦿

87.8

76.8

⦿

10.4

Bahamas

78.8

⦿

72.7

⦿

83.7

⦿

73.7

⦿

7.2

Barbados

78.4

⦿

73.6

88.0

79.9

12.4

⦿

Belize

73.6

67.9

80.3

67.6

14.2

⦿

Bolivia

72.1

67.0

74.3

66.6

34.9

Brazil

79.3

72.1

⦿

85.2

⦿

73.4

⦿

14.8

⦿

Chile

83.1

77.4

89.0

83.5

7.4

Colombia

78.2

⦿

71.0

⦿

85.0

⦿

73.3

⦿

14.7

⦿

Costa Rica

82.9

77.8

90.1

83.6

9.0

Cuba

81.9

78.0

88.7

83.8

5.4

Dominican Republic

77.3

⦿

71.0

⦿

81.5

⦿

71.1

⦿

29.9

Ecuador

79.3

73.9

85.9

77.4

14.5

⦿

El Salvador

78.1

⦿

69.1

84.3

⦿

67.1

14.5

⦿

Grenada

76.3

⦿

71.4

⦿

84.2

⦿

72.6

⦿

16.7

⦿

Guatemala

76.8

⦿

70.4

⦿

82.1

⦿

71.1

⦿

27.6

Guyana

69.2

64.5

72.1

62.3

31.3

Haiti

65.8

61.4

67.1

59.0

71.7

Honduras

76.3

⦿

71.2

⦿

81.2

⦿

73.7

⦿

18.2

⦿

Jamaica

78.5

⦿

73.7

85.0

⦿

77.4

15.2

⦿

Mexico

77.9

⦿

72.9

⦿

86.4

78.8

13.4

⦿

Nicaragua

78.6

⦿

72.6

⦿

83.6

⦿

73.9

⦿

17.2

⦿

Panama

81.3

75.3

87.3

78.6

16.1

⦿

Paraguay

75.5

71.1

⦿

80.2

73.8

⦿

21.0

⦿

Peru

77.9

⦿

72.6

⦿

84.6

⦿

76.3

⦿

15.0

⦿

Saint Lucia

78.4

⦿

73.0

⦿

83.7

⦿

75.1

⦿

16.6

⦿

Saint Vincent and the Grenadines

75.6

⦿

71.2

⦿

80.8

⦿

74.1

⦿

16.0

⦿

Suriname

74.9

68.4

80.7

67.6

20.0

⦿

Trinidad and Tobago

74.4

67.4

79.8

66.9

26.0

Uruguay

81.0

74.0

87.4

79.0

8.0

Venezuela

78.9

⦿

70.8

⦿

84.9

⦿

72.6

⦿

31.0

Determinants of Health

Health status depends not only on the provision of health care, but also on the behaviour of people and the environment in which they live. The five indicators presented in this dashboard offer an overview of the prevalence of risk factors or behaviours (smoking among persons aged 15 and above – 2016, alcohol consumption in litres per capita among persons aged 15 and above – 2016, and prevalence of overweight among adults – 2016) and of environmental factors that affect health (access to basic drinking water – 2017 and access to basic sanitation – 2017) (see Table 1.3).

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Table 1.3. Dashboard on determinants of health

Better than   ⦿ Close to   Worse than LAC countries average

Country

Sanitation

Access to drinking water

Smoking

Alcohol consumption

Overweight adults

% of the population

% of the population

% of daily smokers

Litres per capita

% of male population

% of female population

LAC33

86

 

95

16

 

6

36

32

OECD36

99

100

18

 

9

41

29

Antigua and Barbuda

88

⦿

97

⦿

..

7

⦿

29

30

Argentina

96

100

22

10

39

30

Bahamas

95

99

12

⦿

4

36

⦿

30

Barbados

97

98

⦿

8

10

30

29

Belize

88

⦿

98

⦿

..

7

⦿

32

30

Bolivia

61

93

⦿

..

5

38

⦿

34

Brazil

88

⦿

98

⦿

10

⦿

7

⦿

39

30

Chile

100

100

25

8

49

44

Colombia

90

⦿

97

⦿

13

⦿

5

39

35

Costa Rica

98

100

5

4

39

33

⦿

Cuba

93

95

⦿

35

6

⦿

36

⦿

32

⦿

Dominica

..

..

..

..

35

⦿

30

Dominican Republic

84

⦿

97

⦿

14

⦿

7

⦿

36

⦿

31

⦿

Ecuador

88

⦿

94

⦿

7

4

38

⦿

35

El Salvador

87

⦿

97

⦿

11

⦿

4

38

33

⦿

Grenada

91

⦿

96

⦿

..

9

30

30

Guatemala

65

94

⦿

..

3

36

⦿

34

⦿

Guyana

86

⦿

96

⦿

..

6

⦿

29

30

Haiti

35

65

13

⦿

6

⦿

33

⦿

31

⦿

Honduras

81

⦿

95

⦿

..

4

36

⦿

33

⦿

Jamaica

87

⦿

95

⦿

17

⦿

4

32

30

Mexico

91

⦿

99

8

4

45

43

Nicaragua

74

82

..

5

37

⦿

32

⦿

Panama

83

⦿

96

⦿

6

8

38

34

⦿

Paraguay

90

⦿

100

13

⦿

7

⦿

37

⦿

30

Peru

74

91

..

6

⦿

40

36

Saint Kitts and Nevis

88

⦿

98

⦿

..

9

30

29

Saint Lucia

87

⦿

95

⦿

..

10

27

29

Saint Vincent and the Grenadines

..

..

..

..

32

30

Suriname

84

⦿

95

⦿

25

5

35

⦿

31

⦿

Trinidad and Tobago

93

98

⦿

..

8

26

29

Uruguay

97

99

17

⦿

11

40

30

Venezuela

94

96

⦿

..

6

⦿

41

35

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Coverage and services

Access to health care depends firstly on whether there are enough resources available to provide the necessary care. The dashboard illustrating progress in the coverage and services dimension uses one indicator of medical infrastructure availability (number of hospital beds per 1 000 population – latest year available), three indicators of human resources availability (doctors per 1 000 population – latest year available, nurses per 1 000 population – latest year available and psychiatrists per 100 000 population – latest year available) and one indicator of coverage for maternal and child health services (mothers receiving at least four antenatal visits during pregnancy – latest year available) (see Table 1.4).

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Table 1.4. Dashboard on coverage and services

Better than   ⦿ Close to   Worse than LAC countries average

Country

Hospital beds

Doctors

Nurses

Psychiatrists

Antenatal care

Per 1 000 population

Per 1 000 population

Per 1 000 population

Per 100 000 population

% of women attending at least four antenatal visits during pregnancy

LAC33

2.1

 

2.0

2.8

 

3.4

87

OECD36

4.7

3.5

8.8

 

16.8

..

Antigua and Barbuda

3.8

3.0

4.5

1.0

83

⦿

Argentina

5.0

4.0

2.6

21.7

90

⦿

Bahamas

2.9

2.0

⦿

4.6

1.4

83

⦿

Barbados

5.8

2.5

⦿

3.1

..

98

Belize

1.3

1.1

2.3

..

93

Bolivia

1.1

1.6

⦿

1.6

1.1

85

⦿

Brazil

2.3

⦿

1.8

⦿

1.5

3.2

⦿

91

⦿

Chile

2.1

⦿

2.5

⦿

2.7

⦿

7.0

..

Colombia

1.7

⦿

2.2

⦿

1.3

1.8

90

⦿

Costa Rica

1.1

3.1

3.4

3.9

98

Cuba

5.2

8.4

7.6

9.1

98

Dominica

..

1.1

6.4

..

85

⦿

Dominican Republic

1.6

⦿

1.5

⦿

1.4

2.3

95

Ecuador

1.5

⦿

2.0

⦿

2.5

0.5

80

El Salvador

1.3

1.6

⦿

1.8

0.9

82

Grenada

3.7

1.4

⦿

6.3

1.9

67

Guatemala

0.6

0.4

0.1

0.5

86

⦿

Guyana

1.6

⦿

0.8

1.0

0.9

87

⦿

Haiti

0.7

0.2

0.7

0.1

67

Honduras

0.7

0.3

0.7

0.7

89

⦿

Jamaica

1.7

⦿

1.3

⦿

0.8

1.1

86

⦿

Mexico

1.4

2.4

⦿

2.9

⦿

0.2

94

Nicaragua

0.9

1.0

1.5

0.7

88

⦿

Panama

2.3

⦿

1.6

⦿

3.1

4.0

99

Paraguay

1.3

1.4

⦿

1.7

..

78

Peru

1.6

⦿

1.3

⦿

2.4

2.9

94

Saint Kitts and Nevis

..

2.7

⦿

4.2

5.5

..

Saint Lucia

1.3

0.6

3.2

0.6

90

⦿

Saint Vincent and the Grenadines

..

0.7

7.0

..

73

Suriname

3.1

1.2

2.8

⦿

1.3

67

Trinidad and Tobago

3.0

4.2

4.1

..

100

Uruguay

2.8

⦿

5.1

1.9

14.1

97

Venezuela

0.8

1.9

⦿

0.9

..

84

⦿

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Financial protection

Access to health also depends on whether people can afford care. The indicators included here provide an overview of the expenditure level of the countries of the region (shown as overall health spending per capita – 2016 and the proportion of total health spending which is out of pocket payments – 2016) and the prevalence of financial vulnerability that exists in countries (shown as the proportion of population that are overspending in health – latest year available and the proportion of population being pushed by health expenditures into the poverty line, defined as the higher of the USD 1.90 (USD PPP 2011) poverty line and a 50% of the median consumption poverty line – latest year available) (see Table 1.5).

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Table 1.5. Dashboard on financial protection

Better than   ⦿ Close to   Worse than LAC countries average

Country

Health spending per capita

Out-of-pocket expenditure on health

Population spending more than 10% budget on OOP health care expenditure

Population pushed by OOP health care expenditure below the societal poverty line

USD PPP, per capita

Share of health spending

%

%

LAC33

1026

 

34

7.8

 

1.7

OECD36

3994

21

6.0

 

1.2

Antigua and Barbuda

1071

⦿

35

⦿

..

..

Argentina

1907

15

..

..

Bahamas

1746

31

⦿

2.7

0.1

Barbados

1317

⦿

46

16.4

1.4

⦿

Belize

473

24

..

..

Bolivia

480

25

6.0

⦿

1.7

⦿

Brazil

1280

⦿

27

..

..

Chile

2182

34

⦿

14.6

2.6

Colombia

960

⦿

16

8.2

⦿

1.8

⦿

Costa Rica

1285

⦿

22

9.8

⦿

1.2

⦿

Cuba

2484

10

..

..

Dominica

636

31

⦿

..

..

Dominican Republic

978

⦿

45

..

..

Ecuador

954

⦿

39

⦿

10.3

2.4

El Salvador

582

29

⦿

1.7

0.4

Grenada

714

⦿

52

..

..

Guatemala

470

54

1.4

0.4

Guyana

385

32

⦿

..

..

Haiti

83

40

⦿

11.5

3.3

Honduras

373

49

..

..

Jamaica

532

17

..

..

Mexico

1138

⦿

41

1.6

0.8

Nicaragua

468

33

⦿

14.8

5.2

Panama

1786

33

⦿

..

..

Paraguay

864

⦿

44

7.1

⦿

1.4

⦿

Peru

680

28

⦿

9.2

⦿

1.4

⦿

Saint Kitts and Nevis

1442

48

..

..

Saint Lucia

661

45

..

..

Saint Vincent and the Grenadines

522

31

⦿

..

..

Suriname

944

⦿

26

4.9

..

Trinidad and Tobago

2206

40

⦿

3.9

1.0

Uruguay

2102

18

..

..

Venezuela

141

63

..

..

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Quality of care

Health care which is of low quality can harm patients and waste resources. The quality of care dashboard includes two vaccination coverage indicators (diphtheria tetanus toxoid and pertussis – 2017 and measles – 2017) and three five-year cancer net survival indicators (breast – 2010-14, cervical – 2010-14 and colon – 2010-14). Gaps in data availability for these and other quality indicators remain substantial in the region (see Table 1.6).

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Table 1.6. Dashboard on quality of care

Better than   ⦿ Close to   Worse than LAC countries average

Country

DTP3 immunisation coverage

MCV1 immunisation coverage

Breast cancer

Cervical cancer

Colon cancer

% of population aged around 1

% of population aged around 1

Five-year survival rate

Five-year survival rate

Five-year survival rate

LAC33

90

 

90

78

 

60

52

OECD36

95

95

84

 

66

62

Antigua and Barbuda

95

96

..

..

..

Argentina

86

⦿

94

⦿

84

53

54

⦿

Bahamas

90

⦿

89

⦿

..

..

..

Barbados

95

85

..

..

..

Belize

96

97

..

..

..

Bolivia

83

89

⦿

..

..

..

Brazil

83

84

75

60

⦿

48

⦿

Chile

95

93

⦿

76

57

⦿

44

Colombia

92

⦿

93

⦿

72

49

35

Costa Rica

94

⦿

94

⦿

87

78

60

Cuba

99

99

75

73

64

Dominica

94

⦿

84

..

..

..

Dominican Republic

94

⦿

95

..

..

..

Ecuador

85

83

76

52

48

⦿

El Salvador

81

81

..

..

..

Grenada

96

84

..

..

..

Guatemala

86

⦿

87

⦿

..

..

..

Guyana

95

98

..

..

..

Haiti

64

69

..

..

..

Honduras

90

⦿

89

⦿

..

..

..

Jamaica

97

89

⦿

..

..

..

Mexico

88

⦿

97

..

..

..

Nicaragua

98

99

..

..

..

Panama

88

⦿

98

..

..

..

Paraguay

88

⦿

93

⦿

..

..

..

Peru

84

85

82

57

⦿

59

Saint Kitts and Nevis

97

96

..

..

..

Saint Lucia

95

86

..

..

..

Saint Vincent and the Grenadines

97

99

..

..

..

Suriname

95

98

..

..

..

Trinidad and Tobago

99

90

⦿

..

..

..

Uruguay

91

⦿

97

..

57

⦿

54

⦿

Venezuela

60

74

..

..

..

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Health inequality

Finally, this dashboard illustrates another important consideration necessary to measure a country’s progress towards UHC: the level of inequality experienced by population groups in their health status and health determinants, as well as their access to, affordability of, and coverage of health services. This dashboard displays the average difference between the poorest and the wealthiest income quintile for each indicator in each LAC country and compares them with the regional average. If the difference is larger than the average, a red icon is displayed, while a green one is shown when the difference is smaller than the average. The available international comparable data for this dashboard was taken from the Health Equity and Financial Protection Indicators database (World Bank, 2019[3]).

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Table 1.7. Dashboard on health inequalities

Better than   ⦿ Close to   Worse than LAC countries average

Country

Under-5 mortality rate

Contraceptive prevalence, modern methods (% of females aged 15-49)

Births attended by skilled health staff (% of total)

Pregnant women receiving prenatal care of at least four visits (% of pregnant women)

Diarrhoea treatment (% of children under-5 who received ORS*)

Immunisation, full (% of children aged 15-23 months

Difference between lowest and highest income quintiles, expressed in deaths per 1 000 live births

Difference between lowest and highest income quintiles, expressed in %

Difference between lowest and highest income quintiles, expressed in %

Difference between lowest and highest income quintiles, expressed in %

Difference between lowest and highest income quintiles, expressed in %

Difference between lowest and highest income quintiles, expressed in %

LAC (available countries)

21.3

 

9.4

15.6

 

12.2

8.7

11.0

Barbados

..

9.9 (2012)

⦿

..

..

..

..

Belize

17.7 (2016)

⦿

15.8 (2015)

6.8 (2012)

⦿

2.7 (2015)

..

13.1 (2015)

⦿

Colombia

20.3 (2016)

⦿

3.5 (2015)

10.8 (2015)

⦿

167.0 (2015)

..

..

⦿

Dominican Republic

7.9 (2015)

0.1 (2014)

1.5 (2014)

4.3 (2014)

13.4 (2014)

11.3 (2014)

⦿

El Salvador

17.5 (2015)

⦿

4.7 (2014)

5.5 (2014)

⦿

12.5 (2014)

⦿

3.1 (2014)

11.7 (2014)

⦿

Guatemala

36.0 (2015)

29.7 (2014)

56.8 (2014)

14.2 (2014)

⦿

5.9 (2014)

⦿

16.0 (2014)

⦿

Guyana

8.7 (2015)

4.3 (2014)

20.2 (2014)

⦿

8.3 (2014)

⦿

..

6.1 (2014)

⦿

Haiti

41.6 (2013)

..

68.9 (2014)

35.8 (2016)

12.1 (2016)

39.9 (2016)

Honduras

18.7 (2012)

⦿

12.2 (2011)

⦿

7.1 (2016)

⦿

16.3 (2011)

⦿

9.9 (2011)

⦿

2.0 (2011)

⦿

Jamaica

..

..

3.5 (2010)

⦿

13.3 (2011)

⦿

..

20.0 (2011)

Mexico

..

10.2 (2015)

⦿

5.7 (2010)

⦿

9.9 (2015)

⦿

0.9 (2015)

0.3 (2012)

Panama

..

16.1 (2013)

27.9 (2015)

22.6 (2013)

4.5 (2013)

3.4 (2013)

⦿

Paraguay

25.0 (2016)

⦿

8.4 (2016)

⦿

12.1 (2013)

⦿

13.0 (2016)

⦿

9.2 (2016)

⦿

3.7 (2016)

⦿

Peru

19.3 (2016)

⦿

12.2 (2016)

⦿

14.2 (2016)

⦿

8.4 (2016)

⦿

19.4 (2016)

3.9 (2016)

⦿

Saint Lucia

..

5.2 (2012)

..

..

..

..

Suriname

..

23.2 (2010)

11.8 (2016)

⦿

9.6 (2010)

⦿

..

..

Trinidad and Tobago

..

2.7 (2011)

1.6 (2010)

⦿

2.4 (2011)

..

..

Uruguay

..

..

1.1 (2011)

4.3 (2012)

..

..

* ORS: oral rehydration solution.

References

[2] OECD/WHO/World Bank Group (2018), Delivering Quality Health Services: A Global Imperative, World Health Organization, Geneva 27, https://dx.doi.org/10.1787/9789264300309-en.

[1] WHO and World Bank (2017), Tracking universal health coverage: 2017 global monitoring report: executive summary, World Health Organization and International Bank for Reconstruction and Development / The World Bank, https://apps.who.int/iris/bitstream/handle/10665/260522/WHO-HIS-HGF-17.2-eng.pdf.

[3] World Bank (2019), Health Equity and Financial Protection Indicators (HEFPI), http://datatopics.worldbank.org/health-equity-and-financial-protection/ (accessed on 19 November 2019).

Metadata, Legal and Rights

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https://doi.org/10.1787/6089164f-en

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