PAHO highlights the need to prioritize primary health care to advance towards universal health in the Americas – PAHO/WHO
Washington, DC, December 12, 2024 (PAHO) — The Pan American Health Organization (PAHO) today presented a new report that highlights both the progress made and the persistent challenges faced by countries in the region in their efforts to guarantee access to health services without imposing an unsustainable financial burden on people.
The report, Advances in universal health in the Americas– Addressing unmet healthcare needs, coverage gaps and lack of financial protection through primary health care, launched on Universal Health Day (known globally as Universal Health Coverage Day) , which is celebrated every year on December 12. This day highlights the urgent need to overcome the barriers that limit access to health services for millions of people.
PAHO Director Dr. Jarbas Barbosa emphasized that “the report reflects PAHO’s commitment to moving towards universal health in a region that has made great progress, but also faces persistent challenges that require innovative solutions, particularly in regarding primary health care.” In this context, he highlighted that the COVID-19 pandemic exposed deep vulnerabilities in health systems, such as fragmentation, access barriers and inequalities that disproportionately affect vulnerable populations.
Challenges and approach in Primary Health Care
The report emphasizes that unmet health care needs affect more than a third of the population surveyed in the Americas, primarily impacting the poorest communities. While higher-income countries report fewer unmet needs, in lower-middle-income countries, these needs exceed 40%, contributing to higher rates of preventable mortality.
The causes of these unmet needs are varied and differ between countries, but include organizational, financial, availability, acceptability and geographical barriers.
Another important concern highlighted in the report is the financial burden of household out-of-pocket expenses, including out-of-pocket payments for medical services, medications and treatments, which affect millions of people each year. It is estimated that up to 79 million people in the region face financial hardship due to healthcare costs.
PAHO highlights that a renewed focus on primary health care is essential to address these problems, offering more accessible care, reducing economic barriers and improving the resilience of the system. In this regard, Dr. Barbosa stated: “The way forward is to strengthen primary health care. This will be key to ensuring access to care and strengthening the resilience and equity of our health systems, and mainly to address the diverse needs of communities.”
Regional disparities and new strategies
The report also notes that regional disparities remain a major obstacle to achieving universal health coverage in Latin America and the Caribbean. According to the report, 35.2% of the region’s population reports unmet health care needs, with disparities most pronounced in low-income communities, where 38.5% of the population face barriers to accessing health care. .
While some countries have made substantial progress, others have fallen behind. In many rural and remote areas, health services are insufficient or of poor quality, exacerbating disparities between urban and rural areas.
PAHO urges governments in the region to prioritize investment in health infrastructure and the training of medical personnel, particularly in underserved areas. It also recommends eliminating co-pays and expanding health insurance coverage to protect families from catastrophic and impoverishing expenses. These changes are essential for health systems to be inclusive and fair, especially in low- and middle-income countries, where economic barriers are one of the main causes of exclusion.
Intersectoral action and global collaboration
To strengthen health systems, PAHO highlights the importance of intersectoral actions that involve various sectors of society, such as road infrastructure, telecommunications and education, which are essential to guarantee equitable access to health.
PAHO also highlighted the importance of integrating cultural and gender-sensitive approaches in the delivery of health services to ensure that all communities, especially the most vulnerable, can access the care they need.
Towards universal health in the region
The PAHO report makes it clear that achieving universal health in the Americas is not only about expanding coverage but also about ensuring that it is of quality, accessible and financially sustainable.
“Let us continue to join forces to build strong, fair and resilient health systems. Systems and societies where all people can access quality services without facing financial difficulties,” concluded PAHO Director Dr. Barbosa, clearly outlining the path to universal health.
Key findings from the report:
- 35.2% of the population in the Americas report unmet health care needs, with greater disparities in low-income communities (38.5%).
- Essential health coverage increased from 66% in 2000 to 80% in 2019, but decreased to 74% in 2021.with persistent inequalities in areas such as reproductive health and non-communicable diseases.
- Between 1.5% and 7.8% of the population faces catastrophic health expenses, Mainly affecting rural households and those with elderly members.
- Organizational and financial barriers and lack of adequate availability of services. They are key factors that prevent access to health.
- Disparities in access They are strongly related to income levels and the human development index of countries.
Report recommendations:
- Strengthen primary health care Reduce barriers by limiting access to health, focusing on improving quality and access.
- Address financial and non-financial barriers preventing access to essential services in vulnerable areas.
- Improve financial protectionespecially in rural areas and homes with elderly people.
- Promote policies that reduce socioeconomic inequalities.
