Background

Latin America’s and Caribbean’s health systems suffer from structural weaknesses that became evident due to the health crisis caused by the COVID-19 pandemic. Although the countries have made efforts to increase spending on health, their health systems are chronically underfunded. Underfunding, accompanied by high levels of fragmentation and an organization that separates them into unrelated segments, translates into a set of problems of sufficiency in access, inefficiency, coordination difficulties, lack of solidarity, and situations of inequality (ECLAC, 2022). When considering the health systems indicators of Latin America and the Caribbean considering the condition of the countries of the Organization for Economic Cooperation and Development (OECD), it is observed, for example, that the health per capita expenditure of the region is equivalent to a quarter of the value corresponding to the average of the OECD countries. This situation, in turn, translates into a relative scarcity of human resources around health and beds available for the population (CEPAL /PAHO, 2021).

These problems worsened during the pandemic, generating a situation of reproduction, and deepening of health inequalities, in which the well-being of the region’s population has significantly deteriorated. Faced with this and taking advantage of the historic opportunity that the COVID-19 pandemic offers the region to debate the centrality of the population health for sustainable development, ECLAC has raised the urgency of restructuring health systems and moving towards universal coverage, with timely and quality care for the entire population, through supportive and sustainable financing models. It is stated that this must be accompanied by a sustainable increase in investment in health and a more efficient organization of health services, in which the first level of care occupies a central place and is complemented by a primary health care strategy that incorporates the social determinants of health in its actions (ECLAC, 2022).

From an international perspective, various models of health systems and reform experiences highlight positive practices to move towards universal, comprehensive, and sustainable health systems and allow reflecting on the challenges these reforms imply. Within the framework of the technical assistance that ECLAC is providing to the Ministry of Health of Chile in matters of the health system reform that is under discussion, this hybrid International Seminar organized by ECLAC with the collaboration of the Ministry of Health of Chile, FONASA and Pan American Health Organization aims to learn about the experience of countries from different regions that have more robust health systems and are characterized by their universality, comprehensiveness, and financial sustainability. Furthermore, this seminar provides the opportunity to reflect with the authorities and specialists of each country about the main challenges they face in their management, as well as the main lessons and challenges from those recently implemented reforms.