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Washington D.C., 23 August 2017 (PAHO/WHO) - The Pan American Health Organization/World Health Organization has led a meeting to improve dialogue, advocacy and exchange experiences between countries of the Region related to payment systems and strategic purchasing in health services.

Representatives from 19 countries of the Americas participated and discussed resource allocation and the challenges they face to promote an increase in public expenditure in health with equity and efficiency.

With the approval of the Strategy for Universal Access to Health and Universal Health Coverage (CD53.R14), the countries of the Americas Region manifested their commitment to advance in the direction of Universal health, adopting the right to health, equity, and solidarity, as core values.  

However, inadequate financing and inefficient use of available resources are major challenges in moving towards universal access to health and universal health coverage. On average, for every 100 dollars of public spending only 14 go to the health sector in the countries of the Americas.

"Direct payment is not a financing mechanism that is consistent with a health system that promotes equity and the right to health", said Amalia Del Riego, Chief of the Health Services and Access Unit. "Therefore, one of the pillars or the Regional Strategy for Universal Health is to increase and improve financing toward elimination of direct payment, which has negative consequences on people and communities' health", she added.

In addition, the Strategy states that the most important way forward in advancing efficiency is reforming the model of care in the direction of an integral and integrated health system with a strong basis in the first level of care and applying the principles of a Primary Health Care approach. In this context, payment systems face the challenge of developing the corresponding institutional capacities to design the allocation mechanisms and allocating the resources in a way that incentivizes the accomplishment of these goals.

International experience and technical reflection show that advances in epidemiology, health information systems, statistics, etc. allow the formulation of refined models of allocation and distribution of resources with the objective of supporting the quest for equity and a more efficient use of resources.

As a result of the discussions and exchange of experiences, a group of priorities were identified to intervene in the short term in the area of transforming allocation mechanisms and strategic purchasing in some priority countries.

"Strengthening payment mechanisms and align them with the goals of the health systems, is a necessary condition to reduce inequities in the way towards universal access to health in the Region", said James Fitzgerald, Director of Health Systems and Services, during the closing remarks of the meeting.

The event gathered representatives from Argentina, Bahamas, Belize, Chile, Colombia, Costa Rica, Cuba, Dominican Republic, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Mexico,  Panama, Paraguay, Peru, Surinam, and Uruguay. Also, experts from the University of the West Indies, Universidad Católica de Chile, Universidad Pompeu Fabra de Barcelona, España and Universidad del Pacífico de Lima, Peru.

Relevant links

PAHO Web Page: Health topic - Universal Health

Regional Meeting: Payment Systems and Strategic Purchasing. How can they support progress towards Universal Health? Washington, D.C., 21-23 August 2017.