Health Promotion in Ecuador: A Solution for a Failing System

Rasch, Dana; Bywater, Krista

doi:10.4236/health.2014.610115

Cited by 16 publications

(26 citation statements)

References 22 publications

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“…Public health initiatives address environmental factors that influence health, such as infrastructure improvements (eg, installing sewage systems across the country). 4 Sewage coverage increased from 44% to 49% in just the first year of implementation, and has continued to increase since then. 5 The number of clinics and makeup/number of health care professionals in the new system is dependent on the density of the population in each geographic area.…”

Section: Barriersmentioning

confidence: 99%

“…Both the specialty clinics and hospitals are geographically located based on population density in the area. 4,8 All medications, including contraception, are provided free at the public clinics and hospitals. Physicians and nurses under this new system have time during the work week dedicated to home visits and community outreach.…”

Section: Barriersmentioning

confidence: 99%

“…In the 13 years preceding 2006, Ecuador saw 8 different government transitions, and corruption, administrative instability, and lack of public administration dominated the political system. 5 Simultaneously, health care funding was slashed, and the government's role in health care was decreased significantly 4,5 because of a lack of funding and new laws preventing the government from establishing an efficient health care system. 6 Instead, health care services were privatized, with the goal of allowing the "free market" to bring low-cost, efficient, and quality health care.…”

Section: Introductionmentioning

confidence: 99%

“…An aim of this goal included unimpeded access to high-quality health care services (with a strong focus on primary care) at no direct cost to individuals. 4,5 This, it was thought, would increase the responsiveness and fair financing of the country's health care system.…”

Section: Introductionmentioning

confidence: 99%

“…2 Ecuador is a country that has gone through recent health care reform and used primary care to significantly increase its HCE. 3,4 Ecuador is a middle-income country in South America. Its population is nearly 16 million, and Ͼ23% of the population lives in rural areas.…”

mentioning

confidence: 99%

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A Primary Care System to Improve Health Care Efficiency: Lessons from Ecuador

Aldulaimi

Mora

2017

J Am Board Fam Med

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Ecuador is a country with few resources to spend on health care. Historically, Ecuador has struggled to find a model for health care that is efficient, effective, and available to all people in the country, even those in underserved and rural communities. In 2000, the Ecuador Ministry of Public Health implemented a new system of health care that used primary care as its platform. Since then, Ecuador has been able to increase its health care efficiency, increasing its ranking from 111 of 211 countries worldwide in 2000, to 20 of 211 countries in 2014. This article briefly reviews the new components of the system implemented in Ecuador and examines the tools used to accomplish this. The discussion also compares and contrasts the Ecuador and US systems, and identifies concepts and policies from Ecuador that could improve the US system. (J Am Board Fam Med 2017;30:380 -383.)

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Section: Barriersmentioning

confidence: 99%

Section: Barriersmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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A Primary Care System to Improve Health Care Efficiency: Lessons from Ecuador

Aldulaimi

Mora

2017

J Am Board Fam Med

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Revisiting the debate on health financing in Low and Middle‐income countries: An integrative review of selected models

Domapielle

Sumankuuro

Bebelleh

2022

Health Planning & Management

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Universal Health Coverage (UHC) as a health policy goal is gaining added currency in the policy agendas of many Low and Middle‐Income Countries (LMIC) following the onslaught of the coronavirus (COVID‐19) pandemic. The goal of UHC is to ensure that every citizen has access to quality healthcare services that they need without suffering financial hardship. Whereas most industrialised countries have achieved UHC through the implementation of various traditional health financing mechanisms, most LMIC have not made significant progress in providing financial protection against the costs of illness for majority of the population due to limited fiscal space and or lack of political commitment to raise government revenues and increase fiscal space for health. While the onslaught of COVID‐19 refreshes the call for reform of countries' health financing policies to reflect the healthcare needs of the population, the debate about the type or combination of health financing models to employ in LMIC has yet to reach a consensus. This review critically analyses five health financing models to ascertain their appropriateness in providing financial risk protection against the cost of illness, especially in this era of COVID‐19. Given the limited fiscal space for health in LMICs, we argue that one viable pathway towards achieving UHC is the adoption of an adaptive mix of diverse pooling mechanisms. Moreover, because the creation of fiscal space is context‐specific, and UHC is a political issue rather than technical, securing strong political support is necessary for improving the governance and institutional frameworks for health and ensuring sustained economic growth to respond to the fiscal demands of health systems.

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