Health at a Glance: Latin America and the Caribbean 2020

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.

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.

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.

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.

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.

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).

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).

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	⮽

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).

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	⦿

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).

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	⮽	..		..

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).

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	⮽	..		..		..

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]).

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).