SUMMIT IMPLEMENTATION REVIEW GROUP (SIRG) September 18-19, September 2008

Transcription

1 SUMMIT IMPLEMENTATION REVIEW GROUP (SIRG) OEA/Ser.E Third Regular Meeting of 2008 GRIC/O.3/Inf.2/08 September 18-19, September 2008 Bridgetown, Barbados Original: English (Hilton Barbados Hotel) PRESENTATIONS BY THE PARTNER INSTITUTIONS OF THE JOINT SUMMIT WORKING GROUP JSWG PAN AMERICAN HEALTH ORGANIZATION (Health in the Americas: Regional Challenges)

2 Pan American Health Organization HEALTH IN THE AMERICAS REGIONAL CHALLENGES SUMMIT IMPLEMENTATION REVIEW GROUP Bridgetown, Barbados September 18-19, 2008 Dr. Rebecca de los Rios

3 Life Expectancy in Latin America, in relation to the United States Esperanza de Vida: Países de América Latina en en relación a Estados Unidos CHI CUB COR Esperanza de Vida (Años) BOL GUT 68.9 NIC BRA PER ELS ECU PAR HON DOR COL MEX VEN ARG PANURU HAI EEUU America Latina Source: Health in the Americas. PAHO, 2007

4 The burden of diseases in countries by income, 2002 (Healthy years of life lost by population) 300 Latin America & Caribbean Global average 98 OECD High income Latin Ameria & Caribbean High Income Midle income Low income Group I (communicable diseases) Group II (noncommunicable diseases) Group III (injuries) 26 Source: WHO

5 Obesity among women yr (%) Caribbean USA Chile Brasil México Uruguay 10 5 Canadá Perú Cuba Pan American Health Organization NCD National surveys and representative data. E Jacoby, PAhO 2005

6 Prevalence of Adult Obesity (BMI 30 kg/m2) in selected countries/cities of the Americas circa 2005 Belize USA Managua Santiago Barquisimeto Central Argentina San Jose San Salv ador Mexico Chile Lima Guatemala City Buenos Aires Tegucigalpa Bogota Quito Port au Prince Canada Prevalence (%) Pan American Health Organization Source: NCD National Surveys; CAMDI Studies

7 Prevalence of overweight among children (<5 years) in selected countries % Argentina Chile Bolivia Perú Costa Rica Uruguay Jamaica Canadá Brasil EEUU Guatemala Barbados Paraguay México Panamá Trinidad & Tobago Reference: de Onis M, Blössner M. Prevalence and trends of overweight among preschool children in developing countries. Am J Clin Nutr 72:1032-9: 2000.)

8 Prevalence of Adult Diabetes in selected Countries/cities of the Americas circa 2005 Belize Mexico USA Managua Ontario Guatemala City Bogota San Jose San Salvador Port au Prince Santiago Central Argentina Chile Buenos Aires Tegucigalpa Barquisimeto Quito Lima Pan American Health Organization Prevalence (%) Source: NCD National Surveys; CAMDI Studies

9 Regional Strategies to tackle NCD Epidemic Integrated Approach to the Prevention and Control of Chronic Diseases (population and individual interventions) Integrated public policies: Key actions include fiscal/policy incentives for production and consumption of healthy foods, guidelines to regulate the marketing and sale of foods to children, wide promotion of fruit and vegetable consumption, the elimination of trans fats in processed foods, workplace wellness initiatives, physical education curricula and healthy feeding programs in schools, urban planning that encourages walking and biking, improved access to recreation and sports through partnerships, and massive education campaigns Pan American Health Organization

10 Prelalence of underweight, stunting, wasting, and overweight % Children 5 years old % Argentina, 2006 Republica Dominicana, 2002 Brazil, 1996 Mexico, 2006 Colombia, 2005 El Salvador, 2003 Nicaragua, 2001 Ecuador, 2004 Peru, Haiti, 2005 Honduras, 2005 Bolivia, 2003 Guatemala, 2002 under weight Bajo peso Baja talla Desnutricion aguda Sobrepeso stunting wasting overweight Fuente: Lutter CK, Chaparro CM, La desnutrición en lactantes y niños pequeños en América Latina y el Caribe: Alcanzando los objetivos de desarrollo del milenio. Washington. D.C, OPS 2008

11 For the countries more affected the cost of malnutrition is equivalent to 6% and 11% of GDP Millons of dollars Total cost of global malnutrition VEN CRI PAR PAN PER COL ECU RDO NIC BOL ELS HON GUA 12% 11% 10% 9% 8% 7% 6% 5% 4% 3% 2% 1% 0% Costo Total cost total (left (eje axel) izquierdo) Porcentaje GDP Percentage del PIB (right (eje axel) derecho) Source: ECLAC, 2007

12 Chronic malnutrition determinants Infants < 6 m Infants 6 m a 2 years Pre-school children School children Violence Illiteracy Delivery and Newborn Unemployment Food insecurity Pregnant women Borne Vector Diseases Inadequate housing Environmental pollution Lack of acces to safe water Youth Lack of basic sanitation

13 Regional Strategies to tackle Chronic Malnutrition PAHO Regional Strategy on Nutrition and Health Development Joint Actions to improve efficiency for the response to the food and nutrition crisis: Social and economic determinants approach. Pan American Alliance on Nutrition and Development. Agreement among UN Agencies for Latin America and the Caribbean (PAHO, UNFPA, UNICEF, WFP, UNDP, ECLAC) launched in July, Working group has been set up to define the Plan of Action. The Alliance will joint efforts with the Inter-american institutions, civil society, and non-profit organizations. Pan American Health Organization

14 Infant mortality indigenous and non indigenous and place of residence < 1 year old Death by 1,000 live birth Bolivia 2001 Ecuador 2001 Guatemala 2002 México 2000 Panamá 2000 Urbana no indígena Urbana indígena Rural no indígena Rural indígena Total no indígena Total indígena Source: ECLAC, Millennium Development Goals: A view from Latin America and the Caribbean, 2005

15 Evolution of Neonatal and Infant Mortality in the Region of the Americas by Time Period Per 1000 live births Infant mortality Neonatal mortality 48 % YEAR Source: Estimates based on PAHO, 2000, /11/2009 Organización Panamericana de la Salud 2008

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17 Percentage of deliveries attended by health care professionals by income in selected countries (circa 2002) 100% 90% Porcentaje de partos atendidos por personal especializado 80% 70% 60% 50% 40% 30% 20% 10% 0% Guatemala (35%) Perú (56%) Bolivia (57%) Nicaragua (65%) Paraguay (66%) Colombia (85%) Brasil (88%) Rep. Dominicana (95%) Income Source: Eclac, 2006 Low income Quintil 2 Quintil 3 Quintil 4 High Income

18 Percentage of households with health insurance (public and private) by income 100% 90% % of households with health insurance 80% 70% 60% 50% 40% 30% 20% 10% 0% Argentina 2004 (57%) Costa Rica 2004 (81%) Chile 2003 (64%) Panamá 2004 (49%) México 2004 (50%) Perú 2003 (40%) Paraguay 2000 (19%) Guatemala 2004 (21%) El Salvador 2004 (19%) Ecuador 2004 (18%) Bolivia 2002 (16%) Nicaragua 2001 (9%) Quintil of income Low income Quintil 2 Quintil 3 Quintil 4 High Income Source: Eclac, Social Protection 2006

19 The public expenditure for health care (%GDP) Changes in the Composition of National Health Care Expenditure over Time. Latin American and the Caribbean, NHE as % of GDP Central Gov. Local Gov. Public Insurance Household's Final Cons. Private Ins./Prepaid Medic.

20 The countries that need more are the ones that spend less Global malnutrition and public social expenditure social per capita (2004 y 2005) USD PPA per cápita 1,800 1,700 1,600 1,500 1,400 1,300 1,200 1,100 1, CRI PAR VEN RDO PAN COL BOL PER ECU NIC ELS HON GUA Gasto Social social expenditure per cápita per capita (eje izquierdo) (left axel) Desnutrición Malnutrition (right (eje derecho) axel) 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% Prevalence

21 Public Expenditure in Health - % GDP 9.0% 8.0% 7.0% 6.0% 5.0% 4.0% 3.0% 2.0% 1.0% Trends in Public Expenditures in Health as % of GDP in Canada, Latin America and the Caribbean (LAC) and the United States of America; Selected periods % 1.2% 2.6% 1.3% 3.7% 1.7% 4.9% 2.4% 6.0% 3.6% 7.2% 4.3% 2.80% 2.80% 7.5% 7.6% 5.0% 3.20% 6.4% 7.6% 7.2% 7.1% 7.2% 8.1% 7.4% 3.40% 3.45% 3.50% 3.40% NEA ARU USA CAN 0.0% Year US CAN LAC Line 4 Line 5

22 14.0% Public Expenditures in Health in LAC in relation to trends in Public Expenditures in Health in Canada Public Expenditure in Health - % GDP 12.0% 10.0% 8.0% 6.0% 4.0% 2.0% 0.0% 2.4% ECU GUT MEX PAR PER SKN TRT BEL DOR 2.6% ANT HAI BAH COL GRE JAM NIC BRA BER CHI DOM ELS HON PAN SUR SVG SLU 3.7% ANG BAR BOL PAN VNZ ARG COR TCI 4.9% 6.0% 7.2% 7.5% 7.6% CUB URU Year MNT USA CAN LAC Average NEA ARU 7.2% 7.2% 7.4% 3.40% NEA ARU USA CAN

23 The Impact of public expenditures in health Distribution of public health expenditures for quintiles of income Q1=Poor Q5=Rich Perú Jamaica Guatemala Ecuador Costa Rica Chile Colombia Argentina 0% 20% 40% 60% 80% 100% Fuente: Suárez (2001) y Trejos (2002) Quintil 1 Quintil 2 Quintil 3 Quintil 4 Quintil 5

24 Regional Strategies to Improve Access to Health Care Towards Universal Access to Health Care in 2015 Integrated Public Policies to improve access to health care, especially for the poor To increase public expenditure in health up to 6% of the GDP To implement mechanisms to reach the poor to improve the impact of public expenditure in access to health care (health public insurance, social health protection programs etc. ) Strengthening Health Care Systems and Services based on Primary Health Care Pan American Health Organization

25 Pan American Health Organization ENSURING OUR PEOPLES HEALTH SECURING OUR PEOPLES FUTURE Thank you, Gracias, Obrigada, Merci