Amidst debates about the future of health in Colombia, the country has the difficult task of addressing different factors to achieve a more inclusive sector. This, thinking about health as a whole and not just from the illness.
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Anne Slovic, manager of policy & insights at Economist Impact, explained to Portafolio the details of a study on this inclusion in health, which together with Haleon, they revealed that the country is failing in terms of access and empowerment.
What is the importance of this type of studies?
The importance is to think of health not as a disease, but as inclusiveness. This means that all aspects must be integrated, such as the mental, the physical, various dimensions that are not simply the disease. In addition, looking at social conditions, where someone comes from and the access that people enjoy differently and where society as a whole can benefit from developing more inclusive health.
With our study, what we saw is that countries with higher levels of development also have higher levels of health inclusion. There is a correlation: a society that is better off is interested in having health.
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What did they study?
We had the opportunity to develop the study based on three domains. We looked at what is happening in 40 countries worldwide, analyzing how the health systems are, from the point of view of society.
The index assesses health in society, which includes policies affecting the sector and well-being; inclusive health systems, which integrate health and infrastructure expenditures; and in a third step, the empowerment of people and the community. Here we analyze whether health interventions are designed to be inclusive, accessible and adapted to individuals, communities and vulnerable groups. This study has several phases, and these are the results of the first year.
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Anne Slovic, policy & insights manager at Economist Impact
Courtesy
What can be highlighted about Colombia?
What stands out from the study is that we scored the three domains up to 100, and Colombia was close to the average of 70 points. This is a medium result, and in the 5 or 6 Latin American countries we looked at, it is third.
Colombia is very strong in prioritizing health in its policies, so in the domain of society and health they have a very good score, reaching almost 87. This was something very positive and these results are for 2022. But, when we look at the other two domains, the results begin to decline.
For example, when analysing the inclusive health system, we have a result of 61 and this is explained by the difficulties for the population to access these health services. And for the empowerment of people in the community, there was also a low average score of 62.
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What does that mean?
Although public policies are a priority for the Colombian health system, there are still problems with the need and access to certain populations. There is the will, but there is a lack of further investigation into the problems.
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What needs to be worked on?
Public policy is a priority, but there are other flaws behind it. It is also clear that health coverage, when we conducted the study, was good in Colombia. The issue is to improve the other factors. For example, in the area of empowerment.
The first thing that was skipped in Colombia was health literacy. This basically means educating the population about the sector. Any population that is more health literate has more capacity to have a better system, to ask questions and even to have healthier behaviors. An investment in these issues would be essential.
And we must also look again at accessibility in health care. Not all groups have the same access, so the development of these proposals must be analyzed from another perspective. In addition to addressing the inequality gaps related to health.
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What did they record in terms of spending?
Colombia is spending 20% institutionally on health, which is close to 5% of GDP, but it could still be more. Although the study also shows us that being able to prioritize health management is essential, because for anything related to health, money is needed, but GDP is not the only indicator.
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Should we work on public-private partnerships?
The important thing here is the essential services. If it is based on a model where there is participation from the private and public sectors, and if at the end of the day this will reach a greater part of the population, including the excluded, the discriminated, those who have little access or access not made for them, then it is worth developing this association.
These are political issues that Colombia will have to resolve, but at the end of the day, as a global health expert, what matters most to me and what is also important in the study we conducted, is that health care should be more inclusive.
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What stands out from other countries in the region?
In what we call societal health, the highest score is Canada with 92 points. If we look at Mexico, it is 83, Brazil is 70. In the domain of the inclusive health system, Brazil had a score that was not so high, of 73. What is most worrying about the situation in Latin America is related to the inclusive health system.
And in relation to the empowerment of people and communities, Colombia is behind Brazil and Mexico, with a score of 10 points less than Brazil and 3 less than Mexico. But, for example, it is better than Costa Rica, Cuba and Honduras.
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How do you see the future of health in Colombia?
Despite all the difficulties and debates, Colombia today is not the same as it was 20 years ago, and it has more and more highly educated people, in terms of access to education or all these issues of public policy. I think that now it needs to be passed on to the rest of the population, as in many Latin American countries.
For the country, it will be a debate to see how they will think about the coming years, and what they will want in order to have more inclusive health.
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What strategies should be addressed to be more inclusive in health?
Thinking back on what we saw in year 2, which is the time when the report is being prepared, it is becoming clear that there are several barriers to accessibility, in addition to the lack of adequate structure for staff shortages. Health systems need to make progress in improving access to this service and addressing these issues.
We know from the Year 2 study that three in five people face barriers to accessing essential services, but we need to address the issues of lack of implementation, and reach out to the people who need it most. We hope to get to Year 3, where we will have a greater focus on the policy and implementation side.
