Health sector reform in the Americas : equitable access to basic health services : a proposal from the Pan American Health Organization (PAHO) to the United States Agency for International Development (USAID) -- 1997-2001

The activity, to be implemented by the Pan American Health Organization (PAHO) in collaboration with the Partnerships for Health Reform (1800037) and Data for Decision- Making projects (9365991), is one of four under the regional Health Priorities Project. Efforts will be in the four areas noted below. The activity will develop and test methods and tools for the analysis, design, implementation, and monitoring of national HSR processes. This will include developing a health sector analysis framework and a framework for detailed HSR implementation plans, along with master plans of investment in support of HSR. The activity will also reconcile the differing country approaches to National Health Accounts. PAHO will establish a clearinghouse of information on HSR at its Washington, DC, headquarters to manage and share relevant HSR information. The clearinghouse will utilize the resources of PAHO"s Latin American and Caribbean Center for Health Scientific Information (BIREME), which has developed and maintained LILACS, the Latin American and Caribbean Health Science Literature Database, prepared in cooperation with more than 70 centers in 26 countries. PAHO will also produce a periodic bulletin containing general information and special reports on HSR. The activity will develop a framework for monitoring HSR based on five guiding principles of the HSR processes in the region: equity, effectiveness and quality, efficiency, financial sustainability, and community participation and intersectoral action. For each principle, a set of operational variables and corresponding indicators will be identified and structured to provide the basis for a qualitative analysis of the degree of progress in HSR efforts. The activity will also develop a framework that will allow countries to determine and report: the location, number, and characteristics of populations lacking regular access to basic health services; the types of barriers (e.g., geographical, cultural, financial) that hinder access to these services; and the results of any previous efforts to cope with this problem. Finally, the activity will organize regional and subregional exchanges of projects, experiences, and processes of HSR by organizing meetings of, and personal contacts between, personnel involved in HSR efforts.