Reader’s guide
Health at a Glance: Latin America and the Caribbean 2023 is a joint publication by the OECD and the World Bank. This report was co-ordinated by Frederico Guanais, from the OECD Health Division, and Cristian A. Herrera and Edit V. Velenyi, from the World Bank. Chapter 1 was co-authored by Nicolas Larrain, Gabriel Di Paolantonio, Tom Raitzik Zonenschein, Rushay Naik, and Frederico Guanais from the OECD Health Division. Chapter 2 was co-authored by Yasna Palmeiro, Tomas Plaza Reneses, Edit V. Velenyi, and Cristian A. Herrera from the World Bank. Chapters 3 to 9 were co-authored by Gabriel Di Paolantonio, Frederico Guanais, Cristian A. Herrera, Nicolas Larrain, Rushay Naik, Tomas Plaza Reneses, Edit V. Velenyi, and Tom Raitzik Zonenschein. Alba Gasque and Anamaria Verdugo provided research assistance. The authors would like to thank Stefano Scarpetta, Mark Pearson, and Francesca Colombo from the OECD Directorate of Employment, Labour and Social Affairs, and Michele Gragnolatti and Juan Pablo Uribe from the World Bank.
We would also like to thank Lucy Hulett and Nathalie Corry for editorial input, and Guillaume Haquin for resource management support.
This report has benefitted from the expertise and generous contribution of supporting materials from multiple members of international organisations working in healthcare in Latin America and the Caribbean, such as the World Health Organization and its regional office for the Americas, the Pan American Health Organization. In particular, the authors would like to thank Dr. Maristela Monteiro, Dr. Renato Oliveira e Souza, and Daniel Hugh Chisholm for their insightful exchanges during the elaboration of this report.
This report has benefited from comments, reviews, and the provision of data through questionnaires by countries included in Health at a Glance: Latin America and the Caribbean 2023. In that sense, the authors would like to thank Rafaela Batista Brunale, Carolina Peláez Pelaéz, Francisco Adriazola Santibañez, Tatiana Vargas, Analia Imperioso, Dafne Ruiz Vargas, Anabelle Jones, Kadian Birch, and other officials from Ministries of Health who co-operated to this report.
Health at a Glance: Latin America and the Caribbean 2023 is divided into nine chapters:
Chapter 1 on The impact of the COVID-19 pandemic on Latin American and Caribbean healthcare systems evaluates and compares countries’ performance in mortality outcomes, pandemic response, system responsiveness and baseline structural capacities. By exploring the relationships between these items, the chapter informs about key determinants that played a role in defining the severity of the pandemic in the region.
Chapter 2 on Climate change and health examines LAC countries current level of health systems resilience to climate change, identifying trends in the region and providing key considerations for policy actions that countries can implement to strengthen it.
Chapter 3 on Health status highlights the variations across countries in life expectancy, excess mortality, infant and childhood mortality, and major causes of mortality and morbidity, including both communicable and non-communicable diseases.
Chapter 4 on Determinants of health focuses on non-medical determinants of health. It features the health of mothers and babies, through family planning issues, malnutrition, and adolescent health. It also includes lifestyle and behavioural indicators such as smoking, unhealthy diets, underweight and overweight, and drugs use, as well as water and sanitation. It also includes indicators on environment and climate risks.
Chapter 5 on Healthcare resources and activities reviews some of the inputs, outputs, and outcomes of healthcare systems. This includes digital health, the supply of medical technologies and hospital beds, as well as the provision of services surrounding pregnancy, childbirth and infancy.
Chapter 6 on Health expenditure and financing examines trends in health spending across LAC countries. It looks at how health services and goods are paid for, and the different mix between public funding, private health insurance, direct out-of-pocket payments by households and external resources. It also looks at financial protection measures such as impoverishment due to healthcare out-of-pocket payments.
Chapter 7 on Quality of care builds on the indicators used in the OECD’s Health Care Quality Indicator programme to examine trends in healthcare quality improvement across LAC countries.
Chapter 8 on Health workforce has a look into the provision of doctors and nurses, as well as allied health professionals such as dentists, pharmacists, and community health workers. Attention is given as well to mental health workforce.
Chapter 7 on Ageing exhibits the demographic trends in LAC, both current and projected, as well as life expectancy and healthy life expectancy at age 65. Long-term care is also highlighted, with indicators on expenditure, end-of-life care, and mortality due to Alzheimer and other dementias.
For this second edition of Health at a Glance: Latin America and the Caribbean, 33 regional countries were included as seen in Table 1. Countries were selected based on their geographical location to either Latin America or the Caribbean, and if they are sovereign states.
The indicators have been selected based on being relevant to monitoring health systems performance, considering the availability and comparability of existing data in the LAC region. The publication takes advantage of the routine administrative and programme data collected by the World Health Organization, the World Bank Group, and the OECD, as well as special country population surveys collecting demographic and health information.
The indicators are presented in the form of easy-to-read figures and explanatory text. Each of the topics covered in this publication is presented over two pages. The first page defines the indicator, provides brief commentary highlighting the key findings conveyed by the data, and provides a few key references. On the facing page is a set of figures. These typically show current levels of the indicator and, where possible, trends over time. In some cases, an additional figure relating the indicator to another variable is included. Where an OECD average is included in a figure, it is the unweighted average of the OECD countries presented, unless otherwise specified.
Limitations in data comparability are indicated both in the text (in the box related to “Definition and comparability”) as well as in footnotes to figures.
Health and health system’s situation can evolve rapidly, arguably even more so in low and middle-income countries than in high-income ones. Therefore, it is important to note that some indicators might not reflect the latest situation for some countries. The authors have collected the latest available data so the landscape depicted in each chapter and section of the publication shows the most updated scenario as possible.
Four LAC countries are OECD member states: Chile, Colombia, Costa Rica and Mexico. The OECD average includes all four LAC countries.
Brazil and Peru are currently in the process of accession to the OECD. Argentina is a partner country to the OECD.
For these seven LAC countries, some figures in this publication considered the data that has been reported directly to the OECD, instead of using international sources. This is to maintain consistency among what it is informed in other OECD publications (e.g. Health at a Glance 2021, https://doi.org/10.1787/ae3016b9-en) and what is available in the online database OECD Health Statistics on OECD.Stat at https://oe.cd/ds/health-statistics. These differences are noted in the footnotes of correspondent figures throughout the chapters.