Swimming Against the Tide: Strategies for Improving Equity in Health

The World Bank. The views expressed here do not necessarily reflect those of either the Inter-American Bank or The World Bank nor of their members. 1 Introduction Introduction Introduction Introduction A major objective of developing country governments and of donor agencies, stated repeatedly in their policy documents and speeches, is achieving greater equity in health. Chile's constitution, for example, states that the government has an obligation to "protect free and egalitarian access to actions that promote, protect, restore health and rehabilitate the health status of individuals" (Ministry of Health, 1992). The World Health Organization's most recent report on implementation of "Health for All by the Year 2000" concludes by advocating a new policy framework for "ensuring equity in health through more effective inter-sectoral health promotion and protection; and pursuing equality in access to primary health care..." (WHO, 1992). This concern for achieving greater equity in health is based largely the view, now widely held in most societies, that everyone should have access to basic health care independent of their ability to pay for it.