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Introduction

Over the last decade, Latin America and the Caribbean has experienced rising incomes and countries in the region have substantially improved health-care coverage for people who live in poverty as well as health outcomes for most of their populations.1 Nineteen of thirty-three Latin American and Caribbean countries are now classified by the World Bank as upper-middle income countries.2 Yet progress has been uneven, and regional and national averages for income and social indicators reveal wide inequalities between and within countries. This is extremely apparent in the areas of reproductive, maternal, neonatal, child and adolescent health.

For many countries in Latin America and the Caribbean, efforts towards achieving universal health coverage and access to health care began as early as the 1990s. Over the past two decades, a few countries have implemented health system reforms that have fostered inclusion, citizen participation and equitable access to health care. Despite this progress, however, most countries in the region still experience major inequities in health status and coverage of health interventions, with major differences in health outcomes occurring based on people’s wealth, education, geographic location, gender, ethnicity and/or age.

We have the knowledge base to reduce and even eliminate these inequities. Pro-poor health sector interventions have been shown to improve health equity and overall progress by narrowing existing gaps in access to health services and health status. But strengthening health systems and improving coverage are not enough to improve the health and social well-being of populations. As stated in the 2030 Agenda for Sustainable Development, “sustainable development recognizes that eradicating poverty in all its forms and dimensions, combating inequality within and among countries, preserving the planet, creating sustained, inclusive and sustainable economic growth and fostering social inclusion are linked to each other and are interdependent”.

A Promise Renewed for the Americas (APR-LAC) is a movement that seeks to reduce the profound inequities in reproductive, maternal, neonatal, child and adolescent health that persist in Latin America and the Caribbean. APRLAC collaborates with key regional stakeholders, including Governments, international development agencies, civil society representatives, academic institutions, the private sector, professional institutions and non-governmental organizations to catalyse and support country-led efforts to decrease gaps in access to quality health care. As a regional movement, APR-LAC works in coordination with the global A Promise Renewed initiative. APR-LAC is convened by the Inter-American Development Bank (IDB), the Pan American Health Organization/World Health Organization (PAHO/WHO), the United Nations Children’s Fund (UNICEF), the United States Agency for International Development (USAID) and the World Bank.

As countries consider how to implement the 2030 Agenda for Sustainable Development to achieve the Sustainable Development Goals, it is vital that national priorities and development goals for the next 15 years address the current health inequities in Latin America and the Caribbean, reflect the needs of the most vulnerable populations and be based on current evidence. As a contribution to this effort, UNICEF partnered with the Tulane University Collaborative Group for Health Equity in Latin America to review the available evidence on health inequity in the region. The resulting report, Health Equity Report 2016: Analysis of Reproductive, Maternal,
Newborn, Child and Adolescent Health Inequities in Latin America and the Caribbean to Inform Policymaking,4 draws on over 700 sources, including a review of published research findings and household surveys (Demographic and Health Surveys, Multiple Indicator Cluster Surveys, Reproductive Health Surveys and other national surveys) undertaken from 2008 to 2014, to generate evidence of current health inequities and underscore the need for better data, particularly within countries at the subnational level.

This summary report draws on the findings of the Health Equity Report 2016 5 to illustrate the health inequities affecting children, women and adolescents in Latin America and the Caribbean, to provide government policymakers, non-governmental organizations, civil society partners, communities and all others concerned with the rights of children, women and adolescents relevant evidence they need to recognize and reverse those inequities in health.