Reform provided better access to health care in Ecuador

Over a ten-year period, between 2007 and 2017, the Government of Ecuador carried out a comprehensive reform of the health system with the aim of reducing socio-economic disparities in health care and achieving universal coverage of health care by all residents of the country.

In a thesis at the Department of Epidemiology and Global Health at Umeå University, Edy Quizhpe has evaluated the effects of the reform.

A number of positive effects were observed: access to health care has improved significantly and social inequalities have decreased. We are now much closer to universal coverage of health care. This is a major improvement especially for socially vulnerable groups.

The evaluation also shows reduced expenses for health care fee for many households. At the same time, the reform has led to increased political involvement in health issues.

However, there are still problems. One is that the inequality between the indigenous population and the rest remains. Another is that people who are uninsured still have to pay high fees for health care. There is also concern about health care becoming a commodity and about the system's long-term financial sustainability.

Edy Quizhpe.

ImagePaola Floril

"For further development, it is important that health care's dependence on fees can be gradually reduced, as well as ensuring sufficient resources and achieving a balance between public and private interests so that public health is prioritised over economic gain," says Edy Quizhpe,

Edy Quizhpe is a doctor with many years of experience working in the health system in Ecuador.