La nécessaire couverture universelle

Le plus grand défi sanitaire pour l’Amérique latine et les Caraïbes ne concerne pas un type de maladie particulier, et il ne sera pas réglé en dirigeant des financements vers un seul comportement à risque. Ce défi est que les gens n’obtiennent pas toujours les soins de santé dont ils ont besoin.

De nombreuses personnes vivent loin d’un médecin, et la distance coûte à la fois du temps et de l’argent. En outre, les barrières culturelles appauvrissent la qualité de vie de ceux qui ne parlent pas la langue dominante, notamment les communautés indigènes. Dans d’autres cas encore, les gens ne se rendent pas compte qu’ils ont besoin de soins, ou ne suivent pas les recommandations du médecin. De même, les croyances erronées constituent souvent un problème : par exemple, le diabète est appelé “sucre” dans un certain vernaculaire, et les diabétiques peuvent croire, à tort, qu’ils n’ont besoin que de réduire leurs apports en sucre.

Le financement représente un autre obstacle de taille. Au Mexique, avant de récentes réformes, 2 à 4 millions de ménages dépensaient 30 % ou plus de leur revenu disponible, ou sombraient sous le seuil de pauvreté à cause de dépenses de santé catastrophiques. D’autres se passent tout simplement des soins dont ils ont besoin.

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