The World Health Organization (WHO) defines health as “a state of complete physical, mental and social well-being”. This principle emphasizes the importance of a holistic approach that encompasses not only medical care, but also the social, economic, and environmental factors that influence people’s health. The WHO promotes equity in access to health, disease prevention and the promotion of healthy lifestyles as fundamental pillars to achieve the SDG #3 Good health and well-being, but in most countries of the world, major or significant challenges remain to achieve this goal.
Mental health has been identified as one of the key areas to guarantee the ability to access opportunities for personal, economic, and social development. Without mental health there is no health. Health is a fundamental dimension of inclusive social development and the sustainable development of societies. It is not only a right of the people, but also enables the possibilities of education, access to decent work, and generates inclusive economic growth aimed at ending poverty and inequality.
Health is a Human Right
The right to health is a fundamental principle that guarantees all people access to healthcare services, medicines and living conditions that promote physical, mental and social well-being. It is internationally recognized as a basic human right. This right implies not only the absence of illness, but also conditions that allow people to live a dignified and healthy life. However, its implementation and scope may vary depending on the political, economic and social context of a region.
Primary Health Care and Mental Health in Latin America and the Caribbean
Vulnerable children and adolescents face barriers to accessing health services that prevent them from enjoying good health. In Latin America and the Caribbean, there has been significant progress in improving health indicators in recent decades, but significant disparities still exist between and within countries.
Some of the challenges include the lack of equitable access to quality health services, the persistence of infectious diseases such as HIV/AIDS, malaria, and tuberculosis, as well as the increase in chronic non-communicable diseases such as diabetes, hypertension and obesity. Furthermore, socioeconomic factors, such as poverty, inequality and lack of infrastructure, contribute to the burden of disease in the region.
Healthcare in Bolivia and Peru
Access to health in Bolivia has historically been a challenge due to various factors, including the country’s mountainous and rural geography, the unequal distribution of health resources, and economic and cultural barriers. However, in recent years, the Bolivian government has implemented policies to improve access to health, such as expanding universal health coverage and building new primary care centers. Despite these efforts, significant challenges still exist in areas such as equity in healthcare and the quality of health services, especially in rural areas and among indigenous populations. Thanks to technological advances, the Telehealth Network is expanding for the development of remote teleconsultations, which unites specialist doctors with patients who live in remote areas of the country.
One of the main challenges in Peru is to overcome the segmentation and fragmentation of health services, a situation to which the government has tried to respond through the implementation of Integrated Health Networks. It is important to note that the pandemic has had a negative impact on various health indicators, many of which are used to track the Sustainable Development Goals. Both counrties still faces many new incidence in tuberculosis and low numbers of surviving infants who received 2 WHO recommended vaccines (DTP and measles), major challenges remain to achieve SDG #3.
Healthcare in El Salvador
In El Salvador, significant medical advances have been made in several fields, effective vaccination programs have been implemented to prevent infectious diseases, improvements have been made in maternal and child care, including the promotion of safe childbirth, prenatal care, and the reduction of maternal and infant mortality. Health services have been expanded to guarantee greater access to medical treatments and specialized services such as areas of oncology, cardiology, neurology and other specialties.
The national government carries out the “Crecer Juntos” program, a comprehensive public policy aimed at early childhood, until boys and girls reach 8 years of age. This policy has been designed with a rights-based approach to guarantee chlidren access to quality services in the provision of care, stimulation, education, health, nutrition, environments that protect their rights and special protection, with the ultimate goal of preventing poverty, violence, inequality and lack of opportunities.
Healthcare in Guatemala and Honduras
Health inequality in Guatemala and Honduras is a major problem. Disparities in access to quality health services are evident between urban and rural areas, as well as between different socioeconomic and ethnic groups. Indigenous and marginalized populations in poor communities often face greater barriers to accessing adequate healthcare, due to a lack of infrastructure, resources and trained personnel in rural areas, as well as discrimination and language barriers. Additionally, underfunding and corruption in the health system have been issues of concern. The Honduran health system faces financial limitations that make it difficult to provide adequate health services and acquire necessary medications and medical equipment. These inequalities contribute to the disparities in health outcomes and quality of life for the population.
In both countries, significant advances have been made in several medical fields in recent years. In Honduras, programs are being implemented for the prevention and control of chronic diseases such as diabetes, hypertension and cardiovascular diseases. Guatemala has implemented vaccination programs to prevent diseases, which has contributed to reducing the incidence of diseases such as measles, polio, and influenza.
Despite these advances, there are still significant challenges in the health systems of Guatemala and Honduras to achhieve SDG #3, including the need to improve the universal coverage and quality of health services, as well as address inequalities in access to healthcare.
Healthcare in Mexico
Mexico has a robust vaccination program that has helped eradicate diseases such as polio and reduce the incidence of other infectious diseases, but access to health varies depending on various factors such as geographic location, socioeconomic level, and affiliation to a social security system. The country has a mixed health system that includes public institutions, as well as private health services.
For those who are not affiliated with any social security system, access to health may be more limited and depends largely on public health services which often face saturation problems and long waiting times. In some rural and marginalized areas, access to quality health services can be especially difficult due to lack of infrastructure and resources.
Healthcare in Haiti and the Dominican Republic
Access to healthcare in Haiti is extremely limited and faces numerous challenges in achieving SDG #3. Hospitals and clinics in Haiti often lack basic medical supplies, medications and adequate equipment. Additionally, geographic and economic barriers make it difficult for many people, especially in rural areas, to access healthcare when they need it. This situation is aggravated by factors such as poverty, political instability and the frequency of natural disasters in the country. International organizations and NGOs are working to improve the health situation in Haiti, but there is still much to do to ensure equitable and adequate access to medical care for the entire population as challenges to health system reform in Haiti continue. The health system remains fragmented, with considerable dependence on direct payment at the point of service, as well as external aid and retention of health professionals are of particular concern.
The Dominican Republic continues to face challenges in ensuring equitable and high-quality healthcare for all its citizens. There have been significant strides in expanding access, improving infrastructure, and enhancing the overall healthcare system but there is still a disparity in healthcare access between urban and rural areas and low-income populations.
Window of opportunity after COVID-19
The Economic Commission for Latin America and the Caribbean (ECLAC) highlights the urgency of taking advantage of the window of opportunity that opened during the COVID-19 pandemic to transform the health systems of Latin America and the Caribbean. During this crisis, the structural problems of the region’s health systems became evident, such as the chronic underfinancing of the systems, the fragmentation of services, and the segmentation of the population based on their ability to pay. The current situation strains health systems, reproduces inequalities and hinders the full exercise of the right to health, especially for vulneaable families and their children. To address this, NPH’s Health and Wellness initiative focuse on beneficiaries of NPH community programs and chlidren living in NPH residences.
NPH providing quality health care
Through the NPH Health and Wellness initiative, we seek to put health professionals committed to ensure that children and adolescents in vulnerable situations in Latin America and the Caribbean have access to health services while enjoying good physical and emotional health. NPH health professionals work to reduce the barriers that prevent beneficiaries from having good health, especially those from the most socially disadvantaged sectors.
NPH clinics are led by professional and experienced teams of doctors, nurses, dentist, therapists, psychologists and administrators and provide hospitalization services for non-serious patients who require minimal care. Healthcare services at our clinics are available 24 hours a day, 7 days a week, with a capacity of serving populations between 100 to 1500 people a year.
During 2021, our psychologists with a clinical focus carried out more than 5,000 sessions of preventive and intervention psychological therapy, both individual and group. Throughout 2022, NPH continued to provide quality and free health services to all its beneficiaries in different projects. NPH continues to invest in professionals who provide primary care services, such as medical consultations, nursing services, rehabilitation and therapy services, dentistry, pharmacy, emergency and urgent care transfers, mental health services, sexual and reproductive health, and care for people with disabilities. Also, it is worth mentioning that intellectual disabilities, growth and development disorders, chronic malnutrition, bond and attachment disorders, post-traumatic stress, and learning disorders are prevalent health problems in the populations served by NPH. Diseases and disorders of a neurological, psychiatric, psychological, and infectious nature are the most common and are the ones that present the greatest challenge for health professionals in NPH clinics.
In June 2023, the international team of Medical Services implemented a project to train health professionals, kitchen staff, caregivers, and beneficiaries about how to use a new nutritional guide. This guide aims to improve the quality of the menu served in NPH kitchens by increasing nutritional education within the organization to help to reduce the impact of chronic malnutrition, a common problem in the countries NPH serves.
Medical Services Statistics for the Year 2022
- Vaccinations COVID-19: 1,936
- Other vaccinations: 1,490
- Well-Child consultations: 1,751
- Integral therapies (psychology, physiology, occupational, art,
- language, nutrition): 11,296
- Patients with chronic illnesses: 428
- Patients with HIV: 26
- New entry inquiries: 88
- Dental consultations: 1,779
- Medical consultations: 7,368
- Nurse consultations: 10,470
- Surgeries: 34
- Hospitalizations: 45
St. Damien Hospital in Haiti
St. Damien Pediatric Hospital, funded by NPH, is the only hospital wholly dedicated to pediatric and prenatal care in Haiti that offerd cancer treatment for children. St. Damien provides high quality medical treatment for disadvantaged and sick children in Haiti. More than half of all patients are admitted for an infectious disease such as tuberculosis, malaria, and HIV while twenty-five percent are admitted for non-infectious diseases such as cancer, cardiovascular disease, and kidney infection. Most patients admitted are also malnourished. The outpatient clinic treats 100 children daily, for acute, parasitic, and bacterial infections. In specialized clinics, chronic conditions such as sickle cell anemia, congenital heart diseases (CHD), tuberculosis and cancer are treated for months or years if needed. St. Damien Pediatric Hospital and associated public health and community programs provide over 80,000 services to children and adults annually. St. Damien gives health and hope to the women and children of Haiti. Each year, on average, the medical team provides:
- More than 50,000 services to women and children
- Nearly 8,000 pediatric consults
- More than 7,000 maternity visits
- Nearly 2,000 emergency room visits
- More than 1,300 HIV consults
- And delivers more than 3,000 babies
Support for Children with Disabilities
According to UNICEF figures, 30% of children living with disabilities in Latin America do not attend school, while over 8 million children with disabilities under the age of 14 are at risk of being excluded from their societies. The objective of the NPH Disability Care Program is for children, adolescents, and young people with disabilities in vulnerable situations within Latin America and the Caribbean to develop physically and emotionally.
Another objective is to help population with disabilities to have greater access to economic and social development. NPH currently cares for 1,145 children, adolescents, and young adults living with disabilities through residential care and outpatient therapy centers. The creation of a program aimed at serving the population with disabilities allows us to standardize the interventions to best serve them. This includes providing them with a correct diagnosis, therapy plans, life plans, inclusion, participation, and alliances with related organizations. The objective is for children with disabilities to enjoy the same rights as children without disabilities, so they can have opportunities for social reintegration, access to the labor market, and to lead a more dignified life.
NPH Healthcare Strategy
Good health is the engine that moves us as human beings every day and is an essential requirement for global well-being. NPH is implementing an approach based on co-responsibility, progressive autonomy, and the effective exercise of rights. Strategies are being adopted by NPH that aim to strengthen the role that caregivers and families play in managing their health and that of the children they care for. This requires interconnecting the beneficiaries with their local networks. NPH offers free access to a network of primary healthcare clinics that have general medicine, nursing, pharmacy, and dental services. NPH also has psychologists who offer mental health services in homes, schools, our family reintegration program, family centers, and day care centers. The beneficiaries learn how to use the health services available locally, how to comply with their obligations, and also ways to effectively exercise their health rights.