Published in:
01-08-2021 | Care | Original Article
Model of health and social inequalities in Ecuador: progress and challenges. A systematic review
Published in: Journal of Public Health | Issue 4/2021
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Aim
To analyze the effects that the reform of the public health model of Ecuador has had on the deployment of a comprehensive health care system, taking into special consideration its capacity to respond to social inequalities in health.
Methods
We carried out a systematic review of the literature following the PRISMA checklist in the Scopus and Google Scholar databases. Screening identified 20 documents for inclusion in the review.
Results
Health reform in Ecuador has promoted the creation of a primary care model with a special focus on vulnerable groups and health inequities. However, a history of a dispersed and fragmented health care system, the geographical distribution of health professionals, the tradition of biomedical models of health practices, and structural inequities remain important challenges.
Conclusions
We found evidence of substantial improvements in the structure and coverage of the health system towards a model of unified health care that prioritizes comprehensive primary care. The political and social changes of the last decade and the reform of the health model in Ecuador have provided a framework for the construction of a socially committed health caresystem. However, there are significant shortcomings and challenges that need to be resolved in order to reduce the conditions of notorious social inequality in health still found in Ecuador.