Dimensions of Exclusion from Social Protection in Health in Latin America and the

In spite of legislation establishing health as a universal right, exclusion form social protection in health remains a major problem in the Americas. Structural characteristics of the systems contribute to the situation. Measuring the phenomenon is a challenge due to its multicausal nature. To asses its importance several indicators are developed, which show that at last 20% of the population (or above 82 million people) are excluded, although specific studies will be needed in each country. Those counties with a unified National Health Insurance system have lower levels of exclusion than those with fragmented systems. The indicators presented are deemed best approximations, although some are rejected due to distributional considerations within the countries. Indicators are based on structure, access, process and coverage. Further research is expected at the count ry level for policy intervention