As of 2012, Mexico is well on the road to universal health coverage. In less than a decade, thanks to Seguro Popular, a national health insurance program introduced in 2003, every Mexican is now covered by a public insurance scheme. The program offers health services and financial protection to over 50 million Mexicans who were previously uninsured.
Despite its middle-income status, Guatemala has some of the worst health outcomes in Latin America with more than half of its population living in poverty. Indigenous populations in rural areas, who suffered the most during 36 years of civil war, have gained little from recent social reforms.
In the 1980s, with advice from international organizations, most African countries adopted direct payment for health services as the primary means to finance their health systems. Patients had to pay for health services out-of-pocket, severely hindering access to services for the most vulnerable. New recommendations in the 2000s called for African countries to offer subsidies or abolish payments for certain health services and groups. Until now, the impacts of these reforms in francophone West Africa have not been documented.