The Brazilian health system is comprised of a complex and interconnected mix of public-private service providers and purchasers. The system provides healthcare through three sub-sectors: 1) the public – Unified Health System (Sistema Único de Saúde – SUS) – in which services are financed and provided by the state at the three levels of governance (federal, state, and municipal); 2) the private (for-profit and non-profit) in which services are funded by public and private funds; and 3) the private health insurance sub-sector. People may use services in any of these sub-sectors according to their ability to access and pay for them (Paim et al., 2011).

References:

Paim, J., Travassos, C., Almeida, C., Bahia, L., & Macinko, J. (2011). The Brazilian health system: History, advances, and challenges. The Lancet, 377(9779), 1778–1797. https://doi.org/10.1016/S0140-6736(11)60054-8

The Health System in Kenya is divided into the public sector (largest in terms of number of health facilities), a private for-profit sector and a private not for profit sector. In the private not for profit sector, services are being provided by voluntary organizations, such as faith based organizations (Mugo et al., 2018). According to the 2013 Kenya Household Health Expenditure and Utilization Survey, rural versus urban (66.7% vs 44.1%), (23.5% vs 43.0%), (8.5% vs 8.8%) and (1.3% vs 4.1%) visit public, private, faith based and others facilities (traditional and faith healers and community health workers) respectively to receive outpatient services (Ministry of Health, 2014a).

References:

Ministry of Health. (2014a). 2013 Kenya Household Health Expenditure and Utilization Survey. Nairobi, Kenya. https://www.healthpolicyproject.com/pubs/745_KHHUESReportJanuary.pdf

Mugo, P., Onsomu, E., Munga, B., Nafula, N., Mbithi, J., & Owino, E. (2018). An Assessment of Healthcare Delivery in Kenya under the Devolved System (No. Special Paper No. 19). Nairobi, Kenya.https://repository.kippra.or.ke/bitstream/handle/123456789/2095/an-assessment-of-healthcare-delivery-in-kenya-under-the-devolved-system-sp19.pdf?sequence=1&isAllowed=y

The Health System in Mexico has been highly fragmented since its creation and health services and users are divided according to the health institution that provides the coverage. There are three main providers: social security institutions, public services offered by the Ministry of Health, and the private sector. These providers offer different benefit and service packages, working independently and in parallel to each other. In addition, they have separate financing mechanisms and rely on different sources of funding (Dantés et al., 2011; OECD, 2016b).

As mentioned above, social protection in Mexico is composed of a fragmented framework of programs and institutions. Social security, available to those employed in the formal market, is further divided into a number of institutions that provide services to workers from different sectors. The Mexican Institute of Social Security (IMSS) covers those employed in the private formal sector, while federal and state level employees are covered by the Institute of Social Security and Services for State Employees scheme (ISSSTE). In addition, other institutions cover people employed in specific sectors such as the national oil company PEMEX and the Armed Forces (military and naval). Social security institutions extend their benefits, in addition to affiliated workers, to their spouses, children, and parents (Gutierrez et al., 2015; Dantés et al., 2011).

The Seguro Popular (Popular Health Insurance) is an income-based health care insurance publicly funded and administered by the Ministry of Health that aims at providing coverage to all those who are not insured by any of the social security institutions, including people who are self-employed, working in the informal sector, unemployed and others who are not participating in formal employment (such as homemakers) (Gutierrez et al., 2015). In 2015 the Seguro Popular provided health insurance to 53.5 million Mexicans, close to 50% of the total population, through services provided by the Ministry of Health. Another 9.2% of the population were covered by the IMSS, 7.7% by ISSSTE, and 1.2% by PEMEX and the Armed Forces social institutions.

References:

Dantés, O. G., Sesma, S., Becerril, V. M., Knaul, F. M., Arreola, H., & Frenk, J. (2011). Sistema de salud de México. Salud Pública de México, 53 Suppl 2(1), s220–s232. https://www.redalyc.org/pdf/106/10619779017.pdf

Gutierrez, L. M., Medina-Campos, R. H., & Lopez-Ortega, M. (2015). Present State of Elder Care in Mexico. In W. Vega, J. Angel, K. Markides, & F. Torres-Gil (Eds.), Challenges of Latino Aging in the Americas (pp. 379–392). Springer International Publishing.

OECD. (2016b). OECD Reviews of Health Systems: Mexico. In OECD Publishing (Ed.), OECD Reviews of Health Systems (OECD Reviews of Health Systems). OECD Publishing. https://doi.org/10.1787/f7b8c403-ja