Social exclusion is a great challenge on the political, social and economic agenda of the Region of the Americas. The panorama of the health sector shows that despite various efforts to improve the health status of the people in the last 20 years, users are not satisfied with health services and approximately 20 percent of the population is excluded from existing social protection mechanisms and do not have the minimum resources to access care.

In this context, it is important to emphasize that exclusion in health is a multidimensional phenomenon that extends beyond aspects related to the functioning of health systems. It is related with poverty, inequality, discrimination, cultural factors and employment conditions. It is a dynamic process, in which various forces interact preventing an individual or social group to exercise certain social rights that allow them to access health care. 

In 1999, PAHO with the support of the Swedish International Development Cooperation Agency (SIDA), embarked on the development of a study to analyze social exclusion in health. The first phase of the project corresponded to the characterization of exclusion in seven countries of the Region. The second phase was comprised of social dialogues where relevant actors were identified and convened to develop an action plan to tackle social exclusion in health, considering the needs and interests of every country. 

Due to the success of this initiative and to the excellent response of the countries, Extension of the Social Protection in Health (ESPH) is currently an important topic in the PAHO cooperation agenda.

This Web page aims to offer all the material produced by PAHO on this subject and to disseminate the information generated in the region and by our partners in a timely manner.


Below a brief description of the partners is presented:

	Pan American Health Organization/ World Health Organization (PAHO/WHO). It is an international public health organization located in Washington, DC. It acts as the specialized health agency for the Inter-American system and as the Regional Office for the Americas of the World Health Organization.
	International Labor Organization (ILO). It is a specialized agency of the United Nations that seeks to promote social justice, and internationally recognized human and labor rights.
	Swedish International Development Cooperation Agency (SIDA). It is Sweden’s bilateral cooperation agency for international development and also for most of the cooperation with Central and Eastern Europe.