Health Financing Fragmentation and Universal Health Coverage in Brazil, Colombia, Mexico and India

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2025 Annual Project meeting in Brazil

Partners gathered in São Paulo for the project's annual meeting

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Funded by the Global Health Policy and Systems Research Programme by the National Institute for Health and Care Research, the Health System Fragmentation and Universal Health Coverage in Brazil, Colombia, Mexico and India is a four-year research programme that began in 2022 and is rooted in Brazil, Colombia, Mexico and India, which are global exemplars for studying how financing fragmentation impacts health system goals, including UHC.

Our Research Partners

This project is a collaborative effort between institutions in five countries:

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Publications Highlights

Local governance dynamics in the Colombian health system: an exploratory cross-sectional study among public health sector officials

Authors: Natalia Losada-Trujillo, Javier Eslava-Schmalbach, Carol C Guarnizo-Herreño

Published in: Journal of Public Health Policy. 2026

  • Colombia
  • health care policy
  • health financing
  • health governance
  • political economy
  • public health

Political and institutional determinants of the Colombian health system financing fragmentation: an exploratory qualitative study of stakeholders’ and policymakers’ perspectives

Authors: Natalia Losada-Trujillo, Carol C Guarnizo-Herreño, Javier Eslava-Schmalbach, Luis Alberto Sánchez-Alfaro

Published in: BMC Health Services Research. 2026

  • Colombia
  • health financing
  • health governance
  • health system financing
  • political economy

From Fragmentation to Integration: Patient-reported Access to Cardiovascular Care in Colombia’s Primary Health System

Authors: Sandra Camacho, Diana Pinto Masis, Javier Amaya-Nieto, Steffany Villate-Soto, Nicolle Stefania Quintero Motta, Francy Perdomo Alarcón, Carmen Hernandez Vargas

Published in: Pan American Journal of Public Health. 2026;50:e6

  • access to care
  • Colombia
  • delivery of health care
  • patient outcomes
  • patient-centered care

Catastrophic and impoverishing health expenditures in fragmented public health systems: lessons from Mexico, 2000–2022

Authors: Diego Cerecero-García, Octavio Gómez-Dantés, Thomas Hone, Carlos Pineda-Antúnez, Alejandro Mohar-Betancourt, Laura Flamand, Edson Serván-Mori

Published in: Health Economics Review. 2026

  • catastrophic health expenditure
  • financial protection in health
  • health system fragmentation
  • mexico
  • universal health coverage

Health financing inequality in fragmented health systems: evidence from Mexico, 2000–2023

Authors: Edson Serván-Mori, Diego Cerecero-García, Carlos Pineda-Antúnez, Stephen Jan, Thomas Hone, Laura Flamand, Alejandro Mohar-Betancourt, Miguel Ángel Mendoza, Judith Méndez, Rocio Garcia-Diaz, Octavio Gómez-Dantés

Published in: International Journal for Equity in Health. 2026

  • health expenditures
  • health system fragmentation
  • inequalities
  • mexico
  • universal health coverage

Fragmented healthcare and effective maternal coverage in Mexico, 2009–2023

Authors: Edson Serván-Mori, Diego Cerecero-García, Thomas Hone, Arachu Castro, Rocio Garcia-Diaz, Christopher Millett, Alejandro Mohar-Betancourt, Octavio Gómez-Dantés

Published in: BMC Medicine. 2026

  • effective coverage
  • health care provision
  • health system fragmentation
  • maternal health
  • mexico

News

Seminars | 25/11/2025

Shaping the Future of Health: Health Systems Reform Regional Webinar

How can Latin America reach Universal Health Coverage? See highlights from our webinar

  • Colombia
  • health system reform
  • mexico
  • webinar
Updates | 01/06/2025

2025 Annual Project meeting in Brazil

Partners gathered in São Paulo for the project's annual meeting

  • progress report
Academic | 19/03/2025

How to measure patients’ perspectives on health care?

New publication from UNAL researchers on the development of an innovative tool aimed at capturing patients' perception

  • Colombia
  • delivery of health care
  • patient-centered care
  • publication
Colombia | 05/03/2025

Diana Pinto participates in Health Systems and Reform special issue launch event

The webinar will take place on March 6 and will gather policymakers, researchers and practitioners

  • Colombia
  • health system reform
  • HSR
  • publication
  • UHC
  • webinar
India | 25/01/2025

Getting to know more about India’s efforts to tackle healthcare fragmentation

Our partners foster dialogue among policymakers, researchers, and healthcare practitioners, ensuring that knowledge translates into actionable solutions

  • India
  • newsletter
  • progress report
Colombia | 18/01/2025

Colombia leads the charge in addressing healthcare fragmentation with new research and policy insights

The release of a research brochure and detailed progress update from Universidad Nacional de Colombia showcases our partner’s commitment to strengthening healthcare financing and access

  • Colombia
  • newsletter
  • progress report