Reduction of maternal mortality in Columbia

Both the total of the UPC and the content of the POS were established by the National Council for Social Security in Health. [...] The council is made up of representatives from almost all of the stakeholders in the system: the government, insurers, service providers, unions, employers and pensioners. [...] Although the Law explicitly sets out the goal of offering the same POS to the entire population, it accepts a period of transition when the subsidized POS will be inferior to the contributing POS. [...] In the 17 years since the introduction of the Law 100, documentation shows that the profound imbalance between the system’s financial incentives and the absence of incentives for positive health results has generated negative behaviour that puts the quality of care at risk. [...] In Antioquia, the ratio for the subsidized regime was 56.8 deaths per 100,000 live births, 22.6 for the contributing and 56.8 for the uninsured.7 The available information does not allow us to determine the cause of the important differences in the maternal mortality ratio based on different insurance regimes.