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Barriers of access to social protection in health for unemployed workers in Medellin, Colombia

Date: Poster sessions
Source: Forum 11
Authors: Alvaro Cardona, Professor, Facultad Nacional de Salud Publica, Universidad de Antioquia, Colombia
with Emmanuel Nieto L, Romãn Restrepo V, Luz Mery Meãa O, Carlos Enrique Cardenas R, and Felipe Aguirre A


Access to social protection in health in Colombia is affected by various factors linked to unemployment. One of these factors is the lack of health insurance for a large percentage of workers who lose their jobs. Many workers and their close relatives are exposed to loss of family economic resources (and thus are vulnerable to poverty) if any member of the family requires health services he/she has to pay for.

The objectives of this study were: 1) to identify relevant barriers of access to social protection for unemployed workers in Medellin, Colombia, and to discover possible windows of opportunity to address those barriers through their equitable participation in policy-related decision-making; 2) to disseminate the findings in order to foster discussion about how to translate academic research into public policies for equitable access to health.

The methodology included: a descriptive-retrospective study that combined qualitative and quantitative methods; a survey of a representative random sample of unemployed workers; and a systematic review of the Colombian legal framework on social protection in health and the rights of civil society to become organized.

The study revealed: 1) A similar proportion of women and men lost their jobs (51.8% and 48.2 % respectively). 2) 37% of unemployed workers and their relatives do not have any kind of health insurance. 3) The average salary in the last position held was only 1.2 times the legal minimum wage. 4) The average employed/unemployed cycle was 21.7 months of employment in the last post and 6.3 months needed to find new employment. 5) Unemployed workers have a very little representation in social participation networks. There is no organization that represents their opinions and demands.

The results of this study have encouraged us to propose the creation of a fund with public and private financial resources that combines a low rate loan and financial aid to unemployed workers. This will permit them and their relatives to maintain a basic level of health insurance. This initiative has received the enthusiastic support of unemployed workers and has stimulated them to undertake the process of creating an organization through which to channel their opinions and demands.