First published in 1948, the International Social Security Review is the principal international quarterly publication in the field of social security.
The objective of this article is to analyse the performance of Ecuador’s pension system and the challenges it will face in the future. Over the last 13 years, the pension system has made significant advances in terms of coverage and adequacy. However, demographic ageing is straining the financial sustainability of the contributory scheme. In this context, a number of public policy areas are identified, in terms of parameters and structures, which, together with the expansion of non-contributory coverage, could provide a more equitable and sustainable scheme.
Georgia’s national social security system offers almost complete non-contributory basic pension coverage. The basic pension has, to date, proved effective in dealing with poverty. But Georgia’s fiscal constraints and ageing population also highlight the importance of improving the pension system, in order to ensure its sustainability. This article presents policy reform choices, which suggest that, in Georgia, pension reform might include increasing the statutory retirement ages and reducing the generosity of benefits through means testing. The case of the Georgian non-contributory basic pension might hold value for some low- and middle-income countries that are considering the implementation of, or expanding coverage under, a non-contributory pension programme.
Owing to a favourable economic situation and to national labour market and social protection policy reforms, Latin America has witnessed significant progress in social protection coverage extension. Some countries, however, have seen weaker progress, with stagnant coverage levels. Several factors underlie the extension of pensions and health care coverage and the increased formalization of the labour market: substantial improvements in the quality of employment, more flexible eligibility criteria for contributory coverage, and the strengthening of the supervisory and regulatory roles of the State. This article first addresses the link between social protection and informality in Latin America to show the relationship between informal labour markets, the lack of social protection and the scale of unpaid contributions. Also highlighted is regional progress in extending social protection as a result of labour market formalization. Countries in the region have used various policies to encourage formalization and these have also helped to reduce wage inequalities, since formalization has had especially beneficial effects on low-income sectors. Finally, we discuss controversial and diverging views on social protection financing in the region. These views tend to favour non-contributory over contributory financing mechanisms and support proposals for limited coverage, but do not address the stratification of access to social protection. The move towards the alignment of benefits is deemed essential: strategies to universalize social protection in the region should not focus exclusively on increasing resources, but must address their form given that institutional change is a crucial part of the locus of innovation
This article addresses the reforms introduced in Latin American pension systems that had the aim of increasing coverage beyond formal-sector workers. For this purpose, fourteen representative regional experiences are analysed using a taxonomy based on features of the cases examined in terms of design, implementation and results. The findings show that, although the reforms share the goal of expanding coverage, there are significant differences deriving from the context in which they were originally designed, their goals, and the capacity available to implement them. The results are not homogeneous, and it is possible to identify some aspects in which policy decisions can lead to better or worse results.
This article assesses the effectiveness of pension provision and health insurance in preventing ill health among older people in developing countries. It argues that, until recently, social protection agendas devoted insufficient attention to health risk prevention, instead focusing on the reduction of income poverty through cash transfers. The article shows that there is little reliable evidence to indicate that providing older people with pension benefits enhances their health status and that these effects should not be taken for granted by policy‐makers. The article then focuses on the effect of inclusion in health insurance schemes on health outcomes for older people, with specific reference to outcomes related to hypertension. Drawing on newly‐available data from the World Health Organization for Ghana, Mexico and South Africa, it shows that older people with health insurance are marginally more likely to be aware of health conditions such as hypertension and more likely to have them under control. Nevertheless, the great majority of hypertensive older people, insured or uninsured, are not effectively treated. The chief barriers to treatment are shown to be mainly related to awareness and service provision, rather than financial ones. Consequently, the capacity of pensions or health insurance to enhance health outcomes for older people in such countries, including in rural areas, is heavily contingent upon health education, health screening and adequate health service provision. These interventions should be viewed as an integral element of mainstream social protection strategies, rather than adjuncts to them. Yet, in practice, social protection and health promotion continue to be treated as almost entirely separate spheres, thus presenting substantial institutional barriers to developing combined interventions.