The hospitalization rate for ambulatory care-sensitive conditions serves as a valuable indicator for evaluating progress in strengthening the first level of care, including its economic implications for the overall healthcare system. During this reporting period, only two countries have made notable advances in this indicator: Mexico has integrated it into their National Sectoral Health Program 2022-2024 monitoring system, and El Salvador is currently in the process of collecting data for this indicator.
Measurement of this indicator has posed challenges for many countries in the region. While PASB has provided technical cooperation, tools, and support for this purpose, there is a need to enhance the commitment of countries further and improve countries’ capacities to utilize these resources effectively.

The countries of the Region have made great efforts to incorporate the vaccine into their national vaccination schedules; as of December 31, 2023, only 4 countries had not introduced the HPV vaccine. 26 countries in the Region are vaccinating children and 12 countries have switched to a single-dose schedule.

During the biennium, countries in the Region made progress toward improving their food control systems to prevent and mitigate risks to food safety. PASB has provided technical guidance to countries (Brazil, Chile, Costa Rica, Cuba, Guatemala, Ecuador, Honduras, Panama, Peru, Paraguay, URU) to improve their food control systems based on the principles of risk analysis (risk management, risk assessment and risk communication).

Country achievements include the development of national food safety policies and Codex Alimentarius programs for standard-setting and implementation from farm to fork – One Health (Guatemala, Guyana, Honduras, El Salvador). Additionally, Paraguay, Dominican Republic, Colombia and Haiti are improving the capacity of their traditional food markets to prevent emerging food safety risks under the One Health approach. In the Caribbean, a survey was conducted to assess the readiness of food control systems to mitigate risks related to climate change (Saint Lucia, Trinidad and Tobago, Barbados, Saint Kitts and Nevis, Guyana, Jamaica). Based on the findings of this survey, Trinidad and Tobago and Barbados developed climate-resilient national food safety plans. One of the main challenges in achieving the indicator at country level is the high turnover of government officials. As a lesson learned, it is important to facilitate collaboration across sectors and regularly monitor the implementation of developed policies, programs, and plans. PASB has mobilized resources to improve and harmonize the food safety risk analysis capacity of countries in Latin America.

In the 2022-23 biennium, progress was made toward strengthening country capacity for all-hazards health emergency and disaster risk management. As of the latest assessment, 22 countries fully meet or exceed minimum capacities to manage public health risk associated with emergencies, with another 15 on track to do so. PASB's technical support, including the development of assessment tools and coordinator meetings, remains essential for achieving the 2025 target of 37 countries. Continuous monitoring and emphasis on gender-sensitive disaster preparedness, supported by tools such as the Preparedness Index for Health Emergencies and Disasters and the monitoring survey for the Plan of Action on Disaster Risk Reduction, are critical for maintaining and building on the progress made.

The majority of countries and territories express satisfaction with PAHO/WHO's leading role on global and regional health issues, indicating that the Organization’s efforts and initiatives are generally perceived positively across the region. This widespread satisfaction underscores PAHO/WHO's role as a leading public health authority, engaging countries and territories in the regional and global public health agenda at the highest level – politically, strategically, and technically. Efforts will continue to ensure alignment between biennial work plans and the priorities indicated by national health authorities. This commitment involves ongoing coordination and collaboration with national health authorities to tailor PAHO/WHO's biennial work plans to address the specific health challenges and priorities identified by each country.