to Injury. The coverage of mortality statistics in Brazil Ls lower than the two other countries, thus the information of table IlIl probably underestimates the number of deaths due to Infectious and parasitis diseases In Brazil.

Heaith status Indicators at the national level need to be complemented with information stratified by socioeconomic groups, In order to depict the epidemiologlcal profile. Table IV shows the childhood mortality rate according to different levels of the mother's education. The childhood mortality rates among children whose mothers are less educated are between three and four timos greater than those for children with mothers with the highest educational level.

# _4. Main characterstics_ **_of_** _the Health Systems_

Organizational Structure. Health systems In the three countries have different organizational structures. While in Brazil, govemment and social security agencies have been integrated Into a Unified Health System, In Mexico and Colombia, there is a clear division of responsibilitles between the Ministry of Health and the Social Security Agencies. These responsibilities differ in the two countries: in Colombia, the Ministry of Health provides the majority of the health services to the population and the Social Security Institute covers only a small proportion of the population involved in the labor force. On the contrary, in Mexico, the Ministry of Health concentrates its services on the poor and social security agencies covers about 60 % of the total population.

The size and role of private sector are also quite dNfferent in the three countr.es. In Brazil, it is very large, provides services to the unified public system, and the private insurance plans are also growing very fast In Colombia and Mexico, it also plays an important role, but there is no significant provision of private services funded by the public system. The Insurance plans In these countries are also growing, but their size is very small.

Source of Finance. The sources of finance follow the organizational structures in the three countries. In Mexico and Colombia, where there is a clear division between the Social Security Institutes and the Ministry of Health, the former are financed through contributions from employers and employees and the latter is financed through general taxation and fees. Colombia also obtains funds through earmarked taxation on specific products (like beer or tobtacco) to finance specific components of the health services. Brazil, on the other hand, Integrates these 01ferent sources into an unified heafth fund to finance its UnMed Health System.

Coverace. The three countries have similar coverage indicators. Information on the utilization of services suggests that, In all of them, about 20% of the population has no access to health care. Important dffferences exist between the estimates for geographical access to ambulatory care (which ranges from 82% In Colombia to 96% in Brazio and actual utilization of services which show a lower coverage (80%). Other coverage indicators, such as deliveries attended by health professionals (ranging from 70% in Mexico, to 81% in Brazil) and Immunization of children with DPT3 (ranging from 66% in Mexico to 87% in Colombia) also show lower figures than the normative estimate mentionod above.

Distribution of Resources. Health conditions in Brazil, Colombia, and Mexico have improved considerably for the majority of their populations over the recent decades. Unfortunately, the uneven distribution of the social benefits derived from development has accentuated health inequalities. The current organization of health services widens the existing 9salth inequalities in the three countries analyzed here, mainly because the distribution of resources Is biased towards the middle and upper 5