The social protection systems of the region of achievements, but also those of the considerable institutions. The vast majority of the countries have been entities dedicated to social development with great prominence in the implementation of non-contributory policies, in which progress is observed at the level of management tools. One of the main challenges is the need to improve the coordination between contributory and non-contributory components of social protection, as well as between entities that have general mandates and those corresponding to a social problem or segment of the population. In this context, care policies become a central element of social protection in the region and increase as institutionalization progresses as part of the universal social protection system.
The social protection policies of the region emerged anchored to the participation of people of working age in formal employment, in the context of limited levels of social investment. In this way, and based on labor market regulations in force at all times, workers and their families and dependents accessed social security (pensions), social services such as health, various forms of insurance against various economic, labor and personal contingencies and a good part of the social promotion policies and promotion of access to the supply of social services. In contexts of high informality, this model had clear limitations in terms of coverage in most cases, leaving out important segments of the population.
In light of this evolution, ECLAC has proposed the idea of moving towards universal social protection systems, promoting the integration of its various components (contributory, non-contributory, labor market regulation and care system) as a basis for moving forward towards greater social inclusion and guarantee of rights. The contributory component is associated with social security, the non-contributory component includes the set of actions commonly associated with social assistance, and labor market regulation seeks to protect and promote decent work. Care systems provide the services to assist and facilitate the development of those who, by age or condition, require support from others, as well as the articulation of transfers, regulatory benefits linked to the times to care (licenses), labor standards for those who care and quality standards of care services, among other instruments.
The main functions of social protection and its components include securing and protecting the income of people and their families, identifying unmet demand and facilitating access to social services and social promotion actions and, finally, promoting and protect decent work, ensuring a correspondence between employment and social protection (Cecchini and Martínez, 2011). As will be seen below, the set of actions focused on caring for people in different stages of life constitutes a recent problem of social protection, partly transversal to the aforementioned components, but which also covers other areas of action public and other public, private and civil society actors. The complexity of social problems, as well as the objectives of the policies designed to meet them, requires intersectoral approaches and designs that make it possible to articulate the offer of social protection with demand. On the side of policies and programs, a sectoral (or horizontal) articulation between the different areas of the Government is required, as well as a vertical articulation between the different levels of government. At the same time, policies and programs must simultaneously address general and specific problems that affect certain segments of the population defined according to stages of life (longitudinally) or gender, ethnic, social or economic differences (transversally).
Up to a certain point, social institutions today reflect that aspiration and the difficulties in achieving its realization, in particular because of the coordination challenges involved. The social protection in force in most of the countries of the region presents dual models in their conception and two-way models in their organization, since they respond to two different authorities, depending on whether they are contributory or non-contributory. In turn, the articulation within each component also presents limitations, with the participation of several actors in the contributory component, on the one hand, and a set of non-contributory programs, on the other. The latter, in general, are focused on the population in a situation of poverty or exclusion from formal social security and are publicly financed. The following describes some institutional aspects of this situation and the associated dilemmas. First, aspects of the institutionality of the non-contributory components are addressed, with emphasis on the ministerial entities that have the formal mandate to work for social development; subsequently, integrated care policies are treated specifically as a new problem of social protection that is the subject of novel institutional responses in the region.