Nonetheless, according to the same surveys, 18% of the population report not having any health insurance - signalling a lack of awareness that is likely to translate into poor health care access, poor outcomes and continued financial risk. That review made detailed recommendations for improving health system performance in six areas: 1) ensuring adequate funding of the health system, 2) tackling the remaining barriers in accessing services for those not covered by social security, 3) encouraging greater efficiency of health care providers, 4) encouraging greater productivity of health care professionals, 5) promoting the quality and effectiveness of care, and 6) improving governance of the system. Regarding the former, Seguro Popular has gradually expanded its package, particularly for cancer and other the interventions covered by the fund for high-cost diseases. The National Survey of Health and Nutrition, ENSANUT, and work by the National Institute of Public Health suggest that sendee availability has generally improved, and availability of prescribed medications in particular. In rural areas, the Mobil Medical Units (formerly Caravanas de la Salud) programme, implemented in 2007, appears to have had some transitory benefit.