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Healthcare in El Salvador
 
 
 

The public sub-sector is composed of social security, the services of the Ministry of Public Health and Social Welfare, and other health sector services. The Ministry has a national network of 427 services, broken down as follows: 16 hospitals, 14 health centres, 313 health units, 32 health posts, 11 community posts, eight dispensaries, and 33 rural nutrition centres. As far as hospital beds are concerned, the Ministry has 2,964 and Salvadorian Social Security Institute (ISSS) has 1,583.

80% of the total national population is assigned to the Ministry, although actual coverage is lower than that.

The following entities also belong to the public sub-sector: the National Telecommunications Association (ANTEL), the Electric Lighting Company (CEL), Teachers’ Welfare, and the Military Health Service. These institutions, which cover workers (or their respective members) and their families, together provide health services to 2.3% of the population. Both the public health services of CEL and of Teachers’ Welfare function as a mixed group with public financing and services provided by private entities.

Social security, represented by ISSS, provides coverage to workers in private enterprises and government employees, along with their respective beneficiaries, and takes care of 17% of the population. ISSS has 10 hospitals, 35 medical units and 24 community clinics.

The private system has second- and third-level hospitals and clinics, which are concentrated in the country’s three main departments.

ISSS offers mainly curative care, which is provided by university-educated professionals (physicians, dentists, etc.) based on the needs of its subscribers.

According to data from the Ministry of Public Health and Social Welfare, between 1994-1995 and 1995-1996 the total number of medical consultations in the country went from 2.4 to 3.2 million, and dental consultations went from 265,000 to 369,000. There were 275,700 hospital discharges in 1994-1995 and 280,400 in 1995-1996. In the same years, surgical interventions numbered 123,700 and 113,800, respectively, and there were 65,000 and 69,000 attended deliveries.

For every 10,000 inhabitants, El Salvador has 9.1 physicians, 5.4 midwives, 3.8 nurses and 2.1 dentists.

The public system has 3,473 physicians, 334 dentists, 5,274 nurses, 2,367 administrative staff, 3,404 service and maintenance staff, 1,499 health promoters, and 536 environmental health inspectors. ISSS has 1,621 physicians, 176 dentists, 1,973 nurses, 244 laboratory technicians, 87 X-ray technicians, and 40 health promoters. 60% of all physicians, nurses and dentists are concentrated in the capital, and 70% of all specialised physicians are working in establishments at the second level of care such as hospitals and health centres in the public system, the ISSS and the private sector. The rest of them work in establishments at the first level of care under hourly contracts.

To reduce the human resources problem in the national health system, training has been given to workers in technical, financial, administrative, strategic planning and information areas, and efforts have been made to integrate training entities with the Ministry’s activities so that occupational profiles can be updated as needed in order to provide better primary healthcare.

The Ministry has made some recent changes in the management of human resources. There has been greater participation in the areas of human resources, and activities have been decentralised in each hospital and department. Decentralisation has enabled human resource program heads to participate in decision-making, in development of plans of work, and in administration of resources under their jurisdiction.

The 1997 operating budget for the Ministry of Public Health and Social Welfare was $151.3 million, distributed as follows: expenditure on preventive health services (including drugs and medical and surgical supplies), 33%; expenditure on outpatient and hospital services (including drugs and medical and surgical supplies), 59%; secretariat, 6%; and investments, 2%.

The ISSS operating budget for 1997 was $49.74 million, of which 21% corresponded to pharmaceutical expenditures; spending on medical, surgical and laboratory supplies, 2%; and payroll and miscellaneous (77%).

 

 
 

 



 


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