Health reform in El Salvador: a lost opportunity for reducing health inequity and social exclusion?

Espinoza, Eduardo; Barten, Francoise

doi:10.1136/jech.2007.067066

Cited by 4 publications

(4 citation statements)

References 6 publications

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“…In the Salvadoran context, this was possible because of the following reasons: (1) the political will that was created with the entrance into government of the FMLN, revoking the neoliberal health policies that had been in place for a long time, and (2) the strength of a historically organized population. As reported by Espinoza and colleagues, 31 previous neoliberal governments did not promote the right to have access to essential preconditions for health but only the right to have access to health care services. The health reform moved away from a biomedical approach focusing mainly on curative actions, individual responsibility, and lifestyles, with little concern for the state's responsibility to modify the contextual limitations and address the underlying and structural causes of health inequity, toward a committed government aiming at incorporating people's voice.…”

Section: Discussionmentioning

confidence: 96%

The Role of Social Movements in Strengthening Health Systems: The Experience of the National Health Forum in El Salvador (2009–2018)

et al. 2020

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In 2009, the newly elected FMLN government of El Salvador launched a comprehensive health reform, which gave the National Health Forum (NHF) a key role in developing community participation. This study aims to examine and analyze the content and impact of this social movement during the study period 2009-2018. The context was analyzed through relevant documents, which helped identify key stakeholders. Semi-structured interviews took place at 3 levels of decision making: the political level, the health professionals, and the community. Data were analyzed using a qualitative methodology. Participation is carried by a structure created by the Ministry of Health, the National Health Forum. The NHF developed 3 strategies: (1) leadership building in the communities through the strengthening of social, political, and economic skills, where they developed social accountability mechanisms at all decision-making levels of the health system; (2) the strategy carried by the sectoral working groups, where they responded to prioritized needs identified by the community; and (3) advocacy for human rights-based policies. The NHF, and its role in the strengthening of the National Public Health System, provides strong evidence of community participation strategies and co-governance with the health system within the social determinants of health scope.

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Section: Discussionmentioning

confidence: 96%

The Role of Social Movements in Strengthening Health Systems: The Experience of the National Health Forum in El Salvador (2009–2018)

et al. 2020

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“…31 Latin America is the subcontinent with the highest income inequality, with a high incidence of homicides and violence, unequal distribution of healthcare and social exclusion. 32 In addition, in contrast to Europe, most Latin American and Caribbean countries lack a universal public healthcare system. The availability of mental health workers is very low compared with the USA and European countries.…”

Section: Negative Correlation Between Ppp-adjusted Gdp Per Capita Andmentioning

confidence: 99%

Worldwide impact of economic cycles on suicide trends over 3 decades: differences according to level of development. A mixed effect model study

et al. 2012

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ObjectivesTo investigate the trends and correlations of gross domestic product (GDP) adjusted for purchasing power parity (PPP) per capita on suicide rates in 10 WHO regions during the past 30 years.DesignAnalyses of databases of PPP-adjusted GDP per capita and suicide rates. Countries were grouped according to the Global Burden of Disease regional classification system.Data sourcesWorld Bank's official website and WHO's mortality database.Statistical analysesAfter graphically displaying PPP-adjusted GDP per capita and suicide rates, mixed effect models were used for representing and analysing clustered data.ResultsThree different groups of countries, based on the correlation between the PPP-adjusted GDP per capita and suicide rates, are reported: (1) positive correlation: developing (lower middle and upper middle income) Latin-American and Caribbean countries, developing countries in the South East Asian Region including India, some countries in the Western Pacific Region (such as China and South Korea) and high-income Asian countries, including Japan; (2) negative correlation: high-income and developing European countries, Canada, Australia and New Zealand and (3) no correlation was found in an African country.ConclusionsPPP-adjusted GDP per capita may offer a simple measure for designing the type of preventive interventions aimed at lowering suicide rates that can be used across countries. Public health interventions might be more suitable for developing countries. In high-income countries, however, preventive measures based on the medical model might prove more useful.

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“…In El Salvador the network of public health care providers is available for all citizens. The health expenditure burden over the public health system increased over the years, and the system was highly inequitable as the rural and poorest areas had limited access to health personnel (Espinoza and Barten, 2008). By 2010, the country had only 377 primary care units for a population close to six million inhabitants.…”

Section: Community Health Teams In El Salvadormentioning

confidence: 99%

An Ounce of Prevention for a Pound of Cure: Basic Health Care and Efficiency in Health Systems

Bancalari,

Bernal,

Celhay

et al. 2024

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We examine the efficiency gains in health systems generated after the national roll out of basic healthcare in El Salvador between 2010 and 2013. Using data from over 120 million consultations and five million hospitalizations, we demonstrate that the expansion of community health teams, comprising less-specialized health workers, increases preventive care and decreases curative care and preventable hospitalizations. We also estimate coverage improvements for previously unattended chronic conditions amenable to effective primary care. These results suggest that decentralization of tasks to less-specialized health workers improves efficiency, maintaining quality of care.

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Health reform in El Salvador: a lost opportunity for reducing health inequity and social exclusion?

Cited by 4 publications

References 6 publications

The Role of Social Movements in Strengthening Health Systems: The Experience of the National Health Forum in El Salvador (2009–2018)

The Role of Social Movements in Strengthening Health Systems: The Experience of the National Health Forum in El Salvador (2009–2018)

Worldwide impact of economic cycles on suicide trends over 3 decades: differences according to level of development. A mixed effect model study

An Ounce of Prevention for a Pound of Cure: Basic Health Care and Efficiency in Health Systems

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