Central America Social Expenditures and Institutional Review

World Bank

Central America Social Expenditures and Institutional Review

Autores

World Bank

Editor

Washington, DC

Descripción

El Salvador’s development over the past decade has been dichotomous. On the one hand, economic growth has remained persistently low, employment and labor force participation have barely increased, and progress on poverty reduction has slowed. On the other hand, inequality has fallen, and shared prosperity improved together with advances in many social indicators, such as pre-primary enrollment rates, access to prenatal care, immunizations, and water and sanitation. The increase in the use of social spending, which now accounts for 12.4 percent of GDP, together with an improvement in the quality of social spending, explain at least part of this dichotomy of redistributive and social gains despite low growth, a tight fiscal situation and generally low government revenues and spending. Looking forward, the key challenges El Salvador faces are related to continuing improving the quality and efficiency in the social sectors, while maintaining the overall level of social spending within an increasingly constrained fiscal environment, where fiscal constraints, low revenues, and the need to cut the deficit by 3 percent of GDP are significant elements, as well. Priority will have to be given to reallocations and improvements within the spending envelope for the social sectors to maximize impact. This document analyzes social spending for El Salvador for the education, health and social protection and labor sectors in depth and explores a series of policy options for El Salvador to reallocate social spending for more effective impacts, to enhance and reform social policies and social service delivery, and to improve the management of public spending and budget execution in the social sectors.

Palabras clave

INFANT MORTALITY RATES, ACCESS TO HEALTH CARE, CHILD HEALTH, REPRODUCTIVE HEALTH, UNEMPLOYMENT RATES, BASIC EDUCATION, ECONOMIC GROWTH, OLDER MEN, QUALITY OF SERVICES, QUALITY OF HEALTH CARE, PUBLIC EDUCATION, MATERNAL MORTALITY DATA, LIVE BIRTHS, REDUCING MATERNAL MORTALITY, LABOR FORCE, DISCRIMINATION, GROSS ENROLLMENT RATIO, HEALTH CARE, DEVELOPMENT POLICIES, CRIME, SOCIAL PROGRAMS, FUTURE GENERATIONS, INFORMATION SYSTEMS, HOSPITAL, COMMUNITY PARTICIPATION, MATERNAL MORTALITY, INEQUITIES, HOSPITALIZATION, KNOWLEDGE, HEALTH SECTOR, LABOR MARKET, PUBLIC POLICY, UNIVERSAL PRIMARY EDUCATION, MILLENNIUM DEVELOPMENT GOAL, IMMUNIZATION, TRAINING, HEALTH-CARE POLICY, INTERVENTION, HEALTH INDICATORS, PUBLIC HOSPITALS, CHILD DEVELOPMENT, SECONDARY SCHOOL, HEALTH CARE SERVICES, VIOLENCE, VULNERABLE POPULATIONS, DISSEMINATION, HOUSEHOLD SURVEYS, MORTALITY RATE, SERVICE DELIVERY, SCHOOL LEVELS, MORTALITY, HEALTH CARE SYSTEM, HEALTH PROMOTION, ELDERLY, RISK GROUPS, PROGRESS, INFANT MORTALITY, INFANT, HUMAN CAPITAL, NATIONAL STRATEGY, POLICIES, SOCIAL SECTOR, AGED, QUALITY OF CARE, USER FEES, SCHOOL ATTENDANCE, ECONOMIC STATUS, VULNERABLE GROUPS, CHLAMYDIA, EARLY CHILDHOOD, DECISION MAKING, DISADVANTAGED GROUPS, SCHOOL CHILDREN, MEASUREMENT, POPULATIONS, YOUNG CHILDREN, ADOLESCENTS, POPULATION ESTIMATES, CHILD MORTALITY, SOCIAL POLICIES, HEALTH SYSTEM, WEIGHT, MINORITY, TEACHER RATIO, CHILDREN, MATERNAL DEATHS, LOW BIRTH WEIGHT, NUMBER OF CHILDREN, OLD SYSTEM, HOSPITAL BEDS, POPULATION, PURCHASING POWER PARITY, TRAUMA, GONORRHEA, MEDICINES, HOSPITALS, MATERNAL MORTALITY RATES, LABOR MARKETS, ILLNESSES, COMPLICATIONS, INFANT MORTALITY RATE, FINANCIAL CONSTRAINTS, SECONDARY EDUCATION, INTERNATIONAL COMPARISONS, PREGNANCY, HUMAN DEVELOPMENT, SANITATION FACILITIES, SANITATION, NATIONAL DEVELOPMENT PLAN, PEOPLE, INFORMATION SYSTEM, PREVENTION, EMPLOYMENT OPPORTUNITIES, LEVELS OF EDUCATION, COMMUNITY HEALTH, POPULATION GROUPS, DRUGS, NATIONAL DEVELOPMENT, PRENATAL CARE, HEALTH, HYPERTENSION, NUMBER OF PEOPLE, RURAL POPULATION, HEALTH FACILITIES, PUBLIC HEALTH, COST EFFECTIVENESS, DIABETES, COMMUNITY DEVELOPMENT, MINISTRY OF HEALTH, SOCIAL SERVICE, DISEASES, CAUSES OF DEATH, POOR FAMILIES, HEALTH SYSTEMS, MIGRATION, COVERAGE OF POPULATION, TIMELY USE, MODERNIZATION, ACCESS TO HEALTH SERVICES, PRIMARY HEALTH SERVICES, SOCIAL SECURITY, TEACHER SALARIES, SCHOOL STUDENTS, PRIMARY SCHOOL, GROSS DOMESTIC PRODUCT, SOCIAL DEVELOPMENT, SOCIAL EXPENDITURES, DISPARITIES IN HEALTH, NATIONAL HEALTH SYSTEM, PRIMARY SCHOOLS, UNEMPLOYMENT, HOUSEHOLD LEVEL, FOOD SECURITY, WORKERS, SURVEILLANCE, PENSIONS, IMPACT ON HEALTH, HEALTH POLICY, MINISTRY OF EDUCATION, PURCHASING POWER, SOCIAL POLICY, HEALTH OUTCOMES, UNIVERSAL ACCESS, SAFETY NET, POPULATION DENSITY, URBAN AREAS, IMMUNIZATIONS, MEASLES, NUTRITION, POLICY, PRIMARY HEALTH CARE, SOCIAL SECTORS, VACCINES, HUMAN RIGHTS, COMMUNICABLE DISEASES, PREGNANT WOMEN, CARDIOVASCULAR DISEASES, CITIZENSHIP, PUBLIC HEALTH SERVICES, RURAL AREAS, ILLNESS, COMMUNITY EDUCATION, STUDENTS, NEONATAL MORTALITY, LOCAL DEVELOPMENT, DIGESTIVE SYSTEM, UNFPA, STRATEGY, PRIMARY EDUCATION, SCARCE RESOURCES, FAMILIES, WOMEN, IMPLEMENTATION, HEALTH SERVICES, TERTIARY EDUCATION, AT RISK GROUPS