Extension of Health Services Coverage in El Salvador : The RHESSA Project Experience
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World Bank, Washington, DC
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For a variety of reasons, the
governments of Central America have struggled to provide
basic healthcare services to their rural and impoverished
populations. The lack of incentives for healthcare personnel
to reside in or even to travel to remote areas, along with
the deep rural-urban and rich-poor divides have resulted in
poor coverage and poor health indicators. Further, language
and cultural barriers and the lack of a budget for
transportation in the rural departments have added to the
complications in meeting the needs of the poor. In an effort
to address the poor health indicators and the clients'
complaints, to achieve equitable access to healthcare, and
to reach the goals established by the Millennium Development
Goals, the Salvadoran Government sought to extend essential
healthcare services to disadvantaged populations, especially
mothers and children, the poor, and rural and indigenous
populations. With the help of a World Bank loan, the
Ministry focused on: (1) solidifying the provision of health
services to remote and poor areas; (2) expanding coverage;
and (3) institutionalizing the program to assure its
sustainability and governance for improved health results.
Given the emerging financial crisis, which could affect the
size and effectiveness of social budgets, the challenge is
to maintain this program and consolidate the improvements of
the health indicators.
Palabras clave
ALLOCATION OF RESOURCES, AT RISK GROUPS, CERVICAL CANCER, CHILD NUTRITION, COMMUNITIES, COMPLICATIONS, DEATHS, DISADVANTAGED POPULATIONS, DOCTORS, EARLY DETECTION, EARTHQUAKE, EQUITABLE ACCESS, EXTENDED SERVICES, FEE-FOR-SERVICE, HEALTH INDICATORS, HEALTH INTERVENTIONS, HEALTH MANAGEMENT, HEALTH NEEDS, HEALTH RESULTS, HEALTH SERVICE, HEALTH SERVICES, HEALTH STATUS, HEALTH STRATEGY, HEALTH SYSTEM, HEALTHCARE SERVICES, HEALTHCARE SYSTEM, HOSPITAL, HOSPITAL BEDS, IMPROVEMENTS IN HEALTH, INDIGENOUS POPULATIONS, INFANT, INFANT MORTALITY, INFANT MORTALITY RATE, INFECTIOUS DISEASES, INFORMATION SYSTEM, INHABITANTS, INSTITUTIONAL CAPACITY, INSTITUTIONALIZATION, LIFE EXPECTANCY, LIVE BIRTHS, MATERNAL MORTALITY, MEDICAL ATTENTION, MEDICAL SUPPLIES, MEDICINES, MILLENNIUM DEVELOPMENT GOAL, MILLENNIUM DEVELOPMENT GOALS, MINISTRY OF HEALTH, MOBILE HEALTH UNITS, MORTALITY, NATIONAL PRIORITY, NEWBORNS, NON-GOVERNMENTAL ORGANIZATIONS, NURSE, NURSES, NUTRITION, POOR HEALTH, PREGNANCIES, PREGNANT WOMEN, PRIVATE SECTOR, PROGRESS, PROVISION OF HEALTH SERVICES, PROVISION OF SERVICES, PUBLIC HEALTH, PUBLIC HEALTH SYSTEM, QUALITY OF SERVICES, RURAL AREAS, SERVICES FOR CHILDREN, SET OF GOALS, TRANSPORTATION, VACCINATION, VACCINATIONS, VACCINES, VULNERABLE POPULATIONS