El Salvador
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El Salvador Assessment. ´. ´. ´. Jose Francisco Lopez Beltran. El Salvador. UNDP 1998, World Bank 1999. Health Care Delivery System. Major Health Care Providers Public: MSPAS (MOH) 42% ISSS 12% Private: NGOs 9% For Profit 37%. Pharmaceutical Sector.

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El Salvador Assessment

´

´

´

Jose Francisco Lopez Beltran

El Salvador


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El Salvador

UNDP 1998, World Bank 1999

El Salvador


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Health Care Delivery System

Major Health Care Providers

  • Public:

    • MSPAS (MOH) 42%

    • ISSS 12%

  • Private:

    • NGOs 9%

    • For Profit 37%

El Salvador


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Pharmaceutical Sector

  • Total value of market US $190.5 million

    • Private expenditure: 77%

    • MSPAS (MOH): 10%

    • ISSS: 13%

  • More than 25,000 products registered

  • 60 manufacturers

  • 30 distributors

  • 1,500 pharmacies

El Salvador


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Geographic Accessibility

Average number of facility operating hours per day

Hours

El Salvador


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Availability

Percent

Set of un-expired tracer items in stock

Time out

of stock

Percent dispensed

El Salvador


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Affordability

Number of days worked to treat key conditions

  • Population covered by risk sharing scheme:

    • ISSS: 15%

    • Private insurance: 2%

El Salvador


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Affordability (2)

  • MOH central level purchase price is 82% above median International Tender Price

  • Hospital purchase prices are 23% higher than central level purchase price

El Salvador


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Quality of Products and Services

Drug samples that failed quality testing

Samples found substandard by MOH lab

44.1%

Percent

26.3%

26.5%

4.5%

0.6%

El Salvador


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Quality of Products and Services (2)

Patient Exit Survey

Simulated Client Survey

Percent

Encounters

with antibiotic prescription

Encounters

with vitamin prescription

El Salvador


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Access Gaps

  • Affordability

    • 28% of population earns less than minimum wage

  • Availability

    • Inefficient procurement compounds budget limitations and affects availability in MSPAS and NGO sectors

  • Quality

    • Product and service quality need to be improved

El Salvador


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Potential Strategy

El Salvador


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Viability

  • Facilitators:

    • Current legislation and reform policy

    • MSPAS decentralization is under way

    • NGOs interested in participating with MSPAS

    • Private sector firms have the interest and capacity to provide services

  • Barriers:

    • Payment mechanisms need to be modified

    • Some political opposition to current reforms

El Salvador


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