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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

health care delivery system
Health Care Delivery System

Major Health Care Providers

  • Public:
    • MSPAS (MOH) 42%
    • ISSS 12%
  • Private:
    • NGOs 9%
    • For Profit 37%

El Salvador

pharmaceutical sector
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

geographic accessibility
Geographic Accessibility

Average number of facility operating hours per day

Hours

El Salvador

availability
Availability

Percent

Set of un-expired tracer items in stock

Time out

of stock

Percent dispensed

El Salvador

affordability
Affordability

Number of days worked to treat key conditions

  • Population covered by risk sharing scheme:
    • ISSS: 15%
    • Private insurance: 2%

El Salvador

affordability 2
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

quality of products and services
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

quality of products and services 2
Quality of Products and Services (2)

Patient Exit Survey

Simulated Client Survey

Percent

Encounters

with antibiotic prescription

Encounters

with vitamin prescription

El Salvador

access gaps
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

viability
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