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El Salvador Assessment

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

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  1. El Salvador

  2. El Salvador Assessment ´ ´ ´ Jose Francisco Lopez Beltran El Salvador

  3. El Salvador UNDP 1998, World Bank 1999 El Salvador

  4. Health Care Delivery System Major Health Care Providers • Public: • MSPAS (MOH) 42% • ISSS 12% • Private: • NGOs 9% • For Profit 37% El Salvador

  5. 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

  6. Geographic Accessibility Average number of facility operating hours per day Hours El Salvador

  7. Availability Percent Set of un-expired tracer items in stock Time out of stock Percent dispensed El Salvador

  8. Affordability Number of days worked to treat key conditions • Population covered by risk sharing scheme: • ISSS: 15% • Private insurance: 2% El Salvador

  9. 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

  10. 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

  11. Quality of Products and Services (2) Patient Exit Survey Simulated Client Survey Percent Encounters with antibiotic prescription Encounters with vitamin prescription El Salvador

  12. 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

  13. Potential Strategy El Salvador

  14. 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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