February 16, 2012

Health Care Delivery in El Salvador

Over the past week, we have been engaged in a number of community health campaigns in Las Delicias (see our next post!) and at the local branch of the Unidad de Salud (a clinic run by the El Salvador Ministry of Health). Since a major part of our learning experience is understanding the context of health care delivery in El Salvador, I wanted to dedicate a post to this topic.

The Salvadoran Health Care System
A quick explanation of the health care delivery system of El Salvador: 
  • 80% of the population is covered by the Ministry of Health's public system
  • 15% is covered by an employment-based Social Security system (teachers and government workers belong to this sector)
  • 5% is covered by private insurance
  • Note: everyone is "covered" by one of these 3 systems

Ministry of Health and Unidad de Salud
  • El Salvador has been split into regions by the Ministry of Health; each region features:
    • A "Unidad de Salud" staffed by several primary care physicians, nurses, psychologists, dentists, pharmacists, and other allied health professionals (ummm, the Salvadoran version of a Patient-Centered Medical Home!) 
    • An over-flow clinic system (more like "urgent care" in the US, with night and weekend hours)
    • Very limited hospital access (there is something like 4,000 hospital beds to cover 4 million people nation-wide)
  • Within each region, the population is divided into a number of communities, and each community has a Health Promoter who:
    • Receives resources from the Unidad de Salud
    • Uses his/her knowledge of the community along to effectively communicate important public health messages 
    • Collects and reports various health statistics

Where Do we Fit?
The FIMRC clinic here is technically private, but it serves as an adjunct to patients who would otherwise be going to the Unidad de Salud. To gain some perspective on that system, we spent a day shadowing the physicians at the Unidad de Salud last week. Patients were seen on a first-come-first-serve basis, with no real system of doctor's appointments. Most patients arrived early in the morning, and some waited all day to be seen. The physicians had a 10-15 minute visit with each patient, regardless of their presenting problem, past medical history, or whether this was their first visit. There was a Pediatrician, two Family Docs, and one Internist. Many chief complaints were common and benign, but complicated and "zebra" patients were seen here as well. Despite the many limitations, it was clear to us that all of the staff at Unidad de Salud are hard-workers who are truly invested in the health of their patients.

1 comment:

El Salvador Shipping said...

That's a very effective health care system, compared to America's.

-Panamerican Shipping

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