Masters Thesis

Challenges in promoting the private health care system in El Salvador

The healthcare system in El Salvador is perceived as a fundamental human right that falls under the responsibility of the government. Based on this principle, the government of El Salvador promotes a public healthcare model that provides not only healthcare services but it also influences the cultural, socioeconomic and political arena of the nation. Even though the government healthcare system has become the main provider of healthcare services in the nation, it has been done under a mountain of multiple struggles and challenges that include elevated rates of communicable and non-communicable diseases, population’s limited access to care and increasing high cost of healthcare services. Private healthcare services have been proposed by private stakeholders involved in the delivery of healthcare services; however, these proposals have also been rejected and associated to a mercantilist transformation of this human right into a private business model. Under this environment, the private health care sector has been underexploited and/or under-utilized by a population who still has not been able to reach acceptable health care indicators (World Health Organization [WHO], 2014). The purpose of this study was to identify, evaluate and propose possible reasons why the private sector has failed to fill in the gap left by the current government health care system. At the same time, recommendations to enhance and promote access and quality of care through private healthcare services that can provide a viable alternative to the general health care system are proposed. Also explored were the cultural awareness and behavioral theories that affect the limited use of healthcare resources in the private healthcare sector. The research methods used for this study were a non-experimental, qualitative method that uses a hermeneutics analysis technique for the text interpretation of the documents, theory and data collected for this analysis. The material used for this analysis was acquired through the use of published materials available on the internet and world health organizations. The limitations for this study include the poor accessibility, scarcity and disperse sources of information about the private healthcare sector in El Salvador. Based on these challenges, three recommendations are proposed: first, the use of government vouchers to supplement payment at the point of service in the private sector. These vouchers should be used only in private healthcare establishments to inject revenue, competition, investment and quality of care in the private healthcare sector. Second, the creation of a national policy that demonstrates the commitment of the government to implement the voucher ticket in the private healthcare system which may promote behavioral changes and encourage the use of the private healthcare services by the population. Third, the investment in the private healthcare sector can be supported by international organizations that see the opportunity for investment in a foreign friendly market without competition which rewards high quality of services and promotes them as an alternative access to healthcare for the general population.


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