El Salvador is in the paradoxical situation of producing a relatively large overall number of health workers, yet not being able to meet population needs within the context of the country’s universal health care coverage and the new national health strategy of comprehensive primary health care. Primary challenges include:
- Unemployment and under-employment due to overproduction of health workers in certain categories, financial inability of the health sector to recruit, and inequitable distribution of health workers at different levels of service
- A 43% deficit of health workers for primary care services coupled with inequitable geographic, demographic, and institutional distribution of existing resources
- Disparity in working conditions and financial incentives between Social Security (ISSS) and the Ministry of Health
- Lack of health workers adequately trained for implementation of the current comprehensive health care strategy based on primary care
- Weak mechanisms of coordination and cooperation between health sector institutions and health worker training centers
- Lack of an information system that allows timely HRH decision-making to solve problems and generate personnel actions oriented to the development and quality of care.
(Situación de los Recursos Humanos en Salud en el Salvador: Estudio de caso, 2010)
HRH development encompasses 4 key areas: management capacity and policy; HRH planning and regulation; change in health worker quality and working conditions; and coordination of HRH education. Goals for these 4 areas have been developed within the context of the current 5 year national health strategic plan (Construyendo la Esperanza, Estrategias y Recomendaciones en Salud 2009-2014). Objectives are aimed at:
- Collecting information for the strategic management of HRH development
- HRH education planning and coordination
- Policies to improve health workers’ working conditions and occupational health
- Improving the performance capacity of community health workers
- Increasing nursing staff and medical specialists
- Strengthening the Directorate of HRH
- Strengthening the training of medical specialists.
El Salvador also has recently created a Directorate of Development for Human Resources for Health and CISALUD, an intersectoral commission for health to coordinate health-related activities including those related to HRH. The commission includes the Ministries of Health, Labor, Treasury, and various public agencies.
COUNTRY COORDINATION AND FACILITATION (CCF) IN EL SALVADOR:
El Salvador has completed a formal CCF orientation, an informal stakeholder analysis, an informal HRH coordination structure, and an HRH policy strategic plan. To date, an HRH operational plan has not yet been completed (Overview of GHWA and Experiences with Country Coordination & Facilitation, Pariyo, Nov 2011). El Salvador has put in place a mechanism to inform policy-making, and a functioning HRH information system (KD/AGA Progress Report, 2011, GHWA).
Health Workforce Data
- Latest data available from PAHO: Observatorio Regional de Recursos Humanos de Salud (22/10,000 (2010))
HUMAN RESOURCES FOR HEALTH PLAN
El Salvador is in the initial planning phase of developing an HRH operational plan. For more information on the process see:
- “Construyendo la Esperanza: La Transformación del Sistema de Salud y las Políticas de Recursos Humanos en El Salvador” in: Planes de Recursos Humanos y Atención Primaria de Salud: Desafíos para la Coordinación Intersectorial y Social (2011)
HEALTH SECTOR STRATEGIES / PLANS
- Construyendo la Esperanza, Estrategias y Recomendaciones en Salud 2009- 2014 (in Spanish)
- Construyendo la Esperanza, Estrategias y Recomendaciones en Salud 2009- 2014 (in English)
COUNTRY CASE STUDIES AND OTHER DOCUMENTS
- Situación de los Recursos Humanos en Salud en el Salvador: Estudio de caso (2010)
- Propuesta Política de Desarrollo de Recursos Humanos en Salud. 2006
- Health Systems Profile El Salvador: Monitoring and Analyzing Health Systems Change (PAHO/USAID, 2007)
- >> Alliance Knowledge Centre resources: El Salvador
- >> More Resources From the HRH Global Resource Center