Low-skilled "health promoters" posted in rural villages are doing little to improve health or health-seeking behaviors. In a supply-driven system, such workers have too few incentives , too little knowledge, and too little supervision. Results can be improved without increasing costs.
Low-skilled health promoters posted in rural villages are doing little to improve health or health-seeking behaviors. In a supply-driven system, such workers have too few incentives, too little knowledge, and too little supervision. Results can be improved without increasing costs. Can a supply-driven network of under-skilled rural health promoters make a difference in rural health care? There are few, if any, signs that the current rural health strategy in El Salvador is working, whether the health promoters are government employees or nongovernmental organization (NGO) workers.Lewis, Eskeland, and Traa-Valerezo arrived at this conclusion after conducting interviews and analyzing primary and secondary data. The village-based health promoters lack incentives and supervision, and ultimately have little to offer local communities. NGO workers are more successful than government workers, but neither group performs satisfactorily.Even the rural poor use private services quite intensively, despite the high cost of the services and of getting access to them.Moreover, people seem to seek the services they need. They select self-treatment in 50 percent of illness episodes, with about the same success rate as when they use health providers.Other options should be considered, as results can be improved without increasing costs.This paper - a product of the Human Development Sector Units, Europe and Central Asia Region and Latin America and Caribbean Region; and Public Economics, Development Research Group - is part of a larger effort in the Bank to encourage appropriate policies and programs in the health sector.
Students and health practitioners traveling abroad seek insightful and relevant background material to orient them to the new environment. This volume on El Salvador provides historical, political, and cultural background for contemporary health care challenges, especially related to poverty. Combining the personal insights of the authors and Salvadoran medical personnel with a broader discussion of the uniquely Salvadoran context, it is an essential guide for anyone heading to El Salvador to do health care-related work.
"Healing the Body Politic" examines the contested place of health and development in El Salvador over the last two decades. It recounts the dramatic story of radical health activism from its origins in liberation theology and guerrilla medicine during the third-world country's twelve-year civil war, through development of a remarkable "popular health system," administered by lay providers in a former war zone controlled by leftist rebels. The ethnography contributes to the integration of medical and political anthropology by bringing the semiotics of health and the body to bear on cultural understandings of warfare, the state, and globalization.
The Routeldge Handbook of Latin American Politics brings together the leading figures in the study of Latin America to present extensive empirical coverage and a cutting-edge examination of the central areas of inquiry in the region.
The perfect ambulatory care primer for undergraduate nursing students or practicing nurses transitioning from acute care settings, Perspectives in Ambulatory Care delivers expert insight into this evolving specialty and familiarizes readers with the top issues and trends they’ll encounter in ambulatory nursing practice. This authoritative resource clarifies the distinctions between ambulatory care and acute care, details the wide variety of ambulatory care roles and settings and demonstrates the growing impact and importance of nurses outside the hospital setting to help readers confidently meet the challenges of a changing healthcare landscape and succeed in this critical area of care.