TY  - BOOK
AU  - Eskeland,Gunnar
AU  - Eskeland,Gunnar
AU  - Lewis,Maureen
AU  - Traa-Valerezo,Ximena
TI  - Challenging El Salvador's Rural Health Care Strategy
PY  - 1999///
CY  - Washington, D.C.
PB  - The World Bank
KW  - Aged
KW  - Children
KW  - Clinics
KW  - Decision Making
KW  - First Aid
KW  - Health
KW  - Health Behavior
KW  - Health Care
KW  - Health Monitoring and Evaluation
KW  - Health Services
KW  - Health, Nutrition and Population
KW  - Hospitals
KW  - Injuries
KW  - Knowledge
KW  - Mortality
KW  - Patients
KW  - Physicians
KW  - Prevention
KW  - Primary Health Care
KW  - Public Health
KW  - Strategy
KW  - Workers
N2  - August 1999 - 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. The authors may be contacted at mlewis1@worldbank.org, geskeland@worldbank.org, or xtraavalerezo@worldbank.org
UR  - http://elibrary.worldbank.org/doi/book/10.1596/1813-9450-2164
ER  -