Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-12-03T19:11:47.877Z Has data issue: false hasContentIssue false
  • English
  • Français

The New Left and Health Care Reform in El Salvador

Published online by Cambridge University Press:  02 January 2018

Mary A. Clark
Mary A. Clark*
Affiliation:
Tulane University. [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

After a decade of civil war and four consecutive conservative administrations, El Salvador's leftist FMLN won its first presidential election in 2009. How has public policy changed under this New Left government, and why? This article addresses the question in the area of public health care. An alliance of health sector leaders with both technocratic and diplomatic abilities capitalized on the policy window opened by the FMLN's electoral victory and worked within the parameters set by President Mauricio Funes, the FMLN, and civil society to universalize health care. The new minister of health, a professional highly esteemed inside and outside the country, was able to engage both a large social movement protesting neoliberal policy and an energetic health diplomat sent by the Pan American Health Organization. In designing its reform, this alliance benefited from international as well as “bottom-up” policy diffusion.

Type
Research
Information
Latin American Politics and Society , Volume 57 , Issue 4 , Winter 2015 , pp. 97 - 118
Copyright
Copyright © University of Miami 2015

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Action for Global Health. 2015. Universal access to maternal health in El Salvador on the way. Europa.eu, March 17. https://europa.eu/eyd2015/en/action-global-health/stories/universal-health-coverage. Accessed November 4, 2015.Google Scholar
Allison, Michael E., and Martín Álvarez, Alberto. 2012. Unity and Disunity in the Fmln. Latin American Politics and Society 54, 4 (Winter): 89–118.Google Scholar
Almeida, Paul. 2009. Social Movements, Political Parties, and Electoral Triumph in El Salvador. NACLA Report on the Americas 42, 6): 16–21.Google Scholar
Almeida, Paul. 2010. El Salvador: elecciones y movimientos sociales. Revista de Ciencia Política 30, 2): 319–34.Google Scholar
Aquino, Rosana, de Oliveira, Nelson F., and Barreto, Maruicio L.. 2009. Impact of the Family Health Program on Infant Mortality in Brazilian Municipalities. American Journal of Public Health 99, 1): 87–93.Google Scholar
Bossert, Thomas J., and Hill, Esther E. M.. 2013. Análisis de la política pública de salud en El Salvador. San Salvador: FUSADES.Google Scholar
Briggs, Charles L., and Mantini-Briggs, Clara. 2009. Confronting Health Disparities: Latin American Social Medicine in Venezuela. American Journal of Public Health 99, 3): 549–55.Google Scholar
Brouwer, Steve. 2011. Revolutionary Doctors: How Venezuela and Cuba Are Changing the World's Conception of Health Care. New York: Monthly Review Press.Google Scholar
Chan, Margaret. 2007. Director-General, World Health Organization. Keynote Address at the International Seminar on Primary Health Care in Rural China. Beijing, November 1. www.who.int/dg/speeches/2007/20071101_beijing/en. Accessed January16, 2014.Google Scholar
Clark, Mary A. 2004. Reinforcing a Public System: Health Sector Reform in Costa Rica. In Crucial Needs, Weak Incentives: Social Sector Reform, Democratization, and Globalization in Latin America, ed. Kaufman, Robert R. and Nelson, Joan M.. Washington, DC: Woodrow Wilson Center Press/Johns Hopkins University Press. 189–216.Google Scholar
Comisión Intersectorial de Salud (CISALUD). 2012. Abordaje intersectorial de los determinantes de la salud y la enfermedad en El Salvador. San Salvador: MINSAL.Google Scholar
Abrego, Dubón, Argelia, María. 2013. Director of Primary Care, Minsal. Author interview. San Salvador, July 11.Google Scholar
Abrego, Dubón, Argelia, María, Menjívar López, Dagoberto, Espinoza Fiallos, Eduardo, and Baatz, Christa. 2012. La construcción del sistema comunitario de salud de Guarjila: sistematización de una experiencia de atención primaria de salud integral en El Salvador durante el período 1987–2007. Saúde em Debate 36, 94): 414–20.Google Scholar
Flores, Henry. 2013. Salud aumentó abastecimiento de medicamentos a más del 80% y eliminó pago de cuotas. Transparencia Activa (El Salvador), August 15. www.transparenciaactiva.gob.sv/salud-aumento-abastecimiento-de-medicamentos-a-mas-del-80-y-elimino-pago-de-cuotas. Accessed December 29, 2014.Google Scholar
Flores-Macías, Gustavo A. 2012. After Neoliberalism? The Left and Economic Reforms in Latin America. New York: Oxford University Press.Google Scholar
Fundación Salvadoreña para el Desarrollo Económico y Social (FUSADES). 2013. Los desafíos de una provisión efectiva para el acceso a medicamentos. Report. San Salvador.Google Scholar
Gilardi, Fabrizio. 2012. Transnational Diffusion: Norms, Ideas, and Policies. In Handbook of International Relations, ed. Carlsnaes, Walter, Risse, Thomas, and Simmonds, Beth. Thousand Oaks: Sage. 453–77.Google Scholar
González, Luis Armando. 2011. El Fmln salvadoreño: de la guerrilla al gobierno. Nueva Sociedad 234: 143–58.Google Scholar
Grugel, Jean, and Riggirozzi, Pía. 2012. Post-neoliberalism in Latin America: Rebuilding and Reclaiming the State after Crisis. Development and Change 43, 1): 1–21.Google Scholar
Jacob, Suraj, Scherpereel, John A., and Adams, Melinda. 2014. Gender Norms and Women's Political Representation: a Global Analysis of Cabinets, 1979–2009. Governance 27, 2): 321–45.Google Scholar
Jones, Mark P. 2009. Democracy in the LAC Region, Challenges and Solutions: Political Party and Party System Institutionalization and Women's Legislative Representation. In Latin American Development Priorities, ed. Lomborg, Bjorn. New York: Cambridge University Press. 13–44.Google Scholar
Labonté, Ronald, Sanders, David, Packer, Corinne, and Schaay, Nikki. 2014. Is the Alma Ata Vision of Comprehensive Primary Health Care Viable? Findings from an International Project. Global Health Action 7. www.globalhealthaction.net/index.php/gha/article/view/24997 Google Scholar
Levitsky, Steven, and Roberts, Kenneth M.. 2011. Introduction: Latin America's “Left Turn”: A Framework for Analysis. In The Resurgence of the Latin American Left, ed. Levitsky, and Roberts, . Baltimore: Johns Hopkins University Press. 1–28.Google Scholar
Linares, Carmen, and Pastrán, Rosa. 2009. “No más cuotas voluntarias” dice Funes. elsalvador.com. June 10. www.elsalvador.com/mwedh/nota/nota_completa.asp?idCat=6364&idArt=3718997. Accessed December 29, 2014.Google Scholar
Madrid, Raúl L., Hunter, Wendy, and Weyland, Kurt. 2010. The Policies and Performance of the Contestatory and Moderate Left. In Leftist Governments in Latin America: Successes and Shortcomings, ed. Weyland, Madrid, and Hunter, . New York: Cambridge University Press. 140–80.Google Scholar
Martí y Puig, Salvador, Garcé, Adolfo, and Martín, Alberto. 2013. Liderazgo, organización o ideología? Las diferentes vías de adaptación partidaria de los movimientos guerrilleros. Los casos de Nicaragua, El Salvador, y Uruguay. Revista Española de Ciencia Política 33: 57–79.Google Scholar
Ministerio de Salud de El Salvador (MINSAL). 2013. Informe de labores 2012–2013. San Salvador: MINSAL.Google Scholar
Ministerio de Salud de El Salvador (MINSAL). 2014. Informe de labores 2013–2014. San Salvador: MINSAL.Google Scholar
Ministerio de Salud de El Salvador (MINSAL) and Pan American Health Organization (PAHO). 2004. Exclusión social en salud en El Salvador. San Salvador.Google Scholar
Montoya, Ainhoa. 2013. The Violence of Cold War Polarities and the Fostering of Hope: The 2009 Elections in Postwar El Salvador. In Central America in the New Millennium, ed. Burrell, Jennifer and Moodie, Ellen. New York: Berghahn Books. 49–63.Google Scholar
Pan American Health Organization (PAHO). 2007. Renewing Primary Care in the Americas: A Position Paper of the Pan American Health Organization/World Health Organization (PAHO/WHO). Washington, DC: PAHO.Google Scholar
Pan American Health Organization (PAHO). 2010. Redes integradas de servicios de salud: conceptos, opciones de política y hoja de ruta para su implementación en las Américas. Washington, DC: PAHO.Google Scholar
Pan American Health Organization (PAHO). 2011. El Salvador: estudio de caracterización y análisis de exclusión social en salud: 2002–2010. San Salvador.Google Scholar
Pan American Health Organization (PAHO). 2012. Análisis de los avances de la reforma de salud en El Salvador en el período 2009–2011. Report. San Salvador.Google Scholar
Pan American Health Organization (PAHO). 2014. El Salvador en el camino hacia la cobertura universal de salud: logros y desafíos. Report. San Salvador.Google Scholar
Perla, Héctor Jr., and Cruz-Feliciano, Héctor. 2013. The Twenty-first-Century Left in El Salvador and Nicaragua: Understanding Apparent Contradictions and Criticisms. Latin American Perspectives 40, 3): 83–106.Google Scholar
Reygadas, Luis, and Filgueira, Fernando. 2010. Inequality and the Incorporation Crisis: The Left's Social Policy Toolkit. In Latin America's Left Turns: Politics, Policies, and Trajectories of Change, ed. Cameron, Maxwell A. and Hershberg, Eric. Boulder: Lynne Rienner. 171–91.Google Scholar
Robles, Julio. 2013. National Director of Hospitals, Minsal. Author interview. San Salvador, July 12.Google Scholar
Rodríguez, María Isabel. 2009. Construyendo la esperanza: estrategias y recomendaciones en salud, 2009–2014. San Salvador: MINSAL.Google Scholar
Ruales, José. 2014. Country Representative, Pan American Health Organization-El Salvador. Telephone interview. September 8.Google Scholar
Sanz, José Luis. 2013. Manuel Alcántara, politólogo: “Mauricio Funes ha sido una decepción, un fraude.” ElFaro.net, September 1. www.elfaro.net/es/201309/noticias/13159.Accessed November 20, 2014.Google Scholar
Smith-Nonini, Sandy. 2010. Healing the Body Politic: El Salvador's Popular Struggle for Health Rights from Civil War to Neoliberal Peace. New Brunswick: Rutgers University Press.Google Scholar
Spalding, Rose J. 2014. Contesting Trade in Central America: Market Reform and Resistance. Austin: University of Texas Press.Google Scholar
Weyland, Kurt. 2006. Bounded Rationality and Policy Diffusion: Social Sector Reform in Latin America. Princeton: Princeton University Press.Google Scholar
Weyland, Kurt. 2010. The Performance of Leftist Governments in Latin America. In Leftist Governments in Latin America: Successes and Shortcomings, ed. Weyland, Raúl L. Madrid, and Hunter, Wendy. New York: Cambridge University Press. 1–27.Google Scholar
World Bank. 1993. World Development Report 1993: Investing in Health. New York: Oxford University Press.Google Scholar
World Bank. 2007. Healthy Development: The World Bank Strategy for Health, Nutrition, and Population Results. Washington, DC: World Bank.Google Scholar
World Bank. 2011. Project Appraisal Document on a Proposed Loan in the Amount of Us$80 Million to the Republic of El Salvador for the Strengthening Public Health Care System Project. Washington, DC.Google Scholar