Committee on the rights of the child


C. Health and health services



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C. Health and health services


  1. Furthermore, health care for children is still a priority for the State of El Salvador and it contiues to earmark funds for it, as the following table shows.
Figure 49
Department of health service planning
Health information unit
Cost of child care, 2004, 2005, 2006
Dollars

Costs of hospital child care

Costs of primary-level child care

Year

Child check-ups

Child morbidity

Child check-ups

Child morbidity

Production

Unit cost

Production

Unit cost

Production

Total cost

Unit cost

Production

Total cost

Unit cost

2004

208,486.00

14.80

2,217,023.00

15.40

1,133,296.25

4,576,183.23

4.30

2,080,574.36

9,709,485.21

4.64

2005

155,627.00

14.56

2,255,782.00

17.24

1,064,602.14

6,123,168.19

5.98

2,029,929.94

12,005,318.17

5.43

2006

Scrubbed data not yet available

1,070,643.05

5,343,550.75

4.99

2,037,613.71

10,070,190.69

4.94

Source: Management Information System, 2004-2006

  1. There was a reduction in the proportion of households with no access to piped drinking water, whether via a connection to the home or an easily accessible public source,30 and the country is nearing compliance with the following goals:
Figure 50

GOAL: reduce by one third (2010) (PA-MANA A, 1, 36 (d))

30.7%

GOAL: reduce by half (2015) (MDG 7)

23.0%



  1. Between 1991 and 2005 the proportion of households without access was reduced from 46.06% to 31.92%, a decrease of 14.17 percentage points, at an average rate of 0.94 points a year. If this overall rate is maintained it is highly likely that the country will achieve the goals for 2010 and 2015.31

  2. Between 1991 and 2005 the proportion of households without access to main drainage, a septic tank or earth closet was reduced from 24.16% to 10.12%, a decrease of 14.04 percentage points, at an average rate of 0.94 points a year, which shows that the goal for 2010 (16.11%) has already been achieved and exceeded at national level.32

  3. The Salvadoran Government has set up a Health Solidarity Fund (Fosalud), with a view to raising, collecting, and distributing financial resources to improve public health care. Over the 2005 and 2006 financial years, Fosalud paid out the fololowing amounts for children.
Figure 51
Health Solidarity Fund
Expenditure on children
Tax years 2005 and 2006
Thousand dollars

Description

2005

2006

Expenditure on children 1/

4,136.1

13,876.2

Number of health centres

66.0

105.0

Percentage contribution to total expenditure

80.0

66.2

1/ in 2006 cover was given for: purchase of vaccines for rotavirus, dengue prevention, development of the Maternal and Infant Health Programme on the islands of Jiquilisco Bay and at the San Julián Maternal and Infant Nutrition Centre.

  1. Families in the poorest municipalities of El Salvador represent major challenges which are the basis for the “Solidarity Network”, which since 2004 includes the component of front-line combat against poverty as a part of the Presidential “Opportunities” Programme, which works with sympathizer members, participating municipalities, NGOs, the international community, private enterprise, and work coordinated by the government ministry.

  2. The Solidarity Network tackles extreme poverty in rural areas and in the municipalities that have been identified as most lacking basic services. These are families which, besides having no income, have no access to basic services such as energy, roads, water or health. The Solidarity Network transfers money to every houshold that is in severe extreme poverty, on two conditions: that the children go to school, and that babies and their mothers undergo nutritional and health check-ups.

  3. The important thing is to provide a basic platform to rescue them from the extremely fragile conditions in which they live. Later, they are provided with tools so that they can progress through work and effort, giving priority to health care and education for their children. Most poor households are run by a woman. Solidarity Network aims to comply with the United Nations Millennium Development Goals for the year 2015, and advocates transforming the poverty map of this country, building a viable and sustainable environment, with chances to develop in an environment of new opportunities.

  4. Solidarity Network’s vouchers are already supporting more than 48,000 families in 47 municipalities, 32 of severe extreme poverty and 15 of high extreme poverty, and it had paid out more than $10 million nationwide up to the end of 2007. For 2008, the Network will be extended, with education and health vouchers for 30 new municipalities in high extreme poverty, thereby completing coverage of 77 municipalities.

  5. Note that in the 32 municipalities in severe extreme poverty where the Network operates, there have been signs of an increase in health checks, including ante-natal check-ups, check-ups on babies under one year old and puerperal check-ups. Enrolments have also increased in these 32 municipalities, 23% in nursery school, 6% in first cycle and 9% in second cycle.

  6. The Programme’s main achievements by theme up to December 2007 include:

a) Theme 1: Family solidarity network

  1. Action in 47 municipalities in severe and high extreme poverty;

  2. 87,326 homes surveyed;

  3. 48,659 beneficiary families and $10.7 million handed out in health and education vouchers to severe and high extreme poverty municipalities.

  4. More than 48,000 parents trained in topics such as child health and nutrition, child rights, domestic violence and healthy housing.

b) Theme 2: Basic services network

  1. $32.4 million of investment in basic social infrastructure in 47 municipalities in severe and high extreme poverty, benefiting some 446,447 people (FISDL);

  2. 105 Effective Schooling Networks implemented by MINED;

  3. 83 municipalities served by the MSPAS Health Services Coverage Extension Programme;

c) Theme 3: Family sustainability network

  1. 28,416 families benefit under production projects implemented by the Ministry of Agriculture and Livestock (MAG), in September 2007;

  2. 7,047 microloans provided through the Multisectoral Inverstment Bank (BMI) in municipalities covered by the Programme. These microloans totalled $12.2 million at September 2007.

  1. Solidarity Network operates in three stages:

          1. Immediately changing living conditions;

          2. Expanding opportunities to access basic services such as water and education;

          3. Changing the economic enviroment and helping people to find a sustainable source of income and family development, especially when the woman is alone in the home, with no support from the father.

  2. Around $50 million a year will be invested in each one. The funds will come from four sources: appropriations from the various participating ministries; international cooperation, loans from international bodies; and a specific heading of the national budget. The goal is to support 100,000 families in extreme poverty over the next four years, at a cost of $200 million.

  3. The programme will invest directly in extremely poor households, regardless of their location or the religion or ideology they embrace.

  4. The general objective is to bring about a comprehensive improvement in the living conditions of families living in extreme poverty, focusing on rural areas, expanding their opportunities and providing the necessary resources, by improving the network of basic services, programmes of production development and microloans, to boost their capabilities to take advantage of these opportunities and improve the quality of their personal, family and community life.

  5. The specific objectives are as follows:

  1. to improve the incomes of families in extreme poverty, helping to eradicate hunger and linking it to the basic health and education systems;

  2. to improve rural health and nutrition conditions, giving priority to preventive care for mothers and infants;

  3. to improve the conditions of rural families – especially mothers – in extreme poverty by means of training and support measures;

  4. to improve the education of the school-age population – under 15 – from nursery school to sixth grade in rural areas;

  5. to foster gender, ethnic and age equality, by the active participation of women and men in all the network’s activities, and the implementation of gender-equality training in various environments to improve conditions and relationships in families and communities;

  6. to improve the provision of basic services in health, nutrition programmes and elementary education;

  7. to improve basic social infrastructure – drinking water and sanitation, and strategic infrastructure – for access to services through comprehensive and coordinated action with those sectors;

  8. to improve the population’s legal security, by legalizing the place of residence and personal identity documentation;

  9. to provide tools to enable the home to be financially sustainable, through production projects, job-skills training and micro-loans.


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