El Salvador

The ultimate aim of the program is to support the process of institutional cange at the Salvadoran Social Security Institute (ISSS) so that it can assume gradually its basic function of providing health insurance. The specific objectives of the program are a)to assist the ISSS with the design, testing, and evaluation of the mechanisms of institutional change that are needed to spur reform of the sector, b)to lay the groundwork for building a consensus amongst the leading players on the institutional change at the ISSS, and c)to strengthen the ISSS' strategic capacity to promote organizatinal learning and to produce and disseminate information in support of its institutional transformation.

Under the present program, which is conceptually flexible and will be financed as an innovation loan, the ISSS will build a consensus and reach agreement to facilitate the fundamental changes that are needed for structural reform in the future. This incremental approach is expected to reduce the type of political debate inherent in reforms of this kind and to minimize the risks posed to future operations in the sector.

Although a consensus does not now exist in Salvadoran society on the best way to reform the social security health system, this program will raise resources to develop public information and social communications strategies that engender fundamental agreement on the institutional changes to the ISSS. In addition, the program will encourage the testing and evaluation of initiatives to prepare the ISSS and promote innovative actions in health services delivery and to expand helth insurance coverage to groups in the informal sector. Upon completion of the program, the government will have a menu of policy-based options using the date collected and the lessons learned from the project.

Last updated: 01/16/07