Propuesta Ciudadana I: Salud

This effort responds to the Medical College's commitment to contribute to the construction of a better country and a healthier population for the 21st century. The proposal reflects the concerns of multiple actors and groups in society who have reached a consensus on the health problem and the possible lines of action to resolve it. The result is a historic construction of a citizen's proposal, where the majority of the main actors in the sector have come together to develop a proposal for a health policy and strategy and build a broad citizen front with common goals in the area of health, with the aim of having their contribution taken into account by the State, society, and the new government. The main strength of the proposal is its validity, guaranteed by the participation of more than 150 organizations that contributed to this effort of citizenship and democracy without any distinction. The process was pedagogical and led to the establishment of mutual commitments towards and for all. Deep gratitude is expressed to the individual actors who, in many cases, made long journeys to present and discuss their expectations. The population of El Salvador, whose strength and weaknesses inspired 105 participants in the Citizen Consultation on Health, is particularly acknowledged. International agencies, such as the International Development Agency of the United States (USAID), the Friedrich Ebert Foundation, UNICEF, Capacity 21 PNUD, the Maquilishuat Foundation (FUMA), and the Archdiocesan Pastoral Commission for Health (CAPS) of the Archbishopric, are also acknowledged, as well as Monsignor Gregorio Rosa Chávez, Auxiliary Bishop of San Salvador. The proposal is dedicated to the Salvadoran woman and man who live and work in the interior and exterior of the country in their struggle to make El Salvador a better and healthier country, it is our duty and reason for being. The proposal is structured into several sections, including an introduction, a summary of the methodology, a framework of reference, a diagnosis of the health sector, policies for health, evaluation of the national health policy, pending aspects, references, annexes, and acronyms. The introduction highlights the importance of a national health policy and strategy in El Salvador, which is a country with a high level of poverty and social inequality, where half of the population lives in a situation of poverty and is marginalized from social progress. The proposal reflects the concerns of multiple actors and groups in society who have reached a consensus on the health problem and the possible lines of action to resolve it. The methodology section describes the process of developing the proposal, which involved the participation of more than 150 organizations and 105 participants in the Citizen Consultation on Health. The framework of reference section presents the vision, values, and principles that guide the proposal, including the Decalogue of Values and the Vision of the Health Model. The diagnosis of the health sector section presents an analysis of the current situation of the health sector in El Salvador, including the context of international reform, the reform of the health sector in El Salvador, the economic and social situation of the Salvadoran population, demographics and health, organization of the sector and health services, human resources, infrastructure, equipment, and medicines, expenditure on health, and the quality of care. The policies for health section presents a set of policies and strategies for the health sector, including general policies, such as the policy of sustainable human development, and specific policies, such as the policy of reform of the health sector, the policy of financial sustainability, the policy of integration and coordination, the policy of control and regulation, and the policy of promotion and defense of the right to health. The evaluation of the national health policy section presents an evaluation of the current national health policy, including its strengths and weaknesses, and the pending aspects section presents a set of issues that need to be addressed in the future. The proposal concludes with a set of references and annexes that provide additional information and support for the proposal.