Licencia CC-BY-SA: SOUTH-SOUTH and Triangular COOPERATION EL SALVADOR Presenter:Ms. Fressia Cerna and the IHP El Salvador Health Country Team, Seam Reap, Cambodia 2 to 5 December Ministry of Health, El Salvador

Philosophy behind the El Salvador Health System Reform The good living concept represents a new way to approach the construction of the present in order to face the future. Development is not any more a lineal process, inarticulated and economic growth centered. It is integral and inclusive, therefore it considers new dimensions such as cultural, social, political, economical and environmental in the well being of the population. (5 year Government Plan Proposal ) The National Health System currently under implementation through the Health System Reform ( ), has been conceived recognizing that the healthy living of the population is a public good and a fundamental human right, which must be guaranteed by the State in a process that is collectively, democratically and participatory constructed, based on programmatic areas that include the Human Rights Approach, intersectoriality to address the social and environmental determinants of health, the principles of equity, efficiency, solidarity and universality throughout the 3 levels of health services. (National Health Policy 2009).

Main areas of the Health System Reform of El Salvador ● Integrated integral health service networks ● Medicines and vaccinations ● Medical Emergency System ● Health Information System ● Social and community Participation/ National Health Forum ● National Health Institute ● Intra and Inter Sectorial Participation ● Development of Human Resources ● Environmental Health ● Violence in all its forms Cross cutting issues: Financing, Infrastructure and International Cooperation.

SSC and TrC in El Salvador: Examples: 1. Brasil-El Salvador- Brasil: Technical cooperation related to knowledge exchange, provision of experts in service delivery and training in support to national staff of primary service delivery, and research. 2. Cuba-El Salvador: Through the financial support and logistics of PAHO/WHO for knowledge exchange, provision of experts in service delivery and training to national staff fo primary service delivery and research in areas related to non communicable diseases, vectors eradication, etc. 3. El Salvador-Paraguay: through KOICA technical and financial support for knowledge exchange, provision of experts in service delivery related to integrated integral health networks. 4. El Salvador-Other countries in the LAC region: knowledge exchange and provision of experts in service delivery related to integrated integral health networks, vectors eradication such as dengue, chagas, malaria, etc. Management : SSC and TrC is managed in two ways, on the one hand, the Ministry of Foreign Affairs through the General Direction of International Cooperation establishes contacts and agreements for this type of cooperation. In addition, the different sectors, in this case the Ministry of Health, directly establish contact with possible partners for SSC and TrC.

Challenges and lessons learned (1) ● For a successful SSC and TrC it is important to count with updated catalogs of cooperation offers from the countries involved. In addition catalogs from the donor community interested in TrC are important to develop. ● The formal articulation and permanent dialog of the health sector with the entity responsible for the International Cooperation in the country is of utmost importance in order to establish clear needs in cooperation and to conduct the dialog with the international community. In addition, clear and transparent processes and procedures as well as defined responsibilities are needed in order for the country to conduct its demands toward satisfying the country's needs and not only to react to donors' offers. ● The regional and global initiatives should promote the horizontal exchange among the participant countries example: MESOAMERICA, Global Fund. ● Countries should have a specific budget for addressing SSC and TrC needs in order to be able to provide or to receive this type of cooperation. ● In Latin America the language barriers have not been present given the homogeneity of the language. ● TrC should not be addressed only as financial support but as a value added to regular cooperation beyond funding, such as the affinity between the donor and receptor related to the country's policies which may result in successful cooperation and deliverables seeking same objectives, results and impact.

● Vertical and horizontal knowledge sharing must be promoted even when the donor relates individually to each of its partners (Global Fund and Country Management Mechanisms) in order to democratize the access to knowledge and not remaining in the donors institutions and/or multilateral organizations. ● The country's successful experiences must be evaluated, sistematized and documented to promote them for replication in other countries with the corresponding indigenization. ● Countries must define their needs for advancing in the health sector policy and programme implementation, and from here should move to elaborate a bank of needs related to health responding to these policies and programmes to be presented to the donor community and the SSC community. ● SSC and TrC contribute to validate new successful experiences implemented in a given country, at national and international level. ● SSC and TrC is a good way of providing technical assistance in a moment when resources are scarce and donors are also struggling for funds from their constituents. Challenges and lessons learned (2)

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