Human Resources for Health challenges during health emergencies—low number of workers in El Salvador

Abstract

Abstract El Salvador is one of the 57 countries considered to be in Human Resources for Health (HRH) crisis according to the World Health Organization (WHO). El Salvador’s healthcare worker density is 1.95 health professionals per 1,000 population, with even lower numbers in certain departments of the country. There have been improvements in the distribution of healthcare workers since 2010; however, on average it has remained “in crisis” based on the 2006 World Report definition. The increase in vector borne diseases in the region, has resulted in an overwhelmed vector control system and public health sector in many Central American countries. This study aims to analyze whether the healthcare workers identify the numbers of HRH as a factor that affects the health system response during health emergencies. Through an extensive review of scientific literature, country reports, 16 meetings and 34 in depth semi-structured interviews with key stakeholders; this paper explores the challenges healthcare workers faced and how they were influenced by the numbers of available HRH during recent arboviral epidemics in El Salvador, using the recent Zika epidemic as a point of comparison. The study findings suggest that some of the barriers that the health workforce identified during health emergencies include factors related to the low availability of HRH such as feelings of tiredness, being overwhelmed, as well as a need to rely on doctors in their social year in some areas of the country. Despite this, they also recognize that the recent intersectoral work done by the government and the Ministry of Health, has helped to overcome the obstacles of a low healthcare workforce by involving other sectors of society into the emergency response. Therefore, there is not a clear consensus on how the low number of HRH affect the health emergency response. Key messages The study findings suggest that some of the barriers that the health workforce identified during health emergencies include factors related to the low availability of HRH. They also recognize that the recent intersectoral work done by the government and the Ministry of Health, has helped to overcome the obstacles of a low healthcare workforce.