El Salvador

• People in need: 1.1 million¹
• People targeted: 496,600
• People in need of health assistance: 1 million
• Requirements (US$): 5.3 million

Context

The recurrence of severe climate events combined with economic, social, and institutional fragilities leave El Salvador in an extremely vulnerable and critical humanitarian situation. Located in a disaster-prone subregion, El Salvador is among the 20 countries in the world at highest risk of disasters.

The successive hydrometeorological hazards that have impacted El Salvador over the past two years, including Tropical Storms Amanda and Cristóbal, and Hurricanes Eta, Iota and Julia, have profoundly affected the lives and livelihoods of almost 900 000 people. This has significantly disrupted health services, particularly at the primary care level. In addition, the country is constantly exposed to earthquakes, floods, and droughts. Infrastructural and institutional limitations to deal with emergencies, and low capacity to respond to adverse events, are an additional challenge. These limitations place the population, particularly the most vulnerable, at even higher risk of adverse impacts to health.

According to the Humanitarian Response Plan (HRP) 2021-2022, vulnerable economic conditions and income inequality were amplified by the effects of the COVID-19 pandemic, resulting in an 8% reduction in the country’s GDP and a 4.6% increase in poverty in 2022. The number of people facing food insecurity rose from 620 000 in the year prior to the pandemic to around 1 043 661 as a result of the profound economic crisis caused by COVID- 19 and the repeated impact of extreme climate events and structural challenges. These recurrent shocks have disproportionately affected individuals in vulnerable situations, particularly those faced with extreme poverty and limited safety nets. Increasing homicide rates and rampant violence in recent years have also hampered social development and economic growth and are among of the main causes for forced internal displacement.

Emergency response

WHO will take a multisectoral response approach to the health sector’s needs in El Salvador, providing coordinated and targeted assistance to address critical health needs in high-priority areas prone to the impact of disasters and violence. While focusing on immediate and short-term interventions to restore and scale-up the capacities of local health institutions to address the acute and unattended health needs of the community, WHO will also seek to support and strengthen sustainable solutions through humanitarian-development collaboration. The core objective will be to help restore essential health services and systems and to strengthen community and institutional resilience.

This strategy is aligned with the Humanitarian Needs Overview (HNO) and the health sector’s strategic objectives for the Humanitarian Response Plan (HRP). It responds to the identification of population needs and strategic partner demands and efforts. Implementing a whole-of-society approach, WHO will continue to work in close coordination with all health and humanitarian stakeholders, including not only governmental entities, starting with the Ministry of Health and the Directorate of Civil Protection, but also United Nations partners, civil society organizations and other non-governmental institutions.

Strategic objectives

Key activities

• Coordinate health networks to ensure a comprehensive and multi-hazard response to adverse events, using evidence-based, first-hand field evaluation to adequately tackle the multiple challenges faced in different territories. This will cover migratory flow, environmental or epidemic threats and social conflict.
• Implement corrective measures to increase local capacities for quality health service delivery, including infrastructure repairs and rehabilitation.
• Procure life-saving and essential health supplies and equipment, training and capacity building of health professionals.
  Strength water and sanitation systems to support infection prevention and control in healthcare settings.
• Strengthen primary care health services and response programs for vulnerable populations.
• Prevention and early diagnosis of communicable and non-communicable diseases and conditions, worsened by the effects of existing emergencies.
• Implement mobile clinics and field activities for enhanced coverage of priority public health programs.

Funding requirements

Overall country funding requirements, including COVID-19, by pillar (US$ ‘000)

Success stories

Expanding COVID-19 vaccination coverage

Through of a combination of geographical, economic and social challenges, El Salvador’s population remains at high risk to the adverse impacts of these challenges on health. The country has been subject to successive extreme meteorological events which have significantly disrupted primary health care services, including the delivery of life-saving vaccines. The situation has been worsened by infrastructural limitations to respond to health emergencies.

In a recent visit to a house doubling up as a COVID-19 vaccination center, the Minister of Health took time to talk to people about the country’s program of vaccination, while a PAHO representative explained more about symptoms people may experience after receiving their dose. Through this program, led by the Ministry and supported by PAHO, more remote communities have and will continue to be reached with vaccine doses, helping to support the prevention of severe disease amongst the most hard-to-reach communities.

PAHO has been providing support since the beginning of the pandemic with the provision of supplies, equipment, diagnostic tests and, through the COVAX program, has helped manage the donation of vaccines to the government of El Salvador. Additionally, an agreement between PAHO and the National Health Council has enabled the hiring of vaccinators so COVID-19 vaccines can be brought to more Salvadorans regardless of their location. Teams of vaccinators have worked in partnership across different municipalities to identify and deliver vaccination programs to rural communities.

In Solimán Cantón, located in the Santa Ana municipality, around 200 families had not received any COVID-19 vaccine doses due to transportation issues. The municipality’s vaccination teams were divided into three groups to ensure the maximum number of people could be reached. Teams worked with local doctors, nurses and health promoters, going house to house, visiting families to provide vaccinations.

For more information

Dr. Giovanni Escalante | PAHO/WHO Representative, El Salvador | gescalante@paho.org

Images

A resident of Cantón Solimán receives his dose of vaccine against COVID-19 in a house-to-house vaccination campaign. February 2022, Santa Ana, El Salvador. Photo credit: PAHO/WHO El Salvador, Nubia Carbajal.

House-to-house vaccination team administering vaccines in a colony in San Salvador, El Salvador. Photo credit: Ministry of Health, El Salvador.