The Role of Social Movements in Strengthening Health Systems : The Experience of the National Health Forum in El Salvador (2009-2018)

Abstract

Altres ajuts: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was funded by the NIHR Global Health Research Programme 16/136/100, Queen Margaret University. The views expressed are those of the authors and not necessarily those of the UK National Health Service, the NHR or the UK Department of Health and Social Care.

In 2009, the newly elected FMLN government of El Salvador launched a comprehensive health reform, which gave the National Health Forum (NHF) a key role in developing community participation. This study aims to examine and analyze the content and impact of this social movement during the study period 2009-2018. The context was analyzed through relevant documents, which helped identify key stakeholders. Semi-structured interviews took place at 3 levels of decision making: the political level, the health professionals, and the community. Data were analyzed using a qualitative methodology. Participation is carried by a structure created by the Ministry of Health, the National Health Forum. The NHF developed 3 strategies: (1) leadership building in the communities through the strengthening of social, political, and economic skills, where they developed social accountability mechanisms at all decision-making levels of the health system; (2) the strategy carried by the sectoral working groups, where they responded to prioritized needs identified by the community; and (3) advocacy for human rights-based policies. The NHF, and its role in the strengthening of the National Public Health System, provides strong evidence of community participation strategies and co-governance with the health system within the social determinants of health scope.