The importance of stakeholder perception in understanding impact: The Basic Integrated Health System (sibasi) program and quality of primary healthcare in El Salvador

Abstract

Rev. Gerenc. Polit. Salud, Bogotá (Colombia), 6 (12): 12-30, enero-junio de 2007 12 Abstract Using a methodology which examines the perceptions of stakeholders, including policy-makers, healthcare professionals and community members, this paper details a preliminary evaluation of the impact thus far of the Basic Integrated Health System ( Sibasi) program on quality of healthcare in El Salvador. The paper gives a brief overview of health systems reform in El Salvador, outlines the logic behind the sibasi and presents theoretical perspectives on quality in healthcare. The study found that although the sibasi was “good on paper” and had definite potential, it had not met with a great deal of success. Additionally, existing barriers in the health system in El Salvador- extreme poverty, ineffective governance, politicization, poor financing, and contention in the reform process- severely limited the success of the Sibasi program.