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Subject

Challenges in improving public healthcare in Central America.

Significance

Public healthcare spending has increased in Central America over the last two decades. However, advances towards universal coverage have been uneven, with major differences between El Salvador, Nicaragua and Guatemala. While reforms have resulted in better services and more effective regulation of the private sector in El Salvador, Guatemalan health services have improved little and health indicators are comparatively poor.

Impacts

Salvadoran public debt may rise significantly as Sanchez Ceren attempts to sustain health spending.

The pace of improvements in Guatemala will continue to lag behind those in Nicaragua and El Salvador.

FSLN complacency may hinder public healthcare advancement in Nicaragua.

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