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Articles

The historical contribution of faith-based health providers in the Ecuadorian health system: an overview of the evidence

Pages 670-683 | Published online: 21 Jul 2017
 

ABSTRACT

Faith-based health providers (FBHPs) have historically shaped the national health system in Ecuador, yet there is little robust evidence of this role, or their current contribution to the national health system. This article situates FBHPs in the Ecuadorian health system, using secondary analyses of national health surveys to consider changes in contribution from 1998 to 2014, and synthesising this with secondary literature. The research confirms the important role that FBHPs have historically played in Ecuador, but also shows that their current role needs to be better understood if universalisation of health service coverage is to be achieved.

Si les prestataires de santé confessionnels ont historiquement façonné le système national de santé en Équateur, ce rôle, comme leur contribution actuelle au système national de santé, sont bien peu documentés. Cet article situe les prestataires de santé confessionnels dans le système de santé équatorien en s'appuyant sur des analyses secondaires des enquêtes nationales sur la santé afin de prendre en compte les changements de leur contribution, observés entre 1998 et 2014, et de procéder à une synthétisation de ces constatations avec la littérature secondaire. La recherche confirme le rôle historique majeur des prestataires de santé confessionnels dans le pays, mais montre aussi que leur rôle actuel nécessite d'être mieux compris si la couverture universelle en services de santé doit être réalisée.

Históricamente, los proveedores de servicios de salud basados en la fe (pssbf) han apoyado la conformación del sistema nacional de salud en Ecuador. Sin embargo, existe escasa información al respecto o sobre el aporte que dichos proveedores realizan actualmente a este sistema. El presente artículo da cuenta del lugar ocupado por los pssbf en el sistema de salud ecuatoriano. Con este fin las autoras aprovechan, por un lado, los análisis secundarios de encuestas nacionales de salud orientadas a detectar los cambios ocurridos en el aporte de los pssbf durante el periodo 1998-2014, y por el otro, la síntesis de lo anterior con la literatura secundaria. La investigación confirma el importante papel desempeñado históricamente por los pssbf en Ecuador, mostrando, además, que para lograr la cobertura universal de salud es necesario que su rol actual sea mejor comprendido.

Acknowledgements

We would like to acknowledge the help received by government officials from the Ministry of Human Rights, Justice and Cults and SETECI. We would also like to acknowledge the important collaboration of the different organisations that participated from the survey and personal interviews. Finally, we are grateful for the invitation for Angelica Ullauri to attend the Health Systems Global 2016 Emerging Leaders Program in Vancouver (November 2016), where parts of this research were presented and further developed.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Angelica Ullauri is a researcher working on Health Policy and Systems Research, with a particular focus on the LAC region. She is a postgraduate student in the Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town.

Jill Olivier is a Senior Lecturer and Research Coordinator at the University of Cape Town in the School of Public Health and Family Medicine, Health Policy and Systems Division. She is the Director of the International Religious Health Assets Programme (IRHAP) and holds a PhD in Development Sociology.

Notes

1. The sisters of Saint Vincent of Paul are a French congregation created in 1663 and were the first congregation of women working in areas of social service for the poor. They were also pioneers in mission work in different regions across the world, and in the development of the nursing profession in Latin America.

2. Charity boards were private organisations that were created at the end of the nineteenth century to manage the delivery of social services for the poor and marginalised. People who were part of these boards were wealthy and important citizens. The charity boards were funded by monetary contributions of municipalities and revenues from public properties.

Additional information

Funding

The thesis project on which this article is based was supported by a bursary for Angelica Ullauri from the Collaboration for Health Systems Analysis and Innovation (CHESAI, www.chesai.org) through the Health Policy and Systems Division (HPSD) at the School of Public Health and Family Medicine, University of Cape Town.

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