The Ministerio de Salud (MINSAL) directs public healthcare, prevention, health surveillance and regulation in El Salvador. Its Atención Primaria de Salud Integral (APSI) model provides health promotion, prevention, routine treatment, rehabilitation, environmental health services, vaccinations, injections, wound care and minor surgery. The Sistema Nacional Integrado de Salud (SNIS) links public health services. Redes Integrales e Integradas de Servicios de Salud (RIISS) connect facilities across levels, while a Sistema Básico de Salud Integral (SIBASI) coordinates services within its area. A Unidad Comunitaria de Salud Familiar (UCSF) is usually the first public contact. An intermediate UCSF can also provide dentistry and laboratory services. Specialized facilities provide broader specialist care. Promotores de Salud support prevention, family and community work, and home visits. The public system also includes FOSALUD, the Fondo Solidario para la Salud, and other public providers such as ISBM and COSAM. Community or family care can support daily wellbeing but has no clinical equivalence to professional healthcare. The Instituto Salvadoreño del Seguro Social (ISSS) serves contributors, pensioners and eligible dependents. ISSS users generally attend the center assigned to their address for general medicine and dentistry. Specialist care normally requires a referral sheet from general medicine, together with the required identification and appointment documents. Private providers supplement public and ISSS services; their fees, appointment systems and access conditions depend on the provider. Public SNIS care is provided without charge, but the available service level, capacity, appointment system and opening hours determine the practical pathway. MINSAL schedules vary by facility. FOSALUD units extend first-level access at night, on weekends or on public holidays according to the site. A published inventory listed 184 UCSF units, including 73 with 24-hour service and 111 serving weekends or public holidays, but that inventory dates from 2022 and current opening hours require confirmation. ISSS also publishes a list of 24-hour centers that differs by hospital and unit. Prevention includes the 2026 national vaccination schedule. At birth, BCG and hepatitis B should be given within 24 hours. At 2, 4 and 6 months, children receive the hexavalent vaccine, with rotavirus at 2 and 4 months. At 12 months, the schedule includes measles, mumps and rubella (SPR) and a 20-valent pneumococcal booster. At 15 months, it includes hepatitis A and varicella; at 18 months, a hexavalent booster and SPR; and at 4 years, DPaT-IPV and varicella. HPV vaccination covers girls from 9 to 18 years and boys from 9 to 11 years. Td vaccination is given every 10 years from age 10. During pregnancy, the schedule includes RSV vaccination at 28 to 36 weeks, influenza at the first pregnancy-control visit and Tdap according to the current schedule. Yellow fever and human rabies vaccination may apply to travel or specific exposure risks. Prevention and early detection also include cervical HPV testing, with provider collection or self-collection options where available. Ablative treatment is often available at first level, while complex cases require referral. HEARTS supports hypertension care, and standardized 2026 pathways cover hypertension, type 2 diabetes, chronic kidney disease, obesity and dyslipidemia. Mental-health services are being provided through decentralized prevention, treatment and rehabilitation, including the Centro Polivalente de Atención Psicosocial and the Hospital Nacional Psiquiátrico. MINSAL surveillance covers communicable and noncommunicable risks, with specialized programs for tuberculosis, HIV and ETMI-Plus. For non-emergency care, the usual pathway starts at a UCSF or another first-level service. The provider refers the case through the SIBASI and RIISS network to second- or third-level care or a national hospital when complexity requires it. The MINSAL hospital network and official directory show regional differences. SIS-Telesalud provides teletriage, teleorientation, teleconsultation, teleappointment scheduling, telemonitoring, mental-health support and referrals through 131 in all regions. In 2024, the service recorded 14,957 users, 5,160 teleappointments and 1,395 mental-health contacts. For emergencies, Sistema de Emergencias Médicas (SEM) 132 provides telephone medical triage, care at the incident site, pre-hospital stabilization and transport to a hospital. Medication supply follows the Ley de Medicamentos (LOM), MINSAL rules and the national supply system SINAB, but stock varies by facility. ISSS prescription timing also differs by prescription type: white and blue prescriptions are valid for 24 hours, yellow repeat prescriptions are handled from three days before through three days after the issue date, and green controlled prescriptions are handled within two days. Repeat ISSS medicines may be delivered nationwide to a home or workplace through Punto Seguro or Trabajo Social. After treatment, an Informe de Alta and the Historia Clínica support continuity of care. The SIS system provides digital appointments, pharmacy, laboratory, imaging and clinical-documentation functions as interoperability expands. Chronic conditions require regular checks, continued medication and telemonitoring or referral when symptoms worsen. Mental-health follow-up can include outpatient care, individual or group therapy, crisis intervention, teleseguimiento and hospital treatment when necessary. First-level services can arrange home visits for older, immobile, terminal or otherwise vulnerable people. The cited norm provides for visits at least every six months for frail dependent people. Palliative care may be coordinated between first-level services and a Unidad de Cuidados Paliativos (UDCP) or hospital, including pain treatment, home symptom monitoring with consent, family and caregiver support, and inpatient admission when symptoms cannot be controlled at home. Healthcare users have the right to nondiscriminatory, timely and quality care; understandable information about diagnosis, prognosis, alternatives and risks; informed consent; confidentiality; a second opinion; and copies of the clinical record or discharge report. They may raise complaints through UDS or ODS. Users must provide truthful information, treat staff respectfully, follow treatment and hygiene instructions, use medicines rationally and record a written refusal or voluntary discharge when they decline recommended care. Waiting times, medicine availability and actual opening hours cannot be generalized nationwide, so the relevant MINSAL directory, FOSALUD list or ISSS information should be checked before attending.
Health in El Salvador
El Salvador’s health system combines public services led by MINSAL, social-security care through ISSS, other public providers and regulated private providers. Public SNIS services are provided without charge, while ISSS access depends on affiliation and private care depends on the provider and payment. Primary care through community family health units, known as UCSF, connects prevention, routine treatment, referrals and follow-up. High-priority health needs include cardiovascular disease, chronic kidney disease, cancer, diabetes, mental health, maternal and neonatal care, and infectious or vector-borne diseases.
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