The health sector consists of a public subsector made up of the Ministry of Health (SS), which plays the
steering and regulatory role in the sector, and the Honduran Social Security Institute (IHSS), which is
responsible for collecting and managing fiscal resources and the required contributions made by workers
and employers. The private subsector is formed by for-profit and nonprofit institutions. According to the
National Demographic and Health Survey (ENDESA) 2005-2006, 9% of the population is registered in the
IHSS, 2.7% has private insurance, and 88.3% is covered by the SS.1
In 2005, average public health spending represented 6.7% of GDP. Health was financed primarily by outof-
pocket spending (54%),2 the National Treasury, international cooperation and, to a lesser extent, by
companies.3 Cooperation resources supplement national efforts for socioeconomic development.
However, non-reimbursable international cooperation resources have been reduced.4 In 2008 the funds
donated by the Swedish International Development Authority (SIDA) were withdrawn.
The public sector has 30 hospitals with 5,975 beds at the national level. The private sector has 60
hospitals and 916 beds. The SS is the institution that employs the most physicians and professional
nurses, followed by the IHSS. However, the majority of the medical resources are located in the most
In the early 1990s the country promoted a health sector reform process within the framework of State
modernization and reform. In this context, the national health modernization committee5 worked on
defining a reform proposal based on five specific components: strengthening the steering role of the
Ministry of Health; progressive integration with the IHSS; comprehensive health services network;
decentralization; and equity, efficiency, effectiveness, and social participation as essential requirements
for the health care model.
In 1990-2005 there were a series of projects that aimed to strengthen the steering and managerial
capacities of the SS, as well as its role as service provider and in actions related to priority programs. The
innovations were oriented primarily towards identification of a mechanism to delegate functions to the
departmental regions in order to ensure that the population has access to timely and quality health
services. Work has also been performed in areas such as improved efficiency in delivery of services,
modernization of the hospital network, improved administrative structure of the SS and the IHSS, and
greater transparency in procurement and purchasing mechanisms.6
The National Health Plan 2021 was prepared in 2001. Its general objective is to improve basic health
conditions and health services delivery. The plan emphasizes sectoral reform and increased coverage for
delivery of health services. The main initiative of the plan was to transfer responsibilities to the health
regions, including budget planning and implementation.
1 ENDESA 2005-2006, p. 265.
2 A total of 88% of ambulatory patients pay for medical visits with their own resources. Payment is significantly higher for rural dwellers and persons living in households in the lowest income quintile (ENDESA 2005-2006, p. 273).
3 Many private companies and some public institutions offer their employees private health insurance, while adhering to the requirement to contribute to the IHSS.
4 See Table 13. Financial resources in the health sector from international cooperation.
5 Created by Agreement 16-92.
- Pan American Health Organization,“Health System Profile Honduras, Central America: Monitoring and Analysis of Health Systems Change/Reform Health System Profile Honduras, Central America: Monitoring and Analysis of Health Systems Change/Reform” Washington, D.C.: PAHO, © 2009