• Spending overview
• Policy overview
• Diseases overview

Spending overview

According to the 2010 central government budget, healthcare spending will rise to La 10.0bn (US$530m), equivalent to 14.7% of total expenditure. A major share of public expenditure in the healthcare sector finances healthcare workers’ salaries. In recent years there were rising denounces of the poor efficiency of social programmes (including those that aim to the improvement of healthcare provision), with an important share of funds financing “unproductive” expenditure such as consultancy salaries. Renewed access to foreign credit after the recognition of the new government will help to relax the budget constraint and will allow to increase the financing of public healthcare services.

In a poor country such Honduras, international financial and technical cooperation plays a key role. Honduras receives funds for healthcare programmes from governments of developed countries and from multilateral organizations, and is part of the Millenium Challenge initiative, through which Honduras must achieve certain goals in terms of development by 2015. As part of the High Indebted Poor Countries Initiative, Honduras must also implement a Poverty Reduction Strategy (PRS, which also includes goals for 2015). However, there have been many critics in the implementation of both initiatives, and goals are not expected to be achieved by 2015.

Honduras’ pharmaceutical market is small (the third-smallest in Central America): sales of prescription drugs and over-the-counter medicines reached La3.87bn (US$205m) in 2008, while annual per-capita spending on medicines reached US$27.40 in 2009 (the second-lowest in Central America). Honduras is heavily dependent on pharmaceutical imports: the sector’s trade imbalance is expected to rise to US$252m in 2014, from US$194m in 2009.

Policy overview

Article 145 of the Honduras’ Constitution recognizes the public’s right to health protection and establishes the State’s responsibility in this area. The Ministry of Health governs and regulates the sector, coordinates all health-related activities, sets health priorities and formulates national plans and programmes. The health sector consists of the Ministry of Health, the Honduran Social Security Institute (Instituto Hondureño de Seguridad Social, IHSS), which covers formal workers, and the private sector. There are weak functional links between these entities. According to the Ministry of Health, in 2005 services provided by the Ministry of Health covered around 60% of the population, the IHSS covered around 18%, the private sector around 5% and the remaining 17% had no access to healthcare services. Also in 2005 there were 28 public hospitals, the IHSS run 2 hospitals, while the private sector run 294 clinics and 31 hospitals.

The government that took office for the 2010-2014 term is expected to implement the so-called Plan de Nación (Nation Plan), with goals to be achieved by 2022. Among its goals, the plan aims to improve access to healthcare, reaching 95% of public coverage by 2022. The Nation Plan also attempts to reduce the current infant mortality rate, decrease malnutrition incidence in children under 5 years, reduce the maternal mortality rate, decrease the spread of HIV/AIDS and malaria, and reduce the current percentage of people without access to drinkable water. The government also attempts to build new hospitals and modernize current ones, and also to increase the provision of medicines and improve human resources skills in this area. It also aims to encourage the gradual decentralization of healthcare services. Indeed, goals in the healthcare area are in line with those of the Millenium Challenge and the PRS. However, their achievement will depend on the government’s ability to increase the efficiency of healthcare expenditure and on fluid access to international financial cooperation.

Diseases overview

Average life expectancy at birth has risen from 70.8 years in 2001 to an estimated 73 years in 2008. Honduras shows an epidemiological profile characterized by communicable diseases such as dengue fever, dengue hemorrhagic fever, malaria, tuberculosis and HIV/AIDS, related to the poor conditions of the population. But there are also chronic diseases, such as cardiovascular diseases, diabetes and cancer, which rank among the first 10 causes of hospital mortality.

Infant mortality is high, at around 26 per 1,000 live births in 2008 (according to UNICEF), while mortality of children under 5 years was 31 in 2008. The maternal mortality rate was 280 per 100,000 births, ranking 4^th amongst Latin American countries. In 2010 there were around 27,421 people living with HIV/AIDS, of which 20,000 are active carriers, but only 7,075 people received the antiretroviral treatment.