Organization and Financing of Rural Social Insurance in Ecuador Seguridad Social Campesino. Technical Report No. 12

摘要

This exploratory study examines the organization and financing of Ecuador's Rural Social Insurance Program (SSC), a dependency of the Ecuadorian Institute of Social Security (IESS). SSC operates over 500 health centers that provide basic health services to 153,000 rural households thatthrough their community organizationscontribute monthly payments. The study argues that IESS and the Government, which co-finance SSC, need to review SSC separately from current proposals for the reform of IESS. SSC's program is experiencing administrative and financial difficulties. Personnel appointments and procurement of basic medicines, administered by IESS, are bottlenecks in SSC operations; SSC is also internally inefficient in its management of human and financial resources. The study summarizes these problems, provides an analysis of SSC financing, and offers recommendations.