Health Affairs

Health Affairs, 28, no. 4 (2009): 1003-1010 doi: 10.1377/hlthaff.28.4.1003 © 2009 by Project HOPE	New Online   Getting Health Reform Done   After the State of the Union   Incremental Reform   E-Health in Developing World   Most-Read Articles in 2009

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Care Delivery

The Rural Hospital In Ecuador

David P. Gaus

Over a period of twelve years, the author’s vision of improving the health of rural Ecuadorians has evolved from an initial emphasis on primary health care to secondary care. The local community convinced him of the critical need for an efficiently managed, high-quality, and affordable rural secondary care hospital. Exploring a variety of funding options, the hospital ultimately achieved financial sustainability, principally through Ecuadorian public sources. Now, in partnership with the Ministry of Public Health (MOH), the rural hospital model that evolved in Pedro Vicente Maldonado is being adapted as a pilot project in an existing MOH rural hospital.

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