The Healthcare System in Honduras: Public Network, IHSS, Private Sector and Emergencies

The Honduran Secretariat of Health (SESAL), based in Tegucigalpa, states the objective of building an integrated national health system, founded on equity of access, universal coverage and quality of services. Its website presents notably a national vaccination system with a vaccination record, the expanded vaccination programme, epidemiological alerts and a health emergency portal. Alongside the public network, the Honduran Social Security Institute (IHSS) covers affiliated employees, and a private sector is concentrated in the large cities.

France Diplomatie describes public hospitals as offering a mediocre level of care and specifies that, outside the large cities, medical cover is patchy; private clinics are of acceptable quality. The guide to expat insurance in Honduras gives the overall picture.

The IHSS runs the sickness-maternity insurance of formal-sector employees; affiliation goes through the employer. The contribution rates, the year’s contribution ceiling and the conditions for opening rights could not be read on an official page, the institute’s website not being accessible when consulted: they are confirmed with the IHSS or the employer. A non-salaried resident, a self-employed person or a retiree does not necessarily have an affiliation, and the page does not describe a voluntary scheme open to foreigners.

France Diplomatie insists on several points: an assistance contract or insurance covering all medical costs (surgery, hospitalisation) and medical repatriation is obligatory in practice, failing which access to care may be refused, even in a life-threatening emergency; the French embassy does not cover any of these costs; French health insurance schemes are not recognised locally; foreigners pay their own costs, notably for a day of emergency hospitalisation. The page on healthcare reimbursement in Honduras details who pays depending on status.

The details of the care pathway of an IHSS member (primary care units, referral to the network’s hospitals) are confirmed with the institute. Without affiliation, a resident turns to the Secretariat of Health’s public network or to the private sector, whose fees are not published uniformly: ask the establishment before treatment. The France Diplomatie sheet does not cite the name of any recommended hospital.

The cost of emergency hospitalisation is high for a foreigner, which argues for insurance offering direct payment, with no advance of costs. The guide to how a medical repatriation works explains the steps, and the guide to budgeting for health abroad helps you cost this item.

France Diplomatie does not mention any medical emergency number. It cites 911 for the police, including the traffic police in the event of an accident, with the instruction not to move the vehicle and to wait for them to arrive. The contact details of the French embassy in Tegucigalpa are +504 2235 7275 (the site also gives +504 3148 6632 during office hours). Outside office hours, the French embassy in Guatemala, which is responsible for Honduras, can be reached on +502 5202 2022.

The Secretariat of Health publishes a health emergency portal and epidemiological alerts; the arrangements of the medical emergency service are checked on its website. For journeys, France Diplomatie reminds readers that night driving is strongly advised against and that a flight is preferable to buses for intercity journeys: medical evacuation then depends on the assistance provided by the insurance contract.

France Diplomatie asks you to be up to date with the French vaccination schedule (diphtheria, tetanus, polio, whooping cough, measles). Yellow fever is compulsory for travellers coming from endemic zones, or for a stay or stopover of more than 12 hours in those zones; a delay of about 10 days after vaccination is required before continuing to an uninfected zone. Depending on the length and conditions of the stay, hepatitis A and B, typhoid fever, rabies (young children, rural stays), chikungunya and dengue may be indicated.

Dengue is present throughout the country, with a high risk all year, especially in the large urban centres: Tegucigalpa, Choluteca, San Pedro Sula, Comayagua, Santa Bárbara and Tocoa. Malaria mainly affects Olancho, in the east, and Choluteca, in the south. Added to these are chikungunya, zika (neurological complications and risk of microcephaly), typhoid fever, Chagas disease, transmitted by insects and whose complications appear years later, leprosy in the south (Valle and Choluteca) and rabies. France Diplomatie indicates that Honduras is one of the countries most affected by HIV on the continent and that emergency treatments after an exposure are hard to find there.

The precautions are protection against mosquitoes (covering clothing, repellents, impregnated mosquito nets), food hygiene (safe drinking water only, avoiding raw vegetables, shellfish and cold buffets), caution around animals, swimming in supervised areas and protection against heat and sun. Anti-inflammatory drugs are to be avoided in the case of dengue, and pregnant women or those planning a pregnancy see a doctor before travelling.

For dengue, which has no curative treatment, prevention is essential: protected housing, impregnated mosquito nets and elimination of standing water around the home, because mosquitoes breed in water containers. For malaria, which exists in mild forms and in severe, potentially fatal forms, seek advice quickly in the event of fever. For Chagas disease, the sheet advises avoiding precarious rural housing where the insect vectors live. A resident in a rural area, or in the most affected departments, therefore adapts the choice of housing as much as their insurance cover.

France Diplomatie indicates that Honduras is one of the countries most affected by HIV on the continent and that emergency treatments after an exposure are hard to find there. It recommends avoiding risky sexual behaviour and seeking advice quickly in the event of exposure. Leprosy, of which cases have been recorded in the south, in the departments of Valle and Choluteca, is a reminder that certain tropical diseases persist locally.

On the road, France Diplomatie advises favouring reliable means of transport, avoiding night driving and being wary of two-wheelers. It recommends swimming only in supervised areas, not touching or feeding animals and washing any bite or scratch immediately with soap and water, then seeking urgent medical advice. Pollution is to be limited. This advice applies to tourists and residents alike.

France Diplomatie recommends taking a personal first-aid kit limited to the bare essentials, with medicines in their original packaging and a prescription stating the international non-proprietary name, and checking that they are authorised in Honduras. It advises against buying medicines in the street, because of the risk of counterfeits. A chronic treatment is prepared before departure with your usual doctor.

The Honduran system does not offer cover from day one to a non-salaried new arrival, and French schemes are not recognised: insurance covering care, hospitalisation and repatriation is the basis of protection. The expat health insurance comparison presents the possible plans, and the CFE (Caisse des Français de l’étranger, the French expatriate health fund) is the option for keeping a link with the French scheme. Expavy helps you compare these choices according to your profile.