In the past 20 years, the South American country of Peru has undergone a drastic healthcare reform. The country’s population can more easily access quality healthcare, decreasing the national rates of malnutrition and several causes of mortality. However, Peru still spends less than 3% of its GDP on healthcare and the system has been defunded for the past few years. Peruvian healthcare also suffers from core issues that have prevented rural impoverished regions from receiving the benefits of the country’s healthcare reform. Here are six facts about the current state of Peru’s healthcare system.
6 Facts About Peru’s Healthcare System
- Decentralization: The structure of Peruvian healthcare is decentralized, meaning the system is comprised of a combination of public and private organizations. Five entities work to administer healthcare throughout the country: The Ministry of Health (MINSA), Armed Forced (FFFA), National Police (PNP), EsSalud and the private sector. Decentralization has caused issues with communication that have increased medication costs and impeded understanding of the care patients receive between health provider entities (such as current medications a patient is taking or their medical history). Consequently, progress in designing a better healthcare system and in the reform of universal healthcare has focused on centralizing these five entities.
- Maldistribution: Though the statistics for national health have projected country-wide progress in healthcare accessibility, rural areas of Peru suffer from lack of resources and are excluded from the reform of Peru’s healthcare system. Rural areas in Peru have the slowest national poverty reduction rates and suffer from a severe lack of healthcare funding. The 28% of Peruvians that live in these rural areas, including the Andean and Amazonian regions, have limited access to healthcare professionals and the medical resources that they need. Because of this inequity, the Ministry of Health in Peru created health policy guidelines in the “Institution Strategic Plan 2008-2011” that focus on improving rural health care through universality, equity and social inclusion.
- Underserved populations: The maldistribution of resources is especially problematic, as it keeps Peru’s healthcare system from reaching indigenous populations. The lack of resources getting distributed to these regions causes problems for the access and treatment of populations like the women of Asháninka, an indigenous group that lives in central Peruvian rainforests and has a population of around 45,000 people. For an Asháninka woman to access a hospital they must develop trust for healthcare providers and overcome both distance and the cost of medication. The healthcare providers who are able to see an indigenous woman are often unable to keep their trust due to the poor quality of treatment or long waiting time for test results. The limited number of healthcare providers in these regions have few resources and are often unable to see all of the patients that request care.
- Reform: Peru’s government has taken major steps to create a universal healthcare system. The most momentous changes are the results of legislation signed in the past 20 years. Specifically, the Framework for Universal Health Coverage adopted in 2009 and 23 pieces of legislation passed in 2013 quickly effected change by setting goals around centralizing healthcare and increasing findings for healthcare providers in Peru. This encouraged reforms for accessibility among both the public and private sectors.
- Universal Health Coverage: Peru has made great strides in the spread of accessible healthcare. This progress has been monumental since the establishment of Health Sector Reform in 1998, as more than 80% of the 31 million people have some access to Peru’s healthcare system. This statistic is reflected in the increased number of women giving birth in hospitals and in the significant drop in both maternal and infant mortality rates. Additionally, malnutrition rates dropped from 29% to 15% in a short three-year span of 2010 to 2013. These encouraging movements towards a healthier population continue to be achieved through legislation from Peru’s government and the increased accessibility of private sector healthcare.
- Aid: USAID has been a supporter of the Peruvian Ministry of Health and its goals for reform, while also advocating health insurance reform. The organization played a part in designing Seguro Integral de Salud (SIS), a health insurance financial platform for Peruvians. USAID has also contributed to universal health for Peru by implementing health projects that helped create the Health Finance and Governance project (HFG). The HFG Project in Peru works to streamline healthcare in various ways, such as creating electronic records, developing human resources, and costing medications. In addition to the SIS and the HFG, USAID has been instrumental in passing legislation in Peruvian Congress that promises a future of reform.
Peru’s healthcare system provides both an optimistic view of the progress a country can make for its citizens and an understanding of what improvements still need to be made to create equitable care. With the continued work of the HGF project and the passing of legislation that increases healthcare funding to rural areas, Peru can move even closer to its goal of creating accessible healthcare for all of its citizens.
– Jennifer Long