Embedded Files
Organization of the Healthcare System
Peru's healthcare system has been shaped by its unique historical, political, and social context. The structure of the Peruvian healthcare system is decentralized, consisting of private and public sectors (internationalmedicalaid, 2023).
Figure 1. A national hospital in Peru run by EsSalud.
Public Sector
Ministry of Health (MINSA)
Social Health Insurance (EsSalud)
Armed Forces and National Police
Private Sector
For-profit entities
Non-profit organizations
Figure 2. The organization of the Peruvian Health Care System.
The Ministry of Health provides health insurance services to approximately 60% of the population, mostly those without insurance. Social Health Insurance serves those in formal employment, approximately 25% of the population. Armed Forces and National Police have their own healthcare services, serving 10% of the population (International Trade Administration, 2018). The private sector services are provided at an additional cost and serve those who can afford them (internationalmedicalaid, 2023).
Tiers of Care
Healthcare administration is managed at different levels in Peru (internationalmedicalaid, 2023):
MINSA sets policy, ensures quality, and provides most public health services
Regional Health Directorates manage healthcare provision in their regions
Local Health Networks deliver services at the local level
The Cost of Healthcare
Figure 3. The healthcare expenditure in Peru from 2008 to 2021 in billion Peruvian soles.
Cost to Peru
Healthcare is one of Peru's highest-priority sectors. According to the World Bank, its annual health expenditures remain at approximately 5.5% of GDP (International Trade Administration, 2018). Despite this, the national government's healthcare budget has increased. As shown in Figure 3, spending rose to 48.03 billion Peruvian soles in 2021, from only 11.6 billion Peruvian soles in 2008. These funds have helped to improve insurance coverage, expanding access to healthcare services and infrastructure (International Trade Administration, 2018).
Cost to Individuals
The public and private sectors play a major role in healthcare financing. The MINSA and EsSalud are primarily financed through general taxes and contributions from insured workers, with EsSalud specifically financed through a payroll tax. The private sector is funded through out-of-pocket payments and private insurance premiums from middle-and high-income individuals (internationalmedicalaid, 2023). A significant portion of healthcare costs in Peru remain out-of-pocket, creating financial challenges for Peruvians and leading to limited access to care.
Problems in Healthcare
Currently, Peru has more than 25,000 health facilities nationwide: one for every, 1,300 people. However, many issues exist which prevent the proper care of individuals. The lack of coordination in medical coverage leads to universal closings at 8:00 pm and weekends, which leaves over 77,000 people without access to care during these periods (Martens, 2023). Additionally, 52 percent of primary healthcare centers under MINSA and regional governments lack medical professionals and 98 percent lack essential infrastructure and equipment for patient care (Martens, 2023).
Foreign Aid
The socioeconomic effects of COVID-19 continue to strain Peru's healthcare system, exacerbating existing health, protection, and WASH needs across the country. These issues impact low-income Peruvians, migrants, and refugees who have limited household purchasing power, increased food insecurity, and nutrition concerns. Additionally, the political and economic crisis in Venezuela generates outward migration to neighboring countries, including Peru. Out of the 1.3 million Venezuelans residing in Peru, nearly 810,000 need additional food, shelter, and assistance. This is roughly 62 percent of all migrants and refugees in the country (Bureau for Humanitarian Assistance, 2022). Lastly, Peru's location along the Ring of Fire makes it susceptible to tectonic movements and natural disasters. These instances destroy buildings and infrastructure, leaving civilians without adequate shelter.
USAID's Bureau for Humanitarian Assistance (USAID/BHA) supports humanitarian relief in Peru by providing emergency and early recovery, risk reduction, and resistance (ER4) assistance. Since FY 2017, USAID/BHA has provided nearly $88 million in Peru to respond to the influx of Venezuelan migrants and refugees (Bureau for Humanitarian Assistance, 2022). These funds went directly to emergency food assistance, nutrition, and programming, working with the UN World Food Program to address acute food insecurity. Additionally, $3.6 million has been given by USAID/BHA to provide vulnerable indigenous communities in the Amazon basin region with access to health services (Bureau for Humanitarian Assistance, 2022). Figure 4 shows Peru's USAID/BHA funding for FY 2020 and FY 2021. Additionally, the Australian Government has provided aid to Peru. They have provided financial training, networking, and mentoring for 100,000 women entrepreneurs and their families in Peru, improving economic security for families (Australian Government Department of Foreign Affairs and Trade, 2014).
Figure 4. The emergency, ER4, and total USAID/BHA funding in Peru for FY 2020 and FY 2021.
Page updated
Google Sites
Report abuse