Peru’s Comprehensive Health Insurance and New Challenges for Universal Coverage

This case study analyzes the progress of Peru's Comprehensive Health Insurance (SIS) and evaluates the challenges that remain to achieving universal health care coverage. Peru is an upper-middle-income country with a gross domestic product (GDP) per capita of just over US$10,000 (purchasing power parity). The country has grown rapidly in the last decade; the average growth rate was 6.5 percent. However, 28 percent of the population lives in poverty (2011), which is estimated with regionally differentiated poverty lines between US$1 and US$2 per capita per day. In addition, only one in four individuals has employment with social security coverage. The SIS aims to reduce economic barriers through the elimination of user fees for a package of services. Although its budget has been low, the SIS has played an important role in the reduction of maternal and child mortality. However, the improvements expected to the overall health system have not materialized. Meanwhile, when the decentralization process transferred funds and authority to the regions, it did so in a context of weak management capabilities, and it failed to clearly define the relationship between the national and regional governments. A major effort to strengthen the technical capacity of the Ministry of Health (MOH) should accompany the strategies outlined above. This effort should emphasize a review of health priorities, the design of effective interventions within a fiscally sustainable benefits package, and the introduction of incentives and new payment mechanisms at hospitals and other health facilities.

Bibliographic Details

Main Author:	Francke, Pedro
Format:	Working Paper biblioteca
Language:	en_US
Published:	World Bank, Washington DC 2013-01
Subjects:	access to contraception, access to drugs, access to services, adolescents, Adult mortality, age groups, aged, basic infrastructure, beds, budget caps, budget ceiling, budget increase, budget process, cancer, cancer patients, cardiovascular disease, child health, child health care, child mortality, childbirth, chronic malnutrition, cities, citizen, Citizens, Communicable diseases, comprehensive care, Contraceptive prevalence, contraceptive use, crowding, deaths, demand for health, demand for health services, demand for services, democracy, Dependency ratio, developing countries, diabetes, Discrimination, Discrimination against women, doctors, drugs, early detection, economic growth, education of women, emergencies, emergency care, employment, Epidemiological Transition, equilibrium, equitable access, Essential Health Services, expenditures, families, family planning, Fee-for-service, fertility, fertility rate, financial risks, general practice, gross domestic product, Health Administration, health care, health care coverage, health care management, health centers, Health Coverage, health education, Health expenditure, health facilities, health financing, Health for All, health inequities, health infrastructure, Health Insurance, Health Interventions, health outcomes, health plan, health policies, health policy, health posts, health problems, health professionals, health promoters, health promotion, health reform, health sector, Health service, health services, health spending, Health Strategies, Health System, health system reform, health systems, health workers, healthcare services, HIV/AIDS, holistic approach, hospital, Hospital beds, hospital care, hospital services, hospitals, human development, human resources, Human Rights, ill health, illness, illnesses, immunization, immunizations, income, income countries, income households, Income inequality, indexes, indigenous populations, infant, infant mortality, Infant mortality rate, informal payments, insurance plans, insurers, international economic crisis, intervention, large cities, levels of infant, life expectancy, live births, local governments, malaria, management of health, management systems, maternal care, maternal health, maternal mortality, Maternal mortality rate, maternal mortality ratio, maternity leave, Medical Care, medical school, medical specialists, medicines, mental health, midwives, Ministry of Health, modernization, morbidity, mortality, mother, national level, national policies, national policy, Neonatal mortality, number of people, nurses, Office of Health, outpatient care, outpatient services, patient, patients, physician, physicians, practitioners, pregnant women, prenatal care, primary care, primary health care, private pharmacies, private sector, private spending, progress, provision of care, public expenditure, public expenditure on health, Public Health, public health care, public health care services, Public health expenditure, public health expenditures, public health programs, public health services, public health system, public hospitals, public insurance, public insurance scheme, public sector, Public Spending, purchasing power, purchasing power parity, quality control, quality of health, quality of life, referral system, regional hospital, reimbursement rates, reproductive health, reproductive health program, resource constraints, resource needs, respect, rural areas, rural populations, sanitation, sanitation facilities, Skilled birth attendance, social programs, social security, social security systems, surgery, TB control, technical assistance, technical capacity, transportation, tuberculosis, universal access, urban areas, urban development, urban populations, user fees, vulnerable populations, woman, workers, working-age population,
Online Access:	http://hdl.handle.net/10986/13294
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