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World Bank - Peru: improving health care for the poor

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The Peruvian health sector has recovered rapidly after collapsing in the late 1980s and early 1990s as a result of hyperinflation and terrorism. Total public and private spending on health rose by over 50% in real terms in the three years after 1994. The supply of health services increased sharply,... Health outcomes have also improved rapidly in recent years... Several reforms were attempted during the health sectors recuperative years. Some were successful, others failed. To increase the chances for success in the future, policymakers in Peru must face three key challenges: continue to reduce the large gap between the health status of the poor and that of the nonpoor; increase the resources assigned to provide care for the poor; increase the efficiency in the use of these resources. This report is meant to help the Government continue to develop its agenda to improve health care for the poor. Its focus is on poverty, and particularly on ways to improve the Ministry of Healths primary health subprogram, rather than on sector-wide reforms, to increase efficiency. The report emphasizes that there is much to be gained by sustaining and deepening the reforms directed toward improving health care for the poor while using the shift in focus and responding to the key challenges. The executive summary and introduction are provided in both English and Spanish.

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title Peru Improving Health Care for the Poor World Bank Country Study - photo 1

title:Peru : Improving Health Care for the Poor World Bank Country Study
author:
publisher:World Bank
isbn10 | asin:0821344935
print isbn13:9780821344934
ebook isbn13:9780585261188
language:English
subjectPoor--Medical care--Peru, Public health--Peru, Medical policy--Peru, Poor--Health and hygiene--Peru, Health care reform--Peru.
publication date:1999
lcc:RA477.P485 1999eb
ddc:362.1/086/9420985
subject:Poor--Medical care--Peru, Public health--Peru, Medical policy--Peru, Poor--Health and hygiene--Peru, Health care reform--Peru.
Page i
Peru
Improving Health Care for the Poor
A WORLD BANK COUNTRY STUDY
Peru improving health care for the poor - image 2
Page ii
Copyright 1999
The International Bank for Reconstruction
and Development/THE WORLD BANK
1818 H Street, N.W.
Washington, D.C. 20433, U.S.A.
All rights reserved
Manufactured in the United States of America
First printing August 1999
World Bank Country Studies are among the many reports originally prepared for internal use as part of the continuing analysis by the Bank of the economic and related conditions of its developing member countries and of its dialogues with the governments. Some of the reports are published in this series with the least possible delay for the use of governments and the academic, business and financial, and development communities. The typescript of this paper therefore has not been prepared in accordance with the procedures appropriate to formal printed texts, and the World Bank accepts no responsibility for errors. Some sources cited in this paper may be informal documents that are not readily available.
The findings, interpretations, and conclusions expressed in this paper are entirely those of the author(s) and should not be attributed in any manner to the World Bank, to its affiliated organizations, or to members of its Board of Executive Directors or the countries they represent. The World Bank does not guarantee the accuracy of the data included in this publication and accepts no responsibility for any consequence of their use. The boundaries, colors, denominations, and other information shown on any map in this volume do not imply on the part of the World Bank Group any judgment on the legal status of any territory or the endorsement or acceptance of such boundaries.
The material in this publication is copyrighted. The World Bank encourages dissemination of its work and will normally grant permission promptly.
Permission to photocopy items for internal or personal use, for the internal or personal use of specific clients, or for educational classroom use, is granted by the World Bank provided that the appropriate fee is paid directly to Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, U.S.A., telephone 978 750 8400, fax 978 750 4470. Please contact Copyright Clearance Center prior to photocopying items.
For permission to reprint individual articles or chapters, please fax your request with complete information to the Republication Department, Copyright Clearance Center, fax 978 750 4470.
All other queries on rights and licenses should be addressed to the World Bank at the address above, or fax no. 202 522 2422.
Cover photo: Immunizing children in Peru, by C. Gaggero, Pan American Health Organization.
Library of Congress Cataloging-in-Publication Data has been applied for.
Page iii
Contents
Abstract
v
Preface and Acknowledgments
vi
Acronyms and Abbreviations
vii
Resumen Ejecutivo en Espaol
viii
1. Executive Summary and Introduction
1
Picture 3
Reforms in Health Provision
3
Picture 4
Reforms in Health Financing
4
Picture 5
Management of Programs Directed to the Poor
5
Picture 6
Human Resources for Health Care.
6
Picture 7
Proposed Reforms
7
Picture 8
Outline of the Main Report
7
2. Overview of Health Sector Financing and Delivery Systems
9
Picture 9
Overview of Health Expenditures and System Resources
9
Picture 10
Health Care Access and Use
11
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