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Healthcare expenditure as a percentage of GDP is set to rise to 4.7% over the outlook period, from 4.3% of GDP in 2006-08. As a result of rapid GDP growth in 2003-08, healthcare spending as a percentage of GDP fell slightly, but government efforts to increase spending, together with rising personal incomes, will help to increase the share back towards 5%. According to the World Health Organisation, the government accounted for 57% of Peru's healthcare spending in 2006, more than in Argentina, Brazil and Chile, but less than in Colombia. In local currency terms, the Economist Intelligence Unit expects total spending to rise by an average of over 8% a year over the forecast period, to Ns24bn (US$8bn) in 2013.
Under the social security system, employers pay contributions on behalf of employees. Contributions are made to either the Oficina de Normalización Previsional (the state pension fund) or the Administradoras de Fondos de Pensiones (AFPs, private pension funds). Those who are not affiliated to the state national insurance scheme or to other insurance providers, and who have no private health insurance, are entitled to healthcare provided by the Ministry of Health. Technically this is free, but most public hospitals are so under-funded that many patients buy their own medicines. Private health insurance schemes have proved attractive to the well-off, but cover only a small percentage of the population. Private health insurance programmes will continue to take on new members as private consumption grows, while the government of the president, Alan García, will aim to target spending more effectively and direct it towards basic healthcare services.
Both the public and the private sectors provide healthcare services. More than 450 public hospitals, clinics and healthcare centres around the country provide healthcare services to around 6.5m Peruvians, of whom 2.5m are employees on official company payrolls, and the remainder their spouses and dependents. Hospitals under the health ministry cover around 60% of the population; EsSalud, a public institution that caters to the insured, serves 25%; and the armed forces hospitals cover another 5% of the population. Some universities, municipalities and professional associations also have hospitals and health centres.
The number of private clinics in major cities has grown rapidly since 1990 and now is estimated to provide care for around 15% of the population. Empresas Prestadoras de Salud (EPS, private-sector providers) facilities now include more than 60 clinics and hospitals, and the number of private clinics will continue to grow during the forecast period. The industry is regulated by the Superintendencia de Entidades Prestadoras de Salud (SEPS, the superintendency of healthcare providers), which reported that there were just over 1m beneficiaries by July 2009, an increase of 13% since mid-2008. The best healthcare facilities are located in urban centres. Regional differences are huge, with city hospitals having more doctors and a modern medical infrastructure.
There have been advances in healthcare in recent decades, but there is still a long way to go. Regional variations in infant mortality are pronounced. Vaccination programmes ensure that almost all children are protected against polio, diphtheria, measles, tetanus and tuberculosis. Child malnutrition, measured by height and weight statistics, remains a serious problem, especially in the more remote rural districts. Malnutrition of children under five was estimated at 25.6% in a 2002 survey by the Instituto Nacional de Salud (National Health Institute), with the rate varying from 8% in the Lima to over 40% in parts of the highlands.
In early September 2009 the health ministry reported that a total of 6,961 people had been infected with the AH1N1 influenza virus (swine ‘flu), and that 98 people had died from the virus. The government also announced that it is spending US$100m on a vaccine programme for around 7m people, those most at risk of contracting the virus, and that it plans to have rolled out the vaccines by November. Although the number of new cases per month has fallen since the peak in mid-year, the government has warned of a possible second wave of infection.
The findings of the Health of Nations Index are presented here, along with accompanying information and data on over 50 countries.
Start by scrolling around the map. Hovering over a country will reveal its index results. Click through to find the underlying data and other profile information. Use the tabbed filters above the map to browse by category filter.
How to spend less and get more For most things in life, people usually assume that paying a higher price results in a better quality good or service. But the same maxim is difficult to apply to healthcare.
A world in focus The gift of sight is something most people in the developed world take for granted. In many countries eye-tests for children are routine, so problems are quickly addressed.
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