Skip to Main Navigation

Peru's comprehensive health insurance and new challenges for universal coverage (English)

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.


  • Author

    Francke, Pedro

  • Document Date


  • Document Type

    Working Paper (Numbered Series)

  • Report Number


  • Volume No


  • Total Volume(s)


  • Country


  • Region

    Latin America & Caribbean,

  • Disclosure Date


  • Disclosure Status


  • Doc Name

    Peru's comprehensive health insurance and new challenges for universal coverage

  • Keywords

    benefit package;Seguro Integral de Salud;rural area;primary care;health facility;noncommunicable diseases;Health Service;maternal and child health care;institutional architecture;social security system;public health;conditional cash transfer program;elimination of user fee;Maternal and Child Mortality;access to basic service;demand for health services;public expenditure on health;quality of health services;management of health services;low rate of inflation;public health care services;Primary and Secondary Prevention;participation of civil society;united nations general assembly;demand for health care;supply of health services;human resource policies;human resource policy;payment mechanism;epidemiological transition;public health facility;payment for service;disease burden;maternal mortality ratio;social security contribution;human development indicator;public health programs;public health service;Universal Health Care;decentralization reform;early detection;



Official version of document (may contain signatures, etc)

  • Official PDF
  • TXT*
  • Total Downloads** :
  • Download Stats
  • *The text version is uncorrected OCR text and is included solely to benefit users with slow connectivity.


Francke, Pedro

Peru's comprehensive health insurance and new challenges for universal coverage (English). Universal Health Coverage (UNICO) studies series ; no. 11 Washington, D.C. : World Bank Group.