Improving Access to Health Care in Peru

Trujillo, Peru. – Giovana gave birth to her new daughter in late February at the Alto Trujillo Health Post, a small public clinic in an urban slum of Trujillo, Peru. The opening of this clinic opened up new options for area residents like Giovana, who now have access to a clean facility with a doctor, but inefficiencies in the health system still limit the availability of services to the poor.

With USAID assistance, public health officials and mangers in Trujillo are now undertaking significant efforts to address some of these inefficiencies through the implementation of an Integrated Network of Health Services. USAID is also working to address financial barriers in the health system that keeps the poor from accessing services.

Because small clinics with limited resources such as the Alto Trujillo Health Post can offer only basic health services, they must look to better-equipped clinics to refer patients for more intensive care – such as in the event of a complicated pregnancy. But the lack of an integrated referral network among health facilities in Trujillo, a city of over 600,000, makes referrals to the city’s two regional hospitals difficult and has often meant that hospital beds are filled with patients who don’t require hospital care.

“Strengthening health systems in developing countries like Peru to be more effective, efficient, and equitable is essential for improving the health of the poor,” says Bob Emrey, Health Systems Division Chief at USAID.

Over half of all Peruvians live in poverty. Residents of the many poor areas in and around Trujillo face diverse barriers in accessing basic and emergency health care services. They are effectively restricted from accessing high quality private clinics, and even when they can afford the services they need in the public sector, they may not be able to access them because of lack of transportation, low service quality, and other obstacles.

The lack of effective service coordination among health facilities also resulted in wasteful duplication of investments that reduced the quality and availability of services. Through the new integrated network, USAID is supporting improved cooperation between facilities that will allow them to specialize and complement each other’s services – rather than duplicate them.

By strengthening cooperation and referral systems, reforms are helping reconfigure the local health system to provide services more broadly and more efficiently. To help ensure that services reach those most in need, USAID’s PHRplus Project also helped develop a means testing approach to target public subsidies through the government’s Integrated Health Insurance Program, that is now being implemented throughout the country.

At clinics like the Alto Trujillo Health Post, these reforms will improve services for patients like Giovana, who would have been referred to the regional hospital in the event of birth complications.

USAID continues to work in Peru and around the world to implement changes in policies and management arrangements within the health sector that result in better outcomes for the poor.