Peru has a decentralized health care system administered by 5 entities: the Ministry of Health (MINSA), which provides health services for 60% of the population; EsSalud, which provides for 30% of the population; and the Armed Forces (FFAA), National Police (PNP), and the private sector together provide services to the remaining 10% (Recursos humanos en salud al 2011). The resulting system contains multiple providers of services and insurance, often performing functions with a high degree of overlap and little coordination. Health workers often work several jobs in multiple subsectors.
There has been an increasing trend in the overall number of health workers despite an increase in health worker outmigration, but no significant difference in HRH densities with the exception of nursing, which has increased (9.7/10,000; Recursos humanos en salud al 2011). There also has been an increased demand for providers, especially medical specialists, over the past decade due to the implementation of universal health insurance and associated policies. Current national HRH density is 17.8/10,000 population.
Overall, inequitable geographic distribution of health workers continues, with Lima and coastal areas having the highest densities, and the areas of Piura (9.6), Lambayeque (10.7) and Loreto (10.8) having the lowest (Recursos humanos en salud al 2011). Demographic differences in densities as well as urban/rural differences have begun to disappear due to implementation of the SERUMS plan, a decentralized HRH retention plan to distribute and retain health workers in remote areas. The plan was developed with an accompanying technical guide containing a baseline, and review of good practices and procedures to implement a long-term retention policy based on intersectoral agreements. Other achievements include: development of a national HRH observatory, and development and implementation of a national HRH strategic plan that is fully costed and integrated with a broader health plan.
COUNTRY COORDINATION AND FACILITATION (CCF) IN PERU:
Peru has completed Phases 1-3 of the CCF process and currently is involved in Phases 4 and 5: Mobilization of Resources for HRH Interventions, and Implementation and Monitoring of the HRH Plan.
Peru’s HRH retention policy partners include:
- the Health and Social Security Commission;
- Executive Branch President of the Council of Ministers;
- Secretary of Decentralization;
- National Civil Service Authority (SERVIR);
- regional governments;
- Ministry of Finance and Economy; Ministry of Education;
- Civil Society; and
- International Organizations (GHWA, PAHO/WHO, UNASUR, Andean Agreement).
As part of the CCF process, Peru has been able to: support open dialogue and consensus-building with HRH stakeholders on best health worker retention strategies; improve management capacity at local levels; and create fellowships to obtain diplomas in HRH policy implementation.
Health Workforce Data
- Latest data from Observatorio Nacional de Recursos Humanos en Salud (Peruvian National Human Resources for Health Observatory)
- Recursos humanos en salud al 2011: Evidencias para la toma de decisiones (in Spanish)
HUMAN RESOURCES FOR HEALTH PLAN
- Los lineamientos de política nacional para el desarrollo de los recursos humanos de salud, Ministerio de Salud, Instituto de Desarrollo de Recursos Humanos, 2005 (in Spanish) [pdf, 2.42mb]
- PLAN SALUD Plan Sectorial concertado y descentralizado para el desarrollo de capacidades en salud 2010-2014
HEALTH SECTOR STRATEGIES / PLANS
- Plan nacional concertado de salud 2007-2020
- Ministerio de Salud: Lineamientos de política sectorial para el periodo 2002-2012 y Principios Fundamentales para el Plan Estratégico Sectorial del Quinquenio Agosto 2001 - Julio 2006