Health Care in Peru has changed drastically from pre-colonial times into the modern era. When the European conquistadors invaded Peru, they brought diseases that afflict the Inca population who do not have immunity. Most of the population is destroyed, and this marks an important turning point in Peruvian health. Since Peru became independent, the country's major health problems have shifted to differences in care between the poor and non-poor, as well as between rural and urban populations. Another unique factor is the presence of indigenous health beliefs, which continue to spread in modern society.
Five sectors manage health care in Peru today: the Ministry of Health (60% of the population), EsSalud (30% of the population), and the Armed Forces (FFAA), the National Police (PNP), and the private sector (10% of the population).
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History
Prior to the arrival of the Spanish conquistadors in the early 1500s, the Inca Empire population covering five countries - Ecuador, Peru, Bolivia, northern and central Chile, northwest Argentina - was estimated at between 9 million and 16 million people. The Andean people have been isolated for thousands of years and therefore have no reason to build up immunity against foreign diseases. This means that the introduction of non-native populations has the potential to spell disaster for the Andeans. Even before Francisco Pizarro arrived on the coast of Peru, the Spaniards had spread diseases like smallpox, malaria, typhoid, influenza, and common cold to South Americans. Forty years after the arrival of European explorers and conquerors, the native Peruvians decreased by about 80%. Population recovery is made almost impossible by killer pandemics that occur approximately every ten years. In addition, the stress caused by war, exploitation, socioeconomic changes, and psychological trauma caused by conquest is enough to further weaken indigenous peoples and make recovery impossible.
In 2009, the Peruvian Ministry of Health (MINSA) passed the Universal Health Insurance Act in an effort to achieve universal health coverage. The law introduced a compulsory health insurance system as well, automatically enrolling everyone, regardless of age, living in extreme poverty under Integrated Health Insurance (Seguro Integral de Salud, SIS). As a result, coverage has risen to over 80% of Peruvian population with some form of health insurance. Health workers and access to health care continue to be concentrated in cities and coastal areas, with many areas in the country with very few medical resources. However, the country has been successful in distributing and maintaining health workers in rural and remote areas through a decentralized HR retention plan for health (HRH). This plan, also known as SERUMS, involves every Peruvian medical student who spends a year as a primary care physician in an area or pueblo that lacks medical service providers, after which they proceed to specialize in their own profession.
Maps Healthcare in Peru
Current problem
The risk of infectious diseases in Peru is considered very high. Common diseases include waterborne bacterial diseases, hepatitis A, typhoid fever, dengue fever, malaria, yellow fever, and leptospirosis. In 2010, the World Health Organization collected data on life expectancy of people living in Peru. It was found that, on average, life expectancy for men at birth was 74 years, while for women was 77. These values ​​were higher than the global average of 66 and 71 years respectively. In populations under the age of five, the most common causes of death are congenital anomalies, prematurity, injury, pneumonia, birth asphyxia, neonatal sepsis, diarrhea, and HIV/AIDS. This population mortality has declined steadily since 1990 and now reaches 19 deaths per 1000 live births.
Health care policy struggle
In the years after the collapse of Peru's health sector in the 1980s and 1990s which resulted from hyperinflation and terrorism, health care in Peru has made great strides. Victory includes increased spending; more health care and primary care clinics; sharp spikes in health care utilization, especially in rural areas; improved treatment outcomes, and decreased infant mortality and malnutrition. However, serious problems still exist.
Reduce the gap between poor and non-poor health status
Despite measures taken to reduce the gap between middle- and poor-income citizens, big differences still exist. The infant mortality rate in Peru remains high given the level of income. This figure goes up significantly when discussing the poor. In general, poor citizens in Peru are subject to unhealthy environmental conditions, reduced access to health care, and usually have lower levels of education. Due to environmental problems such as poor sanitation and vector infestations, the incidence of higher infectious diseases is usually seen among these people. In addition, there is a very clear contrast between maternal health in rural (poor) versus urban environments. In rural areas, it was found that fewer than half of women had trained helpers during labor, compared with nearly 90% of urban women. According to a 2007 report, 36.1% of women in the poorest sector delivered in health facilities, compared with 98.4% of those in the richest sector. A relatively high maternal mortality rate can be attributed to this disparity. In addition to allocating less GDP for health care than its Latin American counterpart, Peru also showed inequality in the amount of resources set aside for the poor and non-poor. The richest 20% of the population consumes about 4.5 times the number of health goods and services per capita than the poorest 20%.
Traditional and native medicine
In 2006, about 47% of Peru's population was considered indigenous. Many indigenous people continue to practice the medical practices used by their ancestors, which make the Peruvian medical system very interesting and unique. In many parts of the country, shamans (also known as curanderos) help maintain a balance between body and soul. It is common belief that when this relationship is disrupted, illness will occur. Common diseases suffered by indigenous peoples of Peru include susto, hap'iqasqa (struck by the earth), machu wayra (evil wind or ancestral disease), uraÃÆ' Â ± a (a disease caused by wind or walking soul)), cold , bronchitis, and tuberculosis. To treat many of these diseases, indigenous communities rely on a mixture of traditional and modern medicine.
Many people composed of indigenous peoples of Peru experience health problems due to the environment in which they live. Many of these places are very isolated and there is often reduced access to food, water, and shelter, as well as basic health care. According to one study, infant mortality in indigenous peoples can be 3-4 times higher than the national average.
In recent years, there has been a tendency for migration to urban areas, which has made some indigenous people as a result of acculturation. There have been reports of increases in health problems such as alcoholism, obesity, and hypertension, which are generally observed more frequently in urban populations. Perhaps because of these health risks, many indigenous people choose to live in voluntary isolation from mainstream society.
Intersection of traditional and modern medicine
Shamanism is still an important part of medical care in Peru, with curanderos, traditional healers, serving the local community, often free of charge. One important aspect of the Peruvian Amazon curanderos is the use of ayahuasca, a drink with a long ceremonial history, traditionally used by shamans to assist in his healing work. With the introduction of Western medicine to many areas of Peru, however, interest in training to become curandero is diminishing, and shamans innovate in new ways to use ayahuasca. Young people increasingly use popular tourist interest in beverages and psychotherapeutic properties as an excuse to undergo training to become curandero and continue the tradition.
Curanderos, herbs, and traditional remedies still have a place in Peru's health care system, even as biomedicine (Western Medicine) is available and affordable for everyone, including rural communities. In fact, it has been seen that the use of sustainable traditional medical care does not depend on access or affordability of biomedical treatments, in Peru and in many other customary areas of Latin America. There is a strong dependence on the use of medicinal plants in the household, especially as the first response to a health emergency. Many households have a strong knowledge base on medicinal plants, valuing independence for being able to handle health emergencies, although the emphasis on maintaining the storage of this knowledge decreases. Studies show that Peruvian households, such as those in the Andean region near Pitumarca, and those in the small town of El Porvenir near Trujillo, still prefer herbal treatments for the use of drugs, especially for certain cultural or psychosocial diseases. Although some drugs are preferred for household herbal solutions, as they are more effective, prescribed by doctors, and supported by scientific research, others have many reasons to prefer traditional solutions. The reasons include the view that medicinal plants are more natural and healthier, cheaper, and able to treat cultural and regional diseases beyond the scope of biomedicine. One study also showed dependence on medicinal plants as a form of "cultural resistance"; Despite the biomedical dominance of indigenous community health systems, local communities use both in their relationships and understand local treatment as an effective and representative cultural identity. With the advent of biomedicine in these communities, they see the price increase of traditional and local medicine in response. In other instances, for example with childbirth, the government has played a greater role in encouraging biomedical and technological services. This is partly due to the development and political efforts of the population, but these measures have been opposed, accepted, and modified by indigenous women.
However, many Peruvians do "medical pluralism" in their health seeking behavior, using a combination of different health systems. For example, some women are encouraged and forced to go to a medical clinic to give birth as well as pharmaceutical pills prescribed with herbal tea medicine. Western medicine and traditional medicine are not seen as the only exclusive ones, and are instead used complementarily, with households often providing an assessment of the treatments they think will be most effective with any medical emergency.
Government roles and expenditures
The health system of Peru is divided into several major sectors: the Ministry of Health of Peru (Ministerio de Salud, or MINSA), EsSALUD (Seguro Sosial de Salud), smaller public programs, large public sector, and several NGOs.
Infrastructure
In 2014, the National Registry of Health Establishments and Medical Services (Registry Nacional de Establecimientos de Salud y Servicios Medicos de Apoyo - RENAES) show there are 1,078 hospitals in the country. The hospital is linked to one of 13 dependencies, the most important being the Local Government (450 hospitals, 42% of the total), EsSalud (97 hospitals, 9% of the total), MINSA (54 hospitals, 5% of the total) and Private Sector (413 hospitals, 38% of total) Five, the capital, contributed 23% of hospitals in the country (250 hospitals).
MINSA
According to its website, the mission of the Ministry of Health of Peru (MINSA) is to "protect personal dignity, promote health, prevent disease and ensure comprehensive health care for all residents of the country, and propose and lead health care policy guidelines." in consultation with all public and social actors. "In order to implement its objectives, MINSA is funded by tax revenues, external borrowing and user fees MINSA provides most of Peru's primary healthcare services, especially for the poor.In 2004, MINSA recorded 57 million visits, or approximately 80% of health care the public sector.
ESSALUD
EsSALUD is part of the social security program in Peru, and is funded by payroll taxes paid by sector employers. It came after pressure during the 1920s for some types of systems that would protect the growing number of union workers. In 1935, the Peruvian government took steps to study the social security system of Argentina, Chile, and Uruguay. After the research, EsSalud was formed in Peru. Since private insurance covers only a small percentage of the population, programs like MINSA and EsSALUD are very important for Peruvian society.
The role of non-governmental organizations
NGOs began to emerge in Peru in 1960, and have steadily increased since then. The end of violence associated with the movement of the Shining Path accelerated the growth of NGOs in Peru. NGOs prevalent in Peru today include USAID, Doctors without Borders, Health Partners, UNICEF, CARE, and AIDESEP. Such programs work with MINSA to improve infrastructure and make changes to health practices and insurance programs. Many organizations also work at the forefront of health care, providing drugs (including contraceptives and vitamins), education, and support to Peru, especially in poor or inaccessible areas where the greatest need is. Such programs have helped Peru's war diseases such as AIDS and tuberculosis, and have generally reduced mortality and improved living standards.
Expenditure
Relative to all of Latin America, Peru does not spend much money on health care for its citizens. The 2004 report shows that spending in Peru is 3.5 percent of GDP, compared with 7 percent for other Latin American regions. In addition, Peru spent $ 100 USD per capita on health in 2004, compared to an average of $ 262 USD per capita spent by other countries in Latin America. However, Peru spends more on health care than its military, which sets it apart from many other Latin American countries.
References
Bibliography
- Borja, A. (2010). Medical pluralism in Peru - Traditional medicine in Peruvian society. (Master in Art in Global Studies, Brandeis University).
- Cotlear, D. (Ed.). (2006). New social contract for peru: Agenda for improving education, health care, and social safety nets. Washington, D.C.: World Bank.
- EsSalud: Social Seguridad of todos. (2012). Plan estrategico institucional 2012-2016. Lima, Peru.
- Ministerio de salud del peru. (2012). Retrieved Des/10, 2012, (Minsa.gob.pe)
- Peru: Improving health care for the poor (1999).. Washington, D.C.: World Bank.
- Raul A Montenegro, Carolyn Stephens. (2006). Native health in Latin America and the Caribbean. Lancet, 367, October 28, 2012 - 1859-69.
- Young, F., & amp; Merschrod, K. (2009). Child health and NGOs in Peru province, 12 December 2012.
Source of the article : Wikipedia
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