This is the OECD’s first health system review of Peru, and it finds many reasons to commend recent developments in health care delivery. Life expectancy in Peru is now 75.1 years, an improvement of 5.1 years since 2000. Infant and maternal mortality are improving, and are now close to the regional average; infant chronic malnutrition rates have been significantly reduced from 25.4% in 2000 to 14.4% in 2015. Good progress has been made toward universal health coverage (UHC): insurance coverage increased from 37% in 2004 to 83% by the end of April 2017. Institutions such as the dynamic and ambitious Superintendencia Nacional de Salud are helping to make sure patient views of their health care are heard and better reflected in service redesign.

There are many reasons to commend Peru on recent developments in the health system: greatly improved coverage of health care insurance over recent years; outcomes including life expectancy and infant and maternal mortality are improving; and patient views are better reflected. There is substantial room for improvement, however, and the country is now at a crucial time when priorities must be set out and a number of important decisions must be made. If Peru wishes to see its health system as a peer among OECD countries – in terms of outcomes, governance, quality, and information infrastructure – then multiple issues will need to be addressed.

The Peruvian population’s health needs, and the Peruvian health system, are both young, dynamic, and changing rapidly. Both face complex challenges, where long-standing problems must be confronted alongside emerging concerns. In particular, Peru is experiencing worsening rates of non-communicable diseases – alongside a persistently high rate of infectious disease. The health system, meanwhile, is simultaneously grappling with how to assure basic access – universal health coverage has still not been achieved, for instance – whilst prioritising efficiency and value for money, and improving quality of care.

This chapter describes the context within which the Peruvian health care operates. It begins by summarising the main demographic, socio-economic and epidemiologic trends in Peru. Key achievements towards achieving universal health coverage are discussed, as well as remaining challenges.

Peru has made significant progress towards universal health coverage during the past decades. However, there are still challenges to overcome in order to provide accessible health care services of high quality to the whole population. Health care coverage needs to reach the uninsured population and stronger financial protection against out-of-pocket spending for health services should be established. Furthermore, increasing the health workforce density and distribution across Peru’s geographical areas is a priority.

Peru has made substantial progress toward universal health coverage, increasing population health insurance coverage from 37% in 2004 to 83%, according to latest estimates from SUSALUD. The Sistema Integral de Salud (SIS), provided by government, has been the main source of this expanded coverage. Despite such progress, however, much remains to be done.