USAID and Peruvian Government Partner to Improve Health Care Inequities

Peru has much poverty and large-scale inequalities between urban and rural populations and between indigenous and non-indigenous populations. The government’s commitment to overcome these inequities coupled with USAID’s technical assistance under the Health Policy Initiative created new policies and strategies to improve access to quality health services. The poor in the Junin region, an historically hard-to-reach population, were targeted for an innovative program to improve their access to family planning (FP). In this region, 64 percent and 57 percent of women residing in the sierra and jungle, respectively, would have preferred delaying their most recent pregnancy. While the women were interested in spacing and limiting births, they were not using effective methods, not using methods correctly and consistently, or not accessing FP services at all.

USAID, through its Health Policy Initiative Project, conducted focus groups to identify the barriers that impede these women’s access to and use of FP services then designed interventions to overcome these barriers. The following achievements were the result:

• Inter-governmental funds leveraged to improve access to FP/RH information. Working with national and local government entities, USAID helped work out a successful plan for leveraging money for educational materials about family planning programs and services. By promoting a partnership between government agencies, poor women now have access to accurate and up-to-date family planning information in formats they can easily understand.
  


• Pro-poor approach integrated into Peru’s social health insurance program. Peru’s existing social insurance program included FP counseling as part of pre- and postpartum care, but did not cover FP services or methods. With assistance from USAID, the President and Minister of Health issued a Supreme Decree establishing a list of obligatory interventions in health establishments that receive Seguro Integral de Salud (SIS) [Integrated Health Insurance System (SIS)] financing. Reproductive Health (RH) counseling and FP were included as one of eight preventive priorities with 100 percent coverage.
  


• Culturally appropriate FP/RH counseling guides for poor, indigenous populations in Peru approved at regional and national levels. To improve access to and quality of services for poor, indigenous populations, USAID designed a technical guide and facilitators’ manual that adapted Ministry of Health (MOH) FP/RH norms, guides, and protocols on counselling to reflect local customs and culture. Both the Regional Health Directorate of Junín and the General Director of the MOH’s General Directorate of the People’s Health approved the guides – emphasizing the Government of Peru’s commitment to reach underserved groups both in the region and nationwide.