Joanna has been a nurse for 5 years and works in a Save the Children supported health programme for young mothers and children, Lima, Peru.Credit: Laura Kennedy/Save the Children
Save the Children has worked in Peru for more than 20 years. We work with some of the poorest and most marginalised families here, empowering communities to improve their own environments and livelihoods, helping children get a decent education (even if they speak a minority language or have a disability), and protecting children from exploitation, neglect and abuse.
We work with a partner organisation, Tierra de Niños (Land of Children), in Villa Salvador to run a programme called Family Learning, which helps families better care for their children’s health and wellbeing. We helped Ana’s family create a cleaner, more organised space in which to look after Franco and Luis Alexis, showed them ways to play together, developing patience and better emotional connections, and helped them understand the importance of looking after their health with regular medical check-ups.
Ana says: “The biggest problem here is the water – we don’t have a water system – and ownership. It’s very hard to get papers to show you own your house or land. Over the last year life has changed and it’s a little better. The health workers have come and they’ve taught us some things. We’ve now created spaces for the children to play. I’ve learnt a few techniques to make things better. I’m taking better care of their health – I try to take them to the health centre now. In the past we didn’t go to the hospital but now the health workers come and remind me to go. They ask ‘what about the health of the baby’. And they showed me how to create areas in the house especially for the children to play.”
|Neonatal mortality rate (per 1,000 live births) (2011)||9|
|Under-five mortality rate (per 1,000 live births) (2011)||18|
|Maternal mortality ratio (per 100,000 live births) (2010)||67|
|Number of doctors, nurses and midwives per 10,000 people (2010)||21.9|
|Births attended by skilled personnel (2011)||85%|
|Total expenditure on health as a percentage of gross domestic product (2011)||4.8%|
|General government expenditure on health as a percentage of total expenditure on health (2011)||56.1%|
In Peru, 90% of the population is covered by the Ministry of Health (60%) and the Seguro Social de Salud de Perú, or EsSalud (30%). The remaining 10% receive services from the private sector, the Armed Forces and the National Police. The Integral Health Insurance (Seguro Integral de Salud – SIS) covers the informal economy workers, self-employed in rural areas and the unemployed and their families. As Peru’s system is decentralized, basic health services are defined locally according to financial resources available and organization of services.
Peru has a low health workforce density and faces geographical distribution imbalances: there are 7.7 physicians per 10.000 habitants in Lima while in rural regions such as Andean and Amazon jungle this number is below 4. A similar situation is found for other health cadres such as nurses (1 per physician) and midwives. The country requires a strengthening of the HRH information system, and of regulation of the quality of health professional education and practice. A HRH plan (2010-2014) has been designed to address these challenges.
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