Revista Cubana de Salud Pública
Print version ISSN 0864-3466
MONJE VARGAS, José Antonio. Equity and investment in the public health system of the Republic of Peru. Rev. cub. salud pública [online]. 2011, vol.37, n.4, pp.452-461. ISSN 0864-3466. http://dx.doi.org/10.1590/S0864-34662011000400009.
Introduction The public investment of the Peruvian state in health care has significantly increased in the last five years. However, there are still serious problems of inequality in terms of allocation of resources, conception of the investment system and management. Objective To make reflections on the logics of the Peruvian public investments in health care that will allow providing adequate advice to the Ministry of Health of Peru, in an attempt to optimize the use of available resources and to have bigger impact on the main health indicators. Methods Review of documents from the Ministry of Health of Peru, of follow-up reports and of the evaluation of implemented investment projects; structured interviews to the staff of that ministry and consultation to experts in public investment, social policies and public health. Results Several Peruvian regions like Huancavelica and Puno have high percentages of chronic malnutrition in under 5 years-old children and higher rates of infant mortality respectively. However, they do not have large investments in the field of health care, despite the mining activities that are developed in these regions in charge of transnational companies. Lack of budget management and operational capacity was detected in the staff responsible for the public investments in health. The National System of Public Investment has structural problems such as breaking up of integrated systemic perspectives, inadequacy of planning, follow-up and evaluation mechanisms, low level of participation of the recipient population and shortage of cross-sectional approaches to investment. Conclusions For the purpose of optimizing the public investments in health and to achieve better results, it is required to carry out technical and conceptual rearrangement of the National Public Investment System by adding indispensable elements of social efficiency, quality and solidarity.
Keywords : Equity; investment in health; projects of public investment in health; National System of Public Investments in Peru.