The World Health Organization’s Building Block Framework was established in 2007 by the World Health Organization (WHO) to strengthen health systems worldwide. The framework constitutes what it entails to have a health system so that it can strengthen it. There are six building blocks: service delivery, health workforce, medical products, vaccines and technologies, service delivery, and governance (Carrillo-Larco et al., 2022). When these six building blocks are well strengthened, they will achieve improved health and responsiveness, which determines how well the systems respond to health changes and other needs. The other outcomes are financial risk protection and improved efficiency. This study aims to evaluate how it has established the system-building block of service delivery to achieve the overall goals of improved health and responsiveness.
(Access Coverage) Improved Health (Level and Equity)
Peru has made significant steps in developing healthcare; however, many citizens still live below the poverty line. It has been a challenge for these people to access healthcare services. Peru’s government has partnered with other organizations to increase its healthcare access coverage to the rural population and poor urban locations without access to healthcare. For instance, the Peru Government in 2009 passed universal health Insurance for all Peruvians (Carrillo-Larco et al., 2022). In 2015, it expanded this to cover those with children below five years and pregnant women to access the Ministry of Health’s Integral Health Insurance (Carrillo-Larco et al., 2022). In addition, healthcare workers who work in rural areas are given incentives to encourage more people to work in areas that lack coverage (Carrillo-Larco et al., 2022). This move has helped many healthcare professionals to go to the rural and other zones of high priority, which has made improved health a priority for all.
Peru has commissioned the reformation of all healthcare facilities across the country to improve healthcare service delivery. Towards the end of 2014, the Peru government initiated a plan to renovate all the healthcare facilities and modernize them (Chávez Sosa et al., 2022). This plan has made tremendous efforts by improving the level of technology used in healthcare services hence the quality of services offered. Through the 2014 plan, there was a reconstruction of 13 national hospitals, 23 regional hospitals, and 170 provincial hospitals (Carrillo-Larco et al., 2022). This move has seen improved access coverage to healthcare service delivery for health for all citizens.
The Peru government has commissioned non-governmental organizations known as Partners in Health to work in locations where quality health could not have been reached. The deeply rooted partnership in Peru has ten poverty-stricken clinics in Lima sections. These clinics have significantly helped to improve healthcare delivery in the region of Lima by meeting the specific needs of the residents. Partners in Health (PIH) is the leading global leader in treating and studying tuberculosis and has established a Center for Global Health Delivery in (Partners in Health, 2019). This shows that there has been extensive research on the diseases around Lima and the best solutions to them. This move has increased service delivery in the country and achieved the goal of improved health, bringing level and equity.
Following the COVID-19 pandemic, the world health systems have established the need for responsiveness in service delivery. During the pandemic, service delivery and responsiveness were essential in saving the lives of citizens infected with the virus. Peru has initiated various service delivery strategies that have enhanced responsiveness, such as an open government-citizen engagement policy, better regulation, and service delivery support (Chávez Sosa et al., 2022). Peru has established a multi-sector monitoring commission (CMS) which has been instrumental in engaging the public. This body engages the public on open government priorities to help improve its functions and response to emerging health challenges. When people choose services that will be prioritized, they get to describe the most urgent and fatal health challenges they are experiencing. Therefore the government solves these challenges based on their priority which has made Peru’s healthcare system responsive through service delivery.
The Peru government has increased its responsiveness to the healthcare system by dividing it. The Peru healthcare system has divided into four-tier systems: The Social Science Insurance System, Ministry of Health and District Facilities, private non-profit, and private for-profit organizations (Gianella et al., 2020). With the decentralized healthcare system, the national government sets the overall principles, policies, and frameworks while the local and regional authorities are in the implementation. This is done under the Ministry for Health, where there is a Regional Health Directorate designated by the governor and is in charge of implementing all the national government’s healthcare policies (Gianella et al., 2020). When the services are delegated to the regional health authorities, they control the social insurance, police, and armed forces in implementing the laws. This was first experienced during COVID-19 when the police force was used to ensure that people obey the curfews (Gianella et al., 2020). They had the right to arrest anyone who did not adhere to the curfew laws or was not wearing masks. This shows how the national government has coordinated with regional authorities to enhance service delivery and responsiveness.
After 200 years of independence, Peru has made significant steps in improving its healthcare services. To improve healthcare and enhance equality in service delivery, it has implemented health insurance policies, given incentives to health professionals working in rural areas, commissioned non-governmental organizations, and reformed healthcare facilities. In enhancing responsiveness through service delivery, it has established a multi-sector monitoring commission and decentralized healthcare.
Carrillo-Larco, R. M., Guzman-Vilca, W. C., Leon-Velarde, F., Bernabe-Ortiz, A., Jimenez, M. M., Penny, M. E., Gianella, C., Leguía, M., Tsukayama, P., Hartinger, S. M., Lescano, A. G., Cuba-Fuentes, M. S., Cutipé, Y., Diez-Canseco, F., Mendoza, W., Ugarte-Gil, C., Valdivia-Gago, A., Zavaleta-Cortijo, C., & Miranda, J. J. (2022). Peru – Progress in health and sciences in 200 years of independence. The Lancet Regional Health – Americas, 7(2).
Chávez Sosa, J. V., Guerra Pariona, H. N., & Huancahuire-Vega, S. (2022). Association between perceived access to healthcare and the perception of illness among peruvian adults with chronic diseases during COVID-19 pandemic. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 59(12), 004695802211128.
Gianella, C., Gideon, J., & Romero, M. J. (2020). What does COVID-19 tell us about the Peruvian health system? Canadian Journal of Development Studies / Revue Canadienne d’Études Du Développement, 42(1-2), 55–67.
Partners in Health. (2019). Home. Partners in Health. Web.