Honduras

The Health in the Americas+¹ country profiles are based on the interagency indicators available as of the dates referenced. The sources are referenced in this table. In some cases, the values of the indicators may differ from the most recent data available in the country.

Environmental and social determinants of health

In 2000 the total population of Honduras was 6 656 725 inhabitants; by 2023 this figure had risen to 10 593 798, representing a 59.1% increase. Regarding the country’s demographic profile, in 2023 people over 65 years of age accounted for 4.4% of the total population, an increase of 1.4 percentage points compared to the year 2000. In 2023, there were 98.1 women per 100 men and 14.8 older people (65 years or older) per 100 children under 15 years of age, as can be seen in the country’s population pyramids, distributed by age group and sex (Figure 1). Considering the population between 15 and 64 years of age to be potentially active (i.e., potential participants in the labor force), this group represented 65.9% of the total population of the country in 2023 (6 986 185 people). When we add these figures to the potentially passive population (3 143 628 under 15 years of age and 463 985 over 65 years of age), the result is a dependency ratio of 51.6 potentially passive people per 100 potentially active people. This ratio was 84.5 in 2000.

Life expectancy at birth in 2023 was 73.5 years, lower than the average for the Region of the Americas and 4.8 years higher that in 2000.

Figure 1. Population pyramids of Honduras, years 2000 and 2023

Between 2007 and 2019, the average number of years of schooling in Honduras increased by 43.1%, reaching an average of 7.1 years in the latest year for which information is available. The unemployment rate in 2022 was 7.1%. Disaggregated by sex, the rate was 9.7% for women and 5.4% for men. The literacy rate was 96.1% in 2019. In men, this figure was 97.3%; in women, 94.8%. In addition, 48.0% of the population were below the national poverty line in 2019, a decrease from 49.7% in 2014. In 2019, 14.8% of the population was living in poverty, defined as the percentage of the population with an income of less than US$ 1.90 per day; this is below the regional average of 3%.

During the period 2000-2021, the country improved its score on the Human Development Index, with an increase of 11.7% (from a score of 0.556 to a score of 0.621); during the same period, the index rose 13.5% internationally and 9.4% in Latin America (Figure 2).

Figure 2. Human Development Index in the Region of the Americas, 2021

In 2021, public expenditure on health accounted for 3.42% of gross domestic product (GDP) (Figure 3) and 12.3% of total public expenditure, while out-of-pocket spending on health accounted for 51.71% of total health expenditure.

Figure 3. Domestic general government health expenditure as percentage of gross domestic product, 2020

Digital coverage

In 2021, 48.1% of the population had an internet connection, representing a considerable increase from 2000, when 1.2% of the population had an internet connection.

Health situation

Maternal and child health

Between 2000 and 2021, infant mortality in Honduras decreased from 34 to 17 deaths per 1000 live births, a decrease of 50.0% (Figure 4). The percentage of low-weight births (less than 2500 g) increased from 6.9% to 9.8% between 2004 and 2021, while exclusive breastfeeding in the child population up to 6 months of age was 34.9% in 2001 and 30.7% in 2012 (the latest year for which data are available).

Regarding the immunization strategy, measles vaccination coverage was 77.0% in 2022, a decrease of 21.0 percentage points from 2000.

The maternal mortality ratio for 2020 was estimated at 71.8 deaths per 100 000 live births, a reduction of 12.3% from the estimated value for 2000 (Figure 5). In relation to fertility, it is estimated that in 2023 women had an average of 2.3 children throughout their reproductive lives. In the specific case of adolescent fertility, there was a 43.1% decrease, from 123.6 live births per 1000 women aged 15 to 19 years in 2000 to 70.3 in 2023. In 2021, 52.0% of births were attended by skilled birth personnel. Between 2014 and 2019 the percentage of pregnant people who had four or more consultations for antenatal care increased from 89% to 91%.

Figure 4. Infant mortality per 1000 live births, 1995–2020

Figure 5. Maternal mortality per 100 000 live births, 2000–2020

Communicable diseases

In 2021, there were 20 new cases of tuberculosis per 100 000 population in Honduras. In 2019, the overall tuberculosis mortality rate (age-adjusted and per 100 000 population) was 6.2 (4.5 in women and 8.2 in men).

In 2021, the estimated human immunodeficiency virus (HIV) infection incidence rate (new diagnoses) was 10.3 per 100 000 population. The age-adjusted mortality rate for HIV was 11.0 per 100 000 population in 2019. It should be noted that during the 2000-2019 period this indicator decreased by 75.6%.

There were no reported cases of human rabies in the country in 2020.

Noncommunicable diseases and risk factors

In Honduras, the prevalence of overweight and obesity among people aged 15 and older was 55.8% in 2016.

In 2015, the reported prevalence of arterial hypertension (high blood pressure) among people aged 18 years or older was 21.4%, a decrease of 1.5 percentage points compared to 2000 (22.9%). The prevalence of diabetes mellitus, which stood at 6.5% in 2000, increased to 9.3% in 2014.

Mortality

In 2019, the adjusted rate of potentially preventable premature mortality in Honduras was 381.2 deaths per 100 000 population, a decrease of 9.8% compared to the rate of 422.4 in 2000. This meant that, in 2019, the rate in the country was 68.2% higher than the average rate reported for the Region of the Americas as a whole. Among potentially preventable premature deaths, the rate for preventable causes was 231.7 per 100 000 population in 2019, which is 69% higher than the regional average rate; and the rate for treatable causes was 149.5 per 100 000 population, above the regional average of 89.6.

The overall age-adjusted mortality rate was 8.1 per 1000 population in 2019, a decrease of 2.4% compared to 2000 (8.3 deaths per 1000 population).

When deaths are categorized into three main groups, it is observed that, in 2019, the age-adjusted mortality rate from communicable diseases was 72.3 per 100 000 population (81.2 per 100 000 in men and 64.2 per 100 000 in women), while the age-adjusted mortality rate from noncommunicable diseases was 617.4 per 100 000 population (614.3 per 100 000 in men and 621.5 per 100 000 in women). The rate of age-adjusted mortality from external causes was 125.7 per 100 000 population (191 per 100 000 in men and 67.2 per 100 000 in women), including road traffic accidents (21.1 per 100 000 population), homicides (80.9 per 100 000 population) and suicides (2.6 per 100 000 population). In 2000, the percentage distribution of causes was 54.0% for noncommunicable diseases, 29.7% for communicable diseases, and 16.3% for external causes; in 2019, the percentages were 71.4%, 10.7%, and 17.9%, respectively (Figure 6).

Figure 6. Proportional mortality in Honduras, 2000 and 2019

Cancer mortality

Regarding cancer mortality from tumors, in 2019, the adjusted mortality rate from prostate cancer was 14.1 per 100 000 men; lung cancer, 7.5 per 100 000; and colorectal cancer, 6.2 per 100 000. In women, these values were 13.3 deaths per 100 000 for breast cancer; 4.8 per 100 000 for lung cancer; and 4.9 per 100 000 for colorectal cancer.

The health situation and the COVID-19 pandemic

In Honduras in 2020, there was a total of 121 847 cases of COVID-19, representing 11 856 per million population. In 2021, there were 257 715 identified cases, equivalent to 25 075 per million population. In 2020, there were 3130 deaths directly caused by COVID-19 in people diagnosed with the disease, or 304.5 per million population; in 2021, 7306 deaths were reported, or 710.9 per million. In 2020, Honduras ranked 21st in the Region of the Americas in terms of the number of deaths from COVID-19, and 36th in 2021, with a cumulative 1015 deaths per million population over the two years (Figure 7). 

According to estimates by the World Health Organization, there was a total of 7329 excess deaths in 2020, or 74 per 100 000 population; a total of 15 396 deaths were estimated in 2021, for an excess mortality rate of 153 per 100 000.

As of 31 December 2021, at least one dose of COVID-19 vaccine had been given to 53.2% of the country's population. As of 2 July 2022 (latest available data), 53.4% of the population had completed the vaccination schedule. The vaccination campaign began on 20 February 2021, and six types of COVID-19 vaccine have been used to date.

Figure 7. Cumulative COVID-19 deaths in the Region of the Americas, to July 29th, 2023

Prospects

Measures to achieve universal health coverage

Since 27 January 2022, Honduras has been in a period of transition. One of the new government's priorities is to promote universal health coverage. To this end, the Constitutional Chamber of the Supreme Court of Justice declared unconstitutional Decree 56–2015, which implemented the Framework Law on Social Protection and weakened the governing power and national authority of the Ministry of Health (SESAL), fragmenting its functions and promoting the privatization of health services. The legal vacuum created by this ruling is being addressed through review, updating, and approval of a preliminary draft of the National Health System Law, proposed by a tripartite commission comprising the Secretariat of Health, the United Federation of Health Workers of Honduras, and the Pan American Health Organization. This commission is working to strengthen and recognize the non-delegable stewardship function of the national health authority and is seeking to institute universal access to health and universal health coverage, in addition to reviewing and adjusting the National Health Model, based on primary health care.

Challenges related to population health

Among the main public policy challenges is to recognize and restore the governing power of the national health authority, under the leadership of the Secretariat of Health, allowing it to exercise stewardship of the National Health System. To achieve this objective, a National Health System Law is being drafted to improve primary health care. One of the mechanisms proposed in the draft law involves strengthening the provision of public health services, both in terms of the number of health facilities and the quality and safety of health care services, through initiatives to improve and gradually increase health financing, as well as implementing integrated health services networks.

COVID-19 pandemic response

Currently, SESAL is continuing to deal with the health crisis caused by the COVID-19 pandemic, particularly through the response capacity of health facilities. The provision of essential health services has been restored, after being suspended by the emergency measures enacted by the country on 11 March 2020, at the onset of the pandemic. 

SESAL is also deploying other important measures in response to the pandemic, such as the Plan to Contain and Respond to Coronavirus (COVID-19) Cases in Honduras; the National Plan for COVID-19 Risk Communication and Social Participation in Honduras; and the National Plan for Introduction of COVID-19 Vaccines 2020–2021.

Measures to reduce inequalities in health

The National Health Model, one of the country's most important public health policies, incorporates general guidelines to address health inequalities throughout the country, particularly on issues related to discrimination and gender-based violence.

National strategy to address inequalities in health

To address inequalities, SESAL includes in its Institutional Strategic Plan 2018–2022 certain key, cross-cutting elements of different public policies, such as gender, interculturality, and human rights. It also has a series of important instruments, including the National Policy on Gender in Health, and the National Strategy on Gender in Health, as well as a gender implementation plan, a gender mechanism manual, a methodology manual for gender mainstreaming in health, and a manual on gender concepts in health. 

SESAL also has a National Sexual and Reproductive Health Policy, a Standard of Care for Domestic Violence in Honduras, and a Manual on Comprehensive Care for Women Victims/Survivors of Gender-Based Violence.  In addition, Honduras has signed various international human rights conventions, and complies with the monitoring of human rights indicators (SIMOREH tool). 

Lastly, Honduras, as a Member State of the Council of Health Ministers of Central America and the Dominican Republic, reports regularly on the established interculturality indicators.
 

The sources of the interagency indicators used in this profile can be found in this table.

For the latest data on health indicators for the Region of the Americas, be sure to visit the PAHO Core Indicators portal.