Peru

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 Peru was 26 654 439 inhabitants; by 2023 this figure had risen to 34 352 719, representing a 28.9% increase. Regarding the country’s demographic profile, in 2023 people over 65 years of age accounted for 8.6% of the total population, an increase of 3.9 percentage points compared to the year 2000. In 2023, there were 102. women per 100 men and 33.4 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 65.7% of the total population of the country in 2023 (22 585 144 people). When we add these figures to the potentially passive population (8 822 697 under 15 years of age and 2 944 878 over 65 years of age), the result is a dependency ratio of 52.1 potentially passive people per 100 potentially active people. This ratio was 64.7 in 2000.

Life expectancy at birth in 2023 was 77.0 years, lower than the average for the Region of the Americas and 6.5 years higher that in 2000.

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

Between 2004 and 2018, the average number of years of schooling in Peru increased by 13.5%, reaching an average of 9.8 years in the latest year for which information is available. The unemployment rate in 2022 was 3.7%. Disaggregated by sex, the rate was 4.1% for women and 3.3% for men. The literacy rate was 99.4% in 2020. In men, this figure was 99.4%; in women, 99.5%. In addition, 25.9% of the population were below the national poverty line in 2021, a decrease from 48.4% in 2000. In 2020, 4.4% 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 12.7% (from a score of 0.676 to a score of 0.762); 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 2020, public expenditure on health accounted for 4.28% of gross domestic product (GDP) (Figure 3) and 16.32% of total public expenditure, while out-of-pocket spending on health accounted for 22.76% of total health expenditure.

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

Digital coverage

In 2021, 71.1% of the population had an internet connection, representing a considerable increase from 2000, when 3.1% of the population had an internet connection.

Health situation

Maternal and child health

Between 2002 and 2020, infant mortality in Peru decreased from 16 to 13 deaths per 1000 live births, a decrease of 18.8% (Figure 4). The percentage of low-weight births (less than 2500 g) decreased from 8.4% to 6.7% between 2004 and 2021, while exclusive breastfeeding in the child population up to 6 months of age was 67.2% in 2000 and 69.9% in 2009 (latest available data).

Regarding the immunization strategy, measles vaccination coverage was 74.0% in 2022, a decrease of 23 percentage points from 2000.

The maternal mortality ratio for 2020 was estimated at 68.5 deaths per 100 000 live births, a reduction of 39.5% from the estimated value for 2000 (Figure 5). In relation to fertility, it is estimated that in 2023 women had an average of 2.1 children throughout their reproductive lives. In the specific case of adolescent fertility, there was a 24.8% decrease, from 74.2 live births per 1000 women aged 15 to 19 years in 2000 to 55.8 in 2023. In 2021, 94.9% of births were attended by skilled birth personnel. Between 2000 and 2020 the percentage of pregnant people who had four or more consultations for antenatal care increased from 69% to 88.4%.

Figure 4. Infant mortality per 1000 live births, 1996–2020

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

Communicable diseases

In 2021, there were 76 new cases of tuberculosis per 100 000 population in Peru. In 2019, the overall tuberculosis mortality rate (age-adjusted and per 100 000 population) was 7.1 (4.3 in women and 10.1 in men).

In 2021, the estimated human immunodeficiency virus (HIV) infection incidence rate (new diagnoses) was 22.5 per 100 000 population. The age-adjusted mortality rate for HIV was 2.6 per 100 000 population in 2019. It should be noted that during the 2000-2019 period this indicator decreased by 88.3%.

There was one reported case of human rabies in the country in 2020.

Noncommunicable diseases and risk factors

In Peru in 2023, the prevalence of tobacco use among people aged 15 and older was 6.6%. In the same age group, the prevalence of overweight and obesity was 57.5% in 2016.

In 2015, the reported prevalence of arterial hypertension (high blood pressure) among people aged 18 years or older was 13.7%, a decrease of six percentage points compared to 2000 (19.7%). The prevalence of diabetes mellitus, which stood at 6.7% in 2000, increased to 7.7% in 2014.

Mortality

In 2019, the adjusted rate of potentially preventable premature mortality in Peru was 153.7 deaths per 100 000 population, a decrease of 40.2% compared to the rate of 257.2 in 2000. This meant that, in 2019, the rate in the country was 32.2% lower 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 83.3 per 100 000 population in 2019, which is 39.2% lower than the regional average rate; and the rate for treatable causes was 70.3 per 100 000 population, below the regional average of 89.6.

The overall age-adjusted mortality rate was 4.2 per 1000 population in 2019, a decrease of 30.2% compared to 2000 (six 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 73.5 per 100 000 population (79.9 per 100 000 in men and 66.8 per 100 000 in women), while the age-adjusted mortality rate from noncommunicable diseases was 303.8 per 100 000 population (327.2 per 100 000 in men and 282.6 per 100 000 in women). The rate of age-adjusted mortality from external causes was 42.4 per 100 000 population (63.9 per 100 000 in men and 21.2 per 100 000 in women), including road traffic accidents (13.4 per 100 000 population), homicides (9.1 per 100 000 population) and suicides (2.7 per 100 000 population). In 2000, the percentage distribution of causes was 55.3% for noncommunicable diseases, 33.0% for communicable diseases, and 11.6% for external causes; in 2019, the percentages were 72.6%, 17.5%, and 9.9%, respectively (Figure 6).

Figure 6. Proportional mortality in Peru, 2000 and 2019

Cancer mortality

Regarding cancer mortality from tumors, in 2019, the adjusted mortality rate from prostate cancer was 20.5 per 100 000 men; lung cancer, 10.2 per 100 000; and colorectal cancer, 9 per 100 000. In women, these values were 11.6 deaths per 100 000 for breast cancer, 9.3 per 100 000 for lung cancer, and 6.8 per 100 000 for colorectal cancer.

The health situation and the COVID-19 pandemic

In the Region of the Americas, Peru ranked first in terms of the number of deaths from COVID-19 in 2020, a ranking it maintained in 2021. In 2022 it ranked 16th, with a cumulative figure of 6418.4 deaths per million population for the three years (Figure 7).

According to estimates by the World Health Organization, there was a total of 133 815 excess deaths in 2020, or 406 per 100 000 population. A total of 155 852 deaths were estimated in 2021, for an excess mortality rate of 467 per 100 000.

As of 31 December 2021, at least one dose of COVID-19 vaccine had been given to 87.9% of the country's population. As of 20 April 2022 (latest available data), 81% of the population had completed the vaccination schedule. The vaccination campaign began on 20 February 2021, and three 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

Law No. 30 885, which was approved in 2018, establishes the creation and operation of Integrated Health Networks, which became regulated in 2020, thus instituting the necessary mechanisms for monitoring, supervising, and evaluating them.

In January 2020, the Technical Document Life Course Model of Comprehensive Health Care for the Person, the Family, and the Community (MCI) was approved. A few months later, approval was given to the National Multisectoral Health Policy for 2030: “Peru, Healthy Country,” by which the State committed, over the following ten years, to implement measures to promote healthier behaviors, improve access to health systems, and reduce the social and economic vulnerability of the population. This initiative involves 13 sectors and is overseen by the Ministry of Health.

The following year, in July 2021, the Technical Document National Plan for the Implementation of Integrated Health Networks was approved.

Lastly, the General Government Policy for the period 2021–2026, approved in October 2021, contains ten priority axes and lines of intervention to overcome barriers to the effective and equal exercise of people’s fundamental rights, including the right to health.

Challenges related to population health

One of Peru’s main challenges is to remedy the segmentation and fragmentation of health services, a situation that the government has tried to address by establishing integrated health networks; 91 of these have been structured (the entities that constitute them have been identified), and 75 are operational. 

Another major challenge is to reduce Peruvians’ out-of-pocket spending on health coverage and health care. According to the National Household Survey (ENAHO) 2020, during the pandemic, people without any type of health insurance who experienced symptoms of COVID-19 reported spending 45% more than people with some form of health insurance. 

A third challenge for national health policy is to increase public spending on health (3.3% of GDP in 2018) to reach the medium-term target of 6% by 2030, which was set for the countries of the Region of the Americas in the Sustainable Health Agenda for the Americas 2018–2030.  

The pandemic has had a negative impact on various health indicators, many of which are used to monitor the Sustainable Development Goals. These indicators include maternal mortality and morbidity, particularly among the indigenous population and the dispersed rural population; infant mortality, caused by premature birth and low birth weight; anemia; and vaccine-preventable diseases. Also notable is the high prevalence of overweight and obesity, a condition that especially affects children.

COVID-19 pandemic response

As in many other parts of the world, the COVID-19 pandemic in Peru has provided important lessons, which should be reviewed in the short and medium term to guide the health policies and actions needed in the coming years. 

At the same time, the public policy response to the pandemic had the effect of improving various aspects of people's access to health services and health care, including the following:

 

• The number of human resources for health, primarily medical and nursing professionals, was increased. 
• More than 2500 beds were added in intensive care units (ICUs). 
• The national supply of oxygen was increased through development of oxygen generating plants and by providing oxygen concentrators throughout the country.
• First-level care was strengthened by implementing temporary care centers.
• Stocks of necessary personal protective equipment and supplies, as well as medicines and ICU kits, were secured. 
• The National Laboratory Network for the diagnosis of SARS-CoV-2 was strengthened.
• Essential services were restored.
• Health promotion and primary health care activities were promoted. 
• The work of community health workers—people from the various communities who conduct a variety of activities to promote healthy communities—was strengthened nationwide.
• Telemedicine was promoted and developed at different levels of health care.

Pending tasks include improving health infrastructure, strengthening the work of integrated health networks and at the primary care level, and reactivating priority public health programs.

Measures to reduce inequalities in health

Efforts to address health inequalities are being carried out under the General Government Policy for 2021–2026, which contains ten key areas with priority guidelines and lines of intervention to guide public entities working to eliminate these gaps.

The first of these keys areas promotes social welfare through food security, with a line of action to develop “a universal, unified, free, decentralized, and participatory health system.” 

Similarly, the National Multisectoral Health Policy for 2030: “Peru, Healthy Country” sets forth three objectives:

1. Promote healthier habits, behaviors, and lifestyles in the population.
2. Ensure people's access to timely, quality, comprehensive health services.
3. Improve the living conditions that create vulnerability and health risks.

All these normative instruments, as well as the manual for implementing the Life Course Model of Comprehensive Health Care for the Person, the Family, and the Community, approved in February 2021, establish national strategies to reduce health inequalities and address the social determinants of health throughout the life course, in addition to allocating the resources needed to maintain the entire health system.

Agreement between Peru and the United Nations System

The signing of the United Nations Sustainable Development Cooperation Framework: Peru 2022-2026 focuses on bringing the country into alignment with the 2030 Agenda for Sustainable Development and the Sustainable Development Goals.  Its purpose is to incorporate these guidelines and goals into national policies, through a work plan with five central strategic priorities: social development, environmental sustainability, economic development, democratic governance, and security. 

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.