WASHINGTON, February 17, 2009 - The World Bank Board of Executive Directors today approved a US$15 million loan to Peru to improve the equity of and expand access to mother-child rural health care services. The funds will be allocated to the second phase of the Parsalud program, to be implemented during a five-year period by the Ministry of Health. The total budget for the initiative amounts to US$162 million in the country’s nine priority regions.
“The project will support an implementation scheme for universal health coverage, as provided for in the law, by developing pilot areas that integrate solid experience in building the universal health care system,” said the Minister of Health Óscar Ugarte.
The main goal of Parsalud II is to continue the efforts made by Peru to reduce mother and child mortality rates, currently a severe problem.
Mother mortality rates in Peru –164 per 100,000 born alive– are almost double the Latin American average, and child mortality is still a challenge in equity. For instance, while child mortality rates among the country’s high-income population (higher quintile) amount to five per every 1,000 born alive, the figure increases to 45 per every 1,000 born alive among the poorest population (lower quintiles). Additionally, there are staggering differences among regions. While Lima has the lowest child mortality rates with 14 per every 1,000 born alive, the figure amounts to 33 in the Sierra and 38 in the jungle (statistics from 2006).
The program will also help improve the Regional Health Directorates’ health care service networks so that they can offer services adapted to the cultural needs of the indigenous population regarding obstetric and newborn emergencies. The program also expects to deliver integral health care and nutrition services for women and children, including growth checkups and pregnancy and childbirth monitoring.
The initiative will benefit people in the poorest districts of Amazonas, Huánuco, Huancavelica, Ayacucho, Apurimac, Cusco, Cajamarca, Ucayali and Puno. These areas also benefit from the action of the “Juntos” Program, which includes conditional cash transfers that promote the demand for health and nutrition services among poor households.
“The World Bank is very interested in the efforts made by Peru to ensure universal health coverage and considers this to be essential towards achieving the goal of reducing access and quality gaps in mother-child health care services in the poorest areas. This project helps the Ministry of Health respond to both challenges,” said Felipe Jaramillo, World Bank Director for Bolivia, Ecuador, Peru and Venezuela.
The second phase of Parsalud is based on the success of its first phase in 2000-2005, which benefited 649,000 pregnant women and 3,444,000 children under five years of age, exceeding the original expectations set at 503,000 pregnant women and 1,254,000 children. In spite of these achievements, excluded rural areas still present a significant challenge.
An innovative aspect of Parsalud II is a communications and educational component that promotes healthy lifestyles, aims at increasing the demand for health care services, promotes the rights of the poorest population and encourages registration in the SIS and the use of an identity card.
In addition to the normal control mechanisms for these types of loans, the Government of Peru and the World Bank introduced a technical audit system to ensure accountability of resource use.
The US$15 million approved today are based on a LIBOR rate plus a fixed 0.75 percent margin to be repaid in 25 years and a grace period of 11 years.
MoH Goals for the next 5 Years in 9 Regions:
• Reducing the child mortality rate from 42 to 32 per 1,000 born alive
• Increase the rate of births assisted in a health care facility from 44% to 78%
• Reduce the chronic malnutrition rate in children under 5 from 38% to 30%
• Reduce the prevalence of anemia in children under 3 from 69% to 60%
• Increase from 64% to 80% the percentage of breastfed children up to their 6th month
Number of Benefitted Health Care Facilities:
• 115 health care facilities
• 643,158 children under 3, pregnant women, women breastfeeding, women who have just given birth of rural families of the country´s nine poorest regions