Increased density of health workers and development of health infrastructure

Increased density of health workers and infrastructure build up raised the supply and quality of health care overall and in rural areas. This was driven by programs such as PARSALUD, SERUMS, PAN.

Literature Review

One research study found that relatively few health workers enter the Peru’s Ministry of Health system following completion of a program designed to encourage health worker graduates to work in underprivileged settings for a year or more.¹

Quantitative Analysis

According to the linear mixed effects regression, density of human resources for health (doctors, nurses, midwives per 10,000 population) was not found to be significantly associated with stunting prevalence during 2000-2016 or 2008-2016 time periods. It was also not found to be significant in the decomposition analysis for any age group, over any time period.

Qualitative Analysis

The increase in health personnel and development of health infrastructure were noted as important contextual factors that drove decline in stunting.

“I believe that in the 1990s and also in the 2000s, there was a notable expansion of public health services in the country. We progressed from 3,000 health facilities in 1990 to 8,000 afterwards, and I think that the Basic Health for All Program was key. This was important for the ulterior implementation of results-based budgetary programs that relied on preventive packages of interventions… implemented by health services as a starting point.”

- Former Technical Officer at UNICEF.

Conclusion

The density of doctors, nurses, and midwives per 10,000 population increased from 9.04 in 2000 to 28.24 in 2016. Despite this large increase, our analysis suggests that strengthened human resources for health may have contributed to stunting decline in the earlier period, though during the latter period of rapid change, its effect did not push through as significant, meaning that other factors were more important in stunting decline. However, we were not able to compare health worker distribution (i.e., by residence) over time, or health infrastructure development. All in all, increased health worker density and development of health infrastructure was likely important, but not proven definitively.

Back to Analysis