Primary Healthcare in Paraguay: overview and prospects

This paper presents an overview of Primary Health Care (PHC) in Paraguay, as part of a multicentric study, seeking to identify the possibilities of PHC as a factor for reorganizing the health system. The methodology adopts the comprehensive PHC concept, and takes into consideration the system's segmentation, formed by the public sector of the Ministry of Health and Welfare, Social Security, a not-for-profit private sector, a private for-profit sector and a mixed sector. The study analyzes 5 dimensions: stewardship, financing, resources, integration/continuity, intersectorality/participation, through reviewing data from the literature and official documents, and key informant interviews (experts, decision-makers, professionals and civil society). Advances in health policy legislation since the 1990, with gratuity for all age groups, have been observed. Public spending on health is among the lowest in Latin America. PHC is provided through different vertical programs, with poor coordination and articulation, though a recent political shift prioritizes the progressive implementation of Family Health teams. In conclusion, PHC can contribute to improve health, equity and participation.