Using the Law to Reduce Health Disparities in Peru
Peru has made major strides in recent years in regards to development, with strong economic growth and low inflation. Despite these achievements, among Peru’s more than 29 million inhabitants, great disparities persist: 54% of Peru’s population still lives in poverty, and the UNDP estimates that among those living in poverty, 19% survive on less than USD $1 a day.
In this context, the estimated eight million Peruvians between the ages of 10 and 24 face limited economic, educational, and creative opportunities. They also face enormous challenges in accessing the sexual and reproductive health services—such as family planning and comprehensive sexuality education—that would allow them to make a healthy transition to adulthood. According to the Ministry of Health, less than 2.6% of adolescents use contraception. And although overall teenage birth rates are low relative to other countries in the region, national averages mask great disparities, with less educated and poorer women more likely to have given birth.
These challenges are exacerbated by national regulations that prevent adolescents under the age of 18 from accessing condoms, birth control, pregnancy testing, and counseling at public health clinics without parental consent. Beyond legal obstacles, adolescents also face practical and social barriers to accessing services—particularly if they belong to economically, socially and culturally marginalized communities. The Ministry of Health has issued guidelines to facilitate adolescents’ access to information about family planning as part of its efforts to reduce maternal mortality, but so far, implementation of adolescent-friendly health policies has been slow.
Since the creation of these guidelines at the national level four years ago, many youth advocates in Peru have been looking for a way to accelerate implementation of youth-friendly policies and legislation. Through the Voices project, IPPF/WHR and our Peruvian Member Association, INPPARES, invested in building a strong network of 20 youth organizations to serve as watchdogs for the implementation of adolescent health policies in three regions of Peru.
“One of the principal problems that we’re facing in Peru is that there are a lot of laws, programs, and policies in the area of sexual and reproductive health,” says Giovanna Sofía Carrillo, Voices Project Coordinator at INPPARES, “but very few of them have been applied and implemented in practice. Despite progress at the national level, major gaps persist at the local level.”
INPPARES led a concentrated effort to monitor implementation of existing norms and policies, such as comprehensive sexuality education guidelines, and hold governmental agencies and other key actors accountable. According to Carrillo, this involves more than training governments in effective youth programming in sexual and reproductive health and reproductive rights of youth in Peru.
“This project has been able to give voice to people who have traditionally been excluded from having a real voice and a visible role in the political process,” says Carrillo. “We literally cannot develop as a country without addressing the poverty and discrimination that adolescents face. Preventing unwanted pregnancy is a key part of this: if the state is serious about reducing poverty and promoting development, it has an absolute responsibility to ensure that adolescents have access to family planning services, health information and sexuality education.”
This regional-level focus has also led to increased political participation among young people. In northern Peru’s Lambayeque region, young advocates secured a meeting with government officials to discuss implementation of the youth sexual and reproductive health program. Following this meeting, a Regional Youth Council for citizen monitoring and oversight was established.
“It’s a significant achievement: people who were invisible are now being seen, they are taken into consideration by authorities at the regional and national level. The great struggle that fuels our work is to reduce disparities so that economic growth affects everyone. And to be able to say that Peru’s laws and legal frameworks are more than just symbolic commitments.”