The Health System in Paraguay: structure, functioning and current challenges

Abstract

Paraguay's National Health System is undergoing a dynamic transformation, addressing longstanding structural challenges with an increasingly equity-driven, integrated, and efficient approach. While key issues such as system fragmentation, public-private segmentation, unequal resource distribution, and high out-of-pocket spending remain, significant progress has been made that lays a solid foundation for future strengthening. The expansion of Primary Health Care (PHC) through Family Health Units (FHUs) has notably improved access in historically underserved communities, bringing essential services closer to where they are most needed. Recent efforts toward digitalization, intersectoral collaboration, and a stronger commitment to transparency reflect a health system that is evolving to meet the population’s demands with greater responsiveness. This article offers an analytical and forward-looking overview of Paraguay’s health system, examining its legal framework, organizational structure, financing mechanisms, human resources, and performance indicators. Beyond identifying persistent gaps, it proposes concrete and feasible strategies to advance toward a more just, resilient, and sustainable model—one that ensures the right to health with quality and dignity for all, leaving no one behind.