Peru has achieved major increases in health coverage in recent decades, especially for the poor.¹ Health sector reform began in the 1990s, and health service coverage rose above 80% of the population by 2014.²Along the way, successful steps toward scaling up were supported by broad political consensus along the way. Health reform measures were introduced by the country's ruling political party in 1998 but eventually gained the cross-party approval of a Universal Health Insurance scheme.³ This bipartisan support was particularly important in a decentralizing health system where the national government sets overall policies and frameworks, to be carried out by local and regional authorities.⁴ Peru’s progress towards universal health coverage was initially based on pilot schemes, which it scaled up over time, eventually expanding health legislation to include full population coverage.³ In the early 2000s efforts were made to promote policy dialogue and consensus around health sector reform, helping to strengthen the foundation for this progress. These were followed by efforts to strengthen capacity and governance capabilities of the Peruvian Ministry of Health as well as within regional and local entities.² 

Peru’s progress towards comprehensive health care began seriously in the late 1990s. In 1999 specific categories of workers were guaranteed health coverage. This was expanded in 2002 to include informal sector workers and the poor. Over the next few years, public health services provision began to be regionalized, moving management of public health centers, supervision and control of production, and organization of levels of care from the central to regional governments.⁵ In 2007, a semi-contributory regime was introduced, in which public funds were combined with private contributions.⁶ Finally, in 2009, legislation instituting universal health insurance was passed⁷ and in 2010 the Universal Health Insurance Law was created as a regulatory framework to achieve universal health coverage by integrating the two main social insurance funds that had been established in prior years.⁸ Following this, in 2012 the president requested health reform guidelines be developed to ensure access and quality of health services.⁷ Peru’s policy successes have resulted from a strong emphasis on planning, consensus-building, inclusive participation by the public and private health sectors, and progressive legislative reforms.²