[{"bbox": [194, 152, 1073, 208], "category": "List-item", "text": "- *Red Amachay*, which is not a programme, but an inter-sector and intergovernmental support network to protect for elderly people at high risk and people with severe disability."}, {"bbox": [158, 218, 1073, 323], "category": "Text", "text": "Some of these MIDIS programmes take the form of non-contributory cash transfers, others target specific vulnerable categories or particular groups. Cash-transfers are primarily conditional to children school enrolment, attendance and vaccination or to natal care for mothers and new born babies."}, {"bbox": [158, 336, 1073, 392], "category": "Text", "text": "MIMPV is responsible for social care services targeting specifically vulnerable women or women victim of violence, including:"}, {"bbox": [194, 402, 1073, 457], "category": "List-item", "text": "- Casa de la Mujer, municipal centres responsible for the promotion and protection of women's rights and their active participation;"}, {"bbox": [194, 468, 1073, 523], "category": "List-item", "text": "- Centros Emergencia Mujer (CEM), women's shelters specialised in attending cases of domestic and sexual violence and their prevention preventing; and"}, {"bbox": [194, 534, 1014, 562], "category": "List-item", "text": "- Centros de Desarrollo Integral Familiar, shelters for vulnerable and migrant children."}, {"bbox": [158, 574, 1073, 678], "category": "Text", "text": "The contributory pillar, whose responsibility lies with the Ministry of Labour and Employment Promotion (MTPE) includes the programmes that provide its beneficiaries with insurance that allows them to maintain minimum quality of life in times of sickness, unemployment, incapacity and retirement."}, {"bbox": [158, 692, 1073, 774], "category": "Text", "text": "MTPE is responsible for the health insurance for the formally employed which is administrated by its Social Health Insurance *Essalud*. It also administers insurance and/or subsidies covering invalidity, maternity and lactation."}, {"bbox": [158, 784, 1073, 865], "category": "Text", "text": "The Ministry of Economy and Finance (MEF) is responsible for public pensions disbursed by its *Oficina de Normalización Previsional (ONP)*, which calculates pensions rights and pays pensions for retirement, invalidity, widows, orphans and other."}, {"bbox": [158, 876, 1073, 932], "category": "Text", "text": "Articulation of social assistance programmes needs to be improved at national level (horizontal coordination) and between national, regional and local governments (vertical coordination)."}, {"bbox": [158, 941, 1073, 1103], "category": "Text", "text": "The non-contributory health insurance is provided by the SIS, the state subsidised *Seguro Integral de Salud (SIS)*, which is managed by the Ministry of Health and covers above 70% of the population. It offers a low quality health coverage to vulnerable and informal workers. The contributory social assistance and social insurance components of social protection in Peru are not part of a coherent system where each part converges with the aim of providing a responsive security social net or is responsible for specific social protection floors."}, {"bbox": [158, 1113, 1073, 1222], "category": "Text", "text": "Within the health sector exists the same fragmentation because the two main insurers, the SIS (subsidised) and Essalud (contributory paid by formal workers) generate different sub-systems, each one managing its health centres and clinics nationwide with no inter-operability and with different quality and standards in the services offered."}, {"bbox": [158, 1232, 1073, 1287], "category": "Text", "text": "If the overall social protection system is not reformed, as it stands is not providing adequate coverage of Peruvians and foreign residents in Perú throughout their life cycle."}, {"bbox": [158, 1297, 696, 1326], "category": "Text", "text": "Major short-comings and challenges to be tackled include:"}, {"bbox": [194, 1336, 1073, 1392], "category": "List-item", "text": "- The fragmentation of the social protection system and the lack of coherence and coordination between social assistance, social insurance and active labour market policies;"}, {"bbox": [194, 1402, 1073, 1458], "category": "List-item", "text": "- The need to increase investment in social protection, not least in the light of the current protests, and with a focus on ethnic minorities and gender inequalities;"}, {"bbox": [194, 1467, 1073, 1576], "category": "List-item", "text": "- The need for a comprehensive social protection system in Perú: public debates show that not all stakeholders have a common understanding of social protection. It is critical to promote public discussions, build a shared vision and define a mechanism to ensure the fiscal sustainability and governance of the social protection system;"}, {"bbox": [976, 1665, 1081, 1691], "category": "Page-footer", "text": "Page 7 of 27"}]