Paraguay

Paraguay is a landlocked country in South America with one of the highest rates of poverty in Latin America. Governmental instability and markedly unequal income distribution have impaired efforts to deliver medical and other social services, particularly to the poor, although recently great improvements have been made in maternal and child health. The population of just under 7 million is primarily (95 percent) Mestizo (mixed Spanish and Amerindian) and most people understand both Spanish and Guaran (an Amerindian language). Most of the population (89.6 percent) are Roman Catholic, with most of the remainder Protestant.

Paraguay has the typical age structure of a developing nation, with a median age of 21.9 years of age and 36.7 percent of the population age 14 years or younger. The population growth rate in 2009 is estimated to be 2.4 percent, and the total fertility rate (an estimate of the number of children per woman) is 3.75. The sex ratio in the population is 1.01 males for every female, with 1.05 males per female at birth, 1.01 males per female in the 15–64 age group, and 0.86 males per female in the 65-and-older age group. Life expectancy at birth is 73.2 years for males and 78.5 years for females. Literacy is high and approximately equal for men (94.9 percent) and women (93 percent).

The Gross Domestic Product (GDP) per capita was estimated at $4,200 in 2008, and income distribution is highly unequal. The Gini index (which measures the degree of inequality in family distribution of income; the higher the index, the greater the inequality) is 56.8 and the upper decile of the population receives 46.1 percent of the income, versus 0.7 percent for the lowest decile. Total expenditures on health constitute 8.4 percent of the GDP, with about one-third of that coming from the government: most of the rest is out-of-pocket private expenditures. Private prepaid health plans constitute 11.4 percent of the private expenditure on health. Routine vaccination is entirely financed by government funds, and coverage for major diseases ranges from 55 percent for HiB (Haemophilus influenza type B) to 91 percent for measles.

Forty-eight percent of women use modern methods of contraception, 89 percent have four or more prenatal care visits, and 61 percent of births are attended by skilled personnel. Maternal mortality in 200 was 170 deaths per 100,000 live births, while the stillbirth rate was 10 per 1,000 total births, the early neonatal mortality rate 9 per 1,000 live births, and the neonatal mortality rate 16 per 1,000 live births. Save the Children, an international organization devoted to improving maternal and child health, places Paraguay in its Tier II or less developed countries, where it ranks 44th out of 66 countries on the Women's Index (taking into account factors such as life expectancy, maternal mortality, availability of modern contraception, and maternity leave benefits) and 39th out of 66 countries on the Mothers' Index (taking into account additional factors related to children's health and well-being, such as the under-5 mortality rate and gender parity in primary school enrollment).

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