Health in Paraguay

The MSPyBS is Paraguay's national health authority and the rector of the SNS. Ley 1032/1996 provides the framework for public, private, mixed and university participation, while the Código Sanitario establishes additional health rules. Public care follows the principle of access without discrimination, but the practical system remains segmented: MSPyBS services, Instituto de Previsión Social (IPS) services and private providers operate through parallel formal arrangements. Insurance coverage, private fees and reimbursements belong to the separate insurance and costs topics. A local USF is normally the first contact for routine health care. It provides health promotion, prevention, basic examinations, treatment, medicines available through the institution and family or community work. Depending on the area, a person may instead first reach a Puesto de Salud or Centro de Salud. The 18 Regiones Sanitarias manage territorial coordination, so opening hours, appointment procedures, identification requirements, staffing and available services can differ between facilities. When a USF cannot provide the required care, the provider can arrange a formal referencia to a higher level such as a Hospital Distrital, Hospital Regional, general hospital or specialized hospital. The Redes Integradas e Integrales de Servicios de Salud (RIISS) use referral documentation, relevant findings and a clinical reason for the transfer. A contrarreferencia returns follow-up to the original service when appropriate. A referral does not automatically guarantee a specialist appointment, hospital admission or a particular waiting time. Routine examinations and follow-up depend on the provider and region. Genuine emergencies should go directly to emergency care rather than wait for a routine appointment. SEME provides free pre-hospital emergency assistance through 141, available 24 hours a day. The numbers 911 for police and 132 for firefighters may also be relevant to the incident. Línea 154 provides MSPyBS user information and complaints throughout the year; confirm current contact details before relying on any telephone service. MSPyBS facilities provide their available services, medicines and supplies free of charge. Public users should not be asked to pay for appointments, waiting-list positions, operations, procedures or other public MSPyBS services. An unauthorized payment demand can be reported through MSPyBS channels. Private and IPS prices, insurance coverage and reimbursement depend on the separate arrangement and should not be assumed from the public MSPyBS rules. The Programa Ampliado de Inmunizaciones (PAI) maintains vaccination services across the life course. Vacunatorios provide vaccines free of charge throughout the year, subject to the current schedule and local availability. Check the vaccination record or Libreta, ask the PAI or MSPyBS for the current calendar and confirm the location before attending. Screening and other prevention programs also depend on regional availability. The Dirección Nacional de Vigilancia Sanitaria (DNVS) regulates the registration, prescription and distribution of medicines and health products. The normal rule is to obtain prescription medicines from an authorized pharmacy or a health-service pharmacy; authorities define exceptions. Public facilities do not guarantee every requested medicine because availability follows institutional lists and current stock. Counterfeit, expired, unregistered or illegally imported products are prohibited, and prescription or psychotropic medicines should not be self-medicated. Mental health care follows Ley 7018/2022, which emphasizes person-centred, community-based rehabilitation, the least restrictive care, non-discrimination, understandable information, consent, support and confidentiality. Línea 155 offers free, confidential, nationwide support 24 hours a day for emotional crisis, suicidal thoughts, anxiety or panic, depression and trauma. A person facing immediate danger should also call 141 or 911. Involuntary admission requires strict clinical grounds, assessment by two doctors including a psychiatrist and notification to the Ministerio de la Defensa Pública within 72 hours. Long-term institutionalization cannot be based only on social, political, economic, racial or religious circumstances. PRONASIDA provides voluntary, free and confidential HIV and sexually transmitted infection testing, counselling, diagnosis and treatment through decentralized Servicios de Atención Integral (SAI). Antiretroviral treatment and related support are available through habilitated services. Post-exposure prophylaxis (PEP) works best when started immediately, must begin no later than 72 hours after exposure and is taken for 28 days. Pre-exposure prophylaxis (PrEP) is free through habilitated MSPyBS services, with teleconsultation available in some settings. Pregnancy-related exposure and sexual violence require prompt care. Every MSPyBS level, including USF services, can provide immediate medical, psychological and social care after violence. Assessment may include injuries, sexually transmitted infections, HIV risk and emergency contraception. Staff can preserve evidence and maintain chain of custody when relevant. Fiscalía, Policía, Juzgado or CODENI may provide reporting, protection or child-safeguarding measures depending on the case, but medical care should not be delayed until a complaint has been filed. Paraguay includes 20 Indigenous peoples, and distance, transport, language, cost-related travel burdens and cultural fit can affect access. Mobile or Indigenous USF services, APS teams and regional or specialized facilities can provide functional alternatives, especially in the Chaco and remote border areas. Intercultural practice and community participation support safer communication and continuity. SENEPA and the Dirección General de Vigilancia de la Salud (DGVS) address vector prevention, epidemiological surveillance and laboratory monitoring; dengue prevention combines household and environmental measures, vector control, early fever recognition and timely medical care. After treatment, care may continue through contrarreferencia, chronic-condition monitoring, rehabilitation, mental health follow-up or medicine review. Ley 7340/2024 recognizes palliative care, including informed decisions, pain and symptom control, confidentiality and home care where resources allow. Patients should provide accurate information, follow agreed treatment and medication instructions as far as possible, and keep appointments when they can. Parents and legal guardians have vaccination and child-protection responsibilities under the applicable PAI and child-protection framework. Patients retain rights to understandable information, informed consent, dignity, non-discrimination, privacy, confidentiality and access to their treatment information under the legal framework.