<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2664-2891</journal-id>
<journal-title><![CDATA[Revista científica ciencias de la salud]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. cient. cienc. salud]]></abbrev-journal-title>
<issn>2664-2891</issn>
<publisher>
<publisher-name><![CDATA[Universidad del Pacífico]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2664-28912026000100220</article-id>
<article-id pub-id-type="doi">10.53732/rccsalud/e8822</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Evolución de la cobertura médica y accesos a servicios de salud en Paraguay (1997 &#8211; 2024)]]></article-title>
<article-title xml:lang="en"><![CDATA[Evolution of medical coverage and access to health services in Paraguay (1997 &#8211; 2024)]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ríos-González]]></surname>
<given-names><![CDATA[Carlos Miguel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aguilar-Rabito]]></surname>
<given-names><![CDATA[Ana Carolina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Araújo Pino]]></surname>
<given-names><![CDATA[Silvia Stella]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Ministerio de Salud Pública y Bienestar Social Instituto Nacional de Salud ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2026</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2026</year>
</pub-date>
<volume>8</volume>
<fpage>220</fpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2664-28912026000100220&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2664-28912026000100220&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2664-28912026000100220&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN Introducción. Paraguay mantiene una de las coberturas de seguro médico más bajas de América Latina, con más del 70% de la población sin protección financiera en salud. Esta situación se agrava en áreas rurales donde persisten barreras geográficas, económicas y culturales que limitan el acceso efectivo a servicios sanitarios. Objetivo. Analizar la evolución de indicadores de cobertura médica y acceso a servicios de salud en Paraguay (1997-2024), identificando disparidades territoriales y de género. Materiales y Métodos. Estudio transversal seriado utilizando datos de las Encuestas Permanentes de Hogares del Instituto Nacional de Estadística (1997-2024). Se analizaron la cobertura de seguro médico y acceso a servicios ante enfermedad o accidente estratificadas por área de residencia y sexo de 5,9 millones de habitantes mediante estadística descriptiva. Resultados. La cobertura aumentó del 18,2% (1997/98) al 25,9% (2021), manteniéndose 71,4% sin cobertura en 2024. Las brechas urbano-rurales de la cobertura persistieron; 32,9% urbana versus 13,9% rural (2021). El acceso efectivo mejoró del 64,1% al 73,1% (2022-2024), aunque 31% de población rural enferma no consultó servicios. Las mujeres presentaron mayores tasas de consulta (75,1%) que hombres (70,6%), con brechas acentuadas en áreas rurales. Conclusión. El análisis de 27 años de evolución de los indicadores de salud en Paraguay revela un panorama caracterizado por avances graduales en cobertura médica nacional. Paraguay mantiene inequidades críticas con 4,2 millones sin protección financiera. Las disparidades urbano-rurales configuran un sistema dual donde la residencia determina el acceso sanitario, evidenciando necesidad urgente de reformas estructurales hacia cobertura universal con equidad territorial.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT Introduction. Paraguay maintains one of the lowest health insurance coverage rates in Latin America, with over 70% of the population lacking financial protection in health. This situation worsens in rural areas where geographic, economic, and cultural barriers persist, limiting effective access to healthcare services. Objective. To analyze the evolution of health coverage and health service access indicators in Paraguay (1997-2024), identifying territorial and gender disparities. Materials and Methods. Descriptive observational study with repeated cross-sectional design, using data from the National Statistics Institute's Permanent Household Surveys (1997-2024). Data from 5.9 million inhabitants were analyzed using descriptive statistics, calculating proportions stratified by area of residence and sex. Main variables: health insurance coverage and access to services during illness or accident. Results. Coverage increased from 18.2% (1997/98) to 25.9% (2021), with 71.4% remaining without coverage in 2024. Urban-rural gaps persisted: 32.9% urban coverage versus 13.9% rural (2021). Effective access improved from 64.1% to 73.1% (2022-2024), although 31% of sick rural population did not consult services. Women showed higher consultation rates (75.1%) than men (70.6%), with accentuated gaps in rural areas. Conclusion. Analysis of 27 years of health indicator trends in Paraguay (1997-2024) reveals an interesting picture characterized by gradual progress in national health coverage. However, Paraguay continues to face critical inequalities, with 4.2 million people lacking financial protection. Urban-rural disparities create a dual system where residence determines access to healthcare, highlighting the urgent need for structural reforms toward universal coverage with territorial equity.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[cobertura de servicios de salud]]></kwd>
<kwd lng="es"><![CDATA[acceso a los servicios de salud]]></kwd>
<kwd lng="es"><![CDATA[equidad en salud]]></kwd>
<kwd lng="en"><![CDATA[health services coverage]]></kwd>
<kwd lng="en"><![CDATA[health services accessibility]]></kwd>
<kwd lng="en"><![CDATA[health equity]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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