Access vs Reality: Why Support Services for Children with Disabilities in Peru Fall Short

Last updated: 5 October 2026

Photo: Peru - @ravi

Peru has disability laws on paper. The country ratified the UN Convention on the Rights of Persons with Disabilities (CRPD) in 2008. It passed a General Law on Persons with Disabilities in 2012. However, for children with complex needs, Peru children disabilities services barely exist. The gap between law and reality is enormous. Families of disabled children face a system that promises inclusion but delivers very little. This article examines why support services for children with disabilities in Peru fall short. It is relevant to expert witnesses and decision-makers assessing asylum and immigration cases that involve disabled children.

Legal Framework: Laws That Look Good on Paper

Peru's disability legislation appears strong at first glance. The cornerstone is Law 29973, the General Law on Persons with Disabilities, passed in 2012. This law guarantees equal rights, access to healthcare, inclusive education, and employment opportunities for all persons with disabilities. It also created CONADIS (Consejo Nacional para la Integracion de la Persona con Discapacidad), the National Council for the Integration of Persons with Disabilities. CONADIS is responsible for coordinating disability policy across the government.[1]

In addition, Peru ratified the UN Convention on the Rights of Persons with Disabilities (CRPD) in 2008. This means Peru must follow international standards on disability rights. The CRPD requires states to ensure children with disabilities enjoy all human rights on an equal basis with other children. Article 7 of the CRPD specifically protects children with disabilities. Article 24 requires inclusive education. Article 25 requires accessible healthcare.[2]

Peru also has Law 28044, the General Law on Education (2003). This law mandates inclusive education. It says all children, including those with disabilities, have the right to attend regular schools with proper support. The law created SAANEE (Servicios de Apoyo y Asesoramiento para la Atencion de las Necesidades Educativas Especiales), which are support teams that help schools include disabled children.[3]

On paper, this legal framework is comprehensive. However, the UN Committee on the Rights of Persons with Disabilities has repeatedly found that Peru fails to implement these laws. The committee noted in its 2023 concluding observations that Peru lacks the budget, staff, and infrastructure to turn legal promises into reality. For human rights analysis, the gap between law and practice is the central issue.

Healthcare Gaps: Specialist Services Barely Exist Outside Lima

The healthcare system in Peru does not meet the needs of children with disabilities. This is the most critical failure of Peru children disabilities services. Specialist services are concentrated in Lima, the capital. The rest of the country has very few options. Children who need occupational therapy, speech therapy, or developmental assessments often cannot access them.

Peru has a two-tier healthcare system. The public system, run by the Ministry of Health (MINSA), serves the majority of the population. The private system serves those who can pay. The public system is severely underfunded. Peru spends only about 3.3% of GDP on health, which is well below the Latin American average of 4.2%.[4]

For children with disabilities, this means the following problems:

• No integrated care pathways — there is no system that connects diagnosis, therapy, education, and social support into one plan for the child
• Waiting lists of 6 to 12 months for therapy services at public hospitals in Lima
• No specialist services in rural areas — children in the Andes or the Amazon have no access to developmental paediatricians, child psychologists, or therapists
• Very few trained professionals — Peru has fewer than 200 developmental paediatricians for the entire country

The Instituto Nacional de Rehabilitacion (INR) in Lima is the main public rehabilitation centre. It provides physical therapy, occupational therapy, and speech therapy. However, it serves the entire country from one location. Families from provinces must travel to Lima and stay for weeks or months. Many simply cannot afford this. As a result, children outside Lima go without treatment.[5]

Education Gaps: Inclusive Education That Is Not Inclusive

Peru's inclusive education mandate exists in law, but it fails in practice. Schools lack trained staff, adapted materials, and accessible buildings. The SAANEE support centres are the main mechanism for inclusion. In theory, each SAANEE team serves a group of schools. The team includes special education teachers, psychologists, and therapists. They assess children, create individual plans, and train classroom teachers.

In reality, SAANEE is severely understaffed. A single team may be responsible for 20 to 30 schools across a wide area. Team members cannot visit each school regularly. Many schools receive one visit per semester, or none at all. Teachers in regular schools have no training on how to include children with autism, cerebral palsy, or intellectual disabilities. They often refuse to accept disabled children, despite the legal mandate.[6]

Special education schools (CEBEs — Centros de Educacion Basica Especial) exist, but mainly in cities. There are about 460 CEBEs in Peru. Most are in Lima, Arequipa, and other large cities. Rural provinces may have none. Children with severe disabilities in rural areas simply do not attend school. The Ministry of Education reports that only 61% of children with disabilities are enrolled in any form of education, compared to 94% of children without disabilities.[7]

This situation has serious consequences. Children with disabilities miss critical developmental windows. Without early intervention and proper education, their needs become more complex over time. The country reports on Peru consistently highlight this failure.

Specialist Services by Region: A Stark Divide

What the Law Promises vs What Actually Exists

Therapy and Rehabilitation: Severely Limited Outside Lima

Children with complex needs require ongoing therapy. This includes occupational therapy (OT), speech and language therapy (SLT), and physiotherapy. In Peru, these services are severely limited. The entire public system has fewer than 3,000 rehabilitation professionals, including physical therapists, occupational therapists, and speech therapists. Most work in Lima.[8]

For specific conditions, the situation is even worse. Autism services are almost non-existent outside Lima. Peru passed Law 30150 in 2014, the Law for the Protection of Persons with Autism Spectrum Disorder. This law requires the state to provide early diagnosis, therapy, and educational support for autistic children. However, implementation has been extremely poor. There are no autism-specific services in most provinces. Families must travel to Lima for diagnosis and therapy.[9]

Children with cerebral palsy, Down syndrome, or severe developmental delays face similar barriers. They need regular therapy sessions, assistive devices, and specialist follow-up. The public system cannot provide these consistently. Private therapy is expensive. A single hour of speech therapy costs 80 to 150 PEN ($22 to $40 USD) in the private sector. Most Peruvian families cannot afford this, especially not on a regular basis.

The Committee is concerned about the lack of community-based rehabilitation services for children with disabilities, particularly in rural areas. The Committee notes that specialist services remain concentrated in the capital, leaving children in other regions without access to essential therapy and support.

UN Committee on the Rights of Persons with Disabilities, Concluding Observations on Peru, 2023

Financial Barriers: Insurance That Covers the Basics but Not the Needs

Peru's public health insurance system is called SIS (Seguro Integral de Salud). SIS covers basic healthcare for people in poverty. It pays for hospital visits, basic medications, and some procedures. However, SIS does not cover most specialist disability services. It does not pay for private therapy, specialist assessments, or assistive devices like wheelchairs, hearing aids, or communication tools.[10]

This creates a major barrier. Families of children with disabilities must pay out of pocket for the services their children need. Research shows that having a child with a disability increases household costs by 30% to 50%. At the same time, at least one parent (usually the mother) must stop working to provide daily care. The result is a poverty trap. The family earns less money while spending more on care and treatment.

Peru's poverty rate is approximately 25% nationally. In rural areas, it exceeds 40%. Among households with a disabled family member, poverty rates are even higher. The Programa CONTIGO disability pension of 150 PEN per month (about $40 USD) is available only to people in extreme poverty. It does not cover therapy costs, transport to appointments, or assistive devices. For most families, it is not enough to make a meaningful difference.[11]

Implications for Asylum and Immigration Cases

The failures of Peru children disabilities services have direct relevance for asylum and immigration cases. When courts consider whether a family can be returned to Peru, the best interests of the child must be a primary consideration. This is required by Article 3 of the UN Convention on the Rights of the Child and by ECHR Article 8 (right to private and family life).[12]

For children with disabilities who are currently receiving specialist care in the UK, US, or another developed country, return to Peru would mean:

• Loss of ongoing therapy — speech therapy, occupational therapy, and physiotherapy that may have been in place for years
• Loss of educational support — Education, Health and Care Plans (EHCPs) in the UK or Individualized Education Programs (IEPs) in the US do not exist in Peru
• No continuity of care — medical records, treatment plans, and specialist relationships cannot be transferred
• Regression risk — children with autism or developmental conditions may regress without consistent support

In UK law, the case of Razgar [2004] UKHL 27 established a framework for assessing whether removal would breach Article 8 ECHR. The question is whether the interference with private life is proportionate. For a disabled child, removing them from a functioning support system to a country where services do not exist may be disproportionate. In US immigration law, the best interests of the child standard applies in cancellation of removal cases. The asylum guide section provides further information on these legal standards.

Conclusion

Peru has signed international treaties. It has passed national disability laws. However, the reality for children with disabilities is very different from what the law promises. Specialist healthcare is concentrated in Lima. Schools are not truly inclusive. Therapy services are scarce and expensive. The financial burden falls entirely on families. For children with complex needs, Peru's system simply does not deliver the support they require.

For asylum and immigration decision-makers, this gap between law and reality is the critical issue. The question is not whether Peru has disability laws. The question is whether a child with complex needs would actually receive the services they need. The evidence shows that in most cases, they would not. An expert witness with knowledge of Peru's disability services can present this evidence clearly in court. Understanding the true state of Peru children disabilities services is essential for fair and informed decisions.