ASUNCIÓN, PARAGUAY – Paraguay ranks 7th in pension coverage rates within the Latin American region, yet the low proportion of contributory pensions and the continued labor force participation of the elderly raise serious questions about the nation's preparedness for an aging society. Adriana Valle, a researcher at the Inter-American Social Security Research Center (Ciess), released this analysis on May 26, 2025, pointing out the structural problems within Paraguay's pension system and the reality of elder welfare.

According to Valle, Paraguay's overall pension coverage rate stands at 65.7%, but within this, non-contributory pensions account for 65.7% while contributory pensions are a mere 18.7%. Non-contributory pensions refer to basic pension types paid from government finances, whereas contributory pensions are received by individuals who have contributed a certain portion of their income. This indicates that most elderly individuals rely on government social welfare programs rather than receiving pensions through their contributions. While about half of workers in Central and South America benefit from social security systems, in Paraguay, it's only two out of ten.

 
Pension Gaps and the Reality of the Elderly

Valle explained that the expansion of non-contributory pension systems across Latin America since 2000 has contributed to increasing pension coverage rates, but benefits remain limited in many countries. Paraguay was cited as one of the countries with the largest gap in terms of pension adequacy relative to the minimum wage. Although these non-contributory pension systems have a positive impact on poverty reduction, many elderly individuals still face the reality of having to work to make a living.

According to Ciess data, nearly 50% of male elderly individuals aged 65 and over, and about 25% of female elderly individuals, are still economically active in Paraguay. These figures demonstrate a significant economic burden on the elderly population. Valle added that Paraguay ranks third highest in the proportion of economically active elderly individuals, after Bolivia and Peru. This reflects the reality that a significant number of seniors must remain in the labor market even beyond retirement age.

Valle emphasized, "Spending on the Tekoporã and elderly programs fluctuates between 0.5% and 0.75% of GDP, helping to alleviate the gaps not met by contributory programs." However, despite these efforts, she pointed out that "a significant portion of the elderly population remains in the labor market even after passing retirement age." This reality signifies an urgent need for new opportunities and skills acquisition programs for the elderly, and policies that encourage their employment.

 
Healthcare System Accessibility: Dependent on 'Pocket Money'

In addition to pension issues, the elderly in Paraguay face significant challenges in accessing the healthcare system. Valle stressed that although a non-contributory public health system exists, this does not translate to effective healthcare services for everyone. Access to medical services is often limited by an individual's labor status and household purchasing power.

According to Valle, only 4 out of 10 elderly adults in Latin America have access to universal healthcare systems. Specifically, in Bolivia and Paraguay, most healthcare services are provided by non-contributory social security systems. This suggests that while public healthcare services play a crucial role, there is still a need for improvement in terms of accessibility and quality.

More concerning is the out-of-pocket medical expenditure rate. Paraguay ranked 8th highest with an out-of-pocket medical expenditure rate of 35.9%, following Mexico and Haiti. This means that a significant portion of the cost required for accessing medical services must be paid directly by individuals, often leading to situations where basic medical services cannot be utilized due to financial burdens. The health expenditure as a percentage of GDP averages around 4.5%, which is a low level compared to other Latin American countries.

Particularly problematic is the fact that 63.9% of the Paraguayan population aged 60 and over are not covered by health insurance. This situation is even more severe in rural areas, where 81.4% of the rural elderly lack health insurance. Urban areas fare slightly better, with 53.4% of the population aged 60 and over uninsured. The low health insurance coverage rate contributes to deteriorating health among the elderly and increases their risk of falling into poverty.

 
Aging Society, Paraguay's Future Challenge

This Ciess analysis clearly illustrates the reality of the aging society that Paraguay faces. The low contributory pension coverage rate, the high labor force participation rate among the elderly, and the vulnerable healthcare system accessibility are urgent challenges that the Paraguayan government and society must address.

As of 2020, Paraguay's population aged 65 and over was approximately 400,000, accounting for about 5.5% of the total population. According to UN projections, this proportion is expected to exceed 12% by 2050. This signifies a rapid increase in the elderly population and serves as a warning that the current pension and healthcare systems will struggle to cope with the future aging society.

Moving forward, the Paraguayan government needs a comprehensive policy approach, including:

Pension System Reform: Reforms are needed to increase participation in contributory pension schemes and secure long-term sustainable pension finances. This should include encouraging workers to join social security systems and bringing those in the informal economy into the formal system.
Employment Support for the Elderly: Tailored job creation, retraining programs, and the creation of age-friendly work environments are needed for elderly individuals who wish to work beyond retirement age. This can help the elderly achieve economic independence and broaden their social participation.
Strengthening Universal Healthcare System: The accessibility and quality of the public healthcare system must be improved so that all citizens, especially vulnerable groups and the elderly, can access quality medical services without financial burden. Policy efforts to lower out-of-pocket medical expenses and increase health insurance coverage are essential.
Improving Social Perception: Social perception of the elderly needs to be positively improved, fostering an atmosphere where they are seen not merely as dependents but as important members and resources of society.
Paraguay is a country with potential, possessing abundant natural resources and a young population structure. However, if it fails to proactively address the rapidly changing demographic structure and its associated social challenges, it could become an obstacle to sustainable development. This Ciess report clearly demonstrates that Paraguay must begin to change now for a better future.