The present research work identifies various improvement opportunities for the execution phase of health investment projects managed by the Piura Regional Government. It addresses the study of cases of six projects in the execution phase; from there on, design and implementation limitations of the investment policy are identified. The research used a qualitative investigation method, which employs instruments such as interviews and field cards. Furthermore, to explore lessons learned in the management of public investment systems in Latin America; useful for proposing opportunities for improvement. Regarding the limitations of the design of the investment policy, it is found that the control and incentive mechanisms were not contemplated in the original design of the policy and that their subsequent incorporation slows down the execution; in addition, of not noticing, during the design, ...