On top of 23 percent inflation and growing government debt, worsening blackouts have emerged as a serious dilemma, forcing Chavez's government to announce rationing measures including rolling power outages in some parts of the country.
Chavez is increasingly focused on shoring up support ahead of his 2012 re-election bid, and some analysts say his domestic woes seem to be limiting his international reach in Latin America.
"President Chavez is going through a very difficult time," said Maria Teresa Romero, a professor of international studies at the Central University of Venezuela. "He's not the same Hugo Chavez he was four, five years ago."
She said Chavez no longer has the financial ability to promote oil-funded diplomacy the way he did several years ago, and is increasingly consumed with confronting issues such as the blackouts, deadly prison riots and deficiencies in the health care system.
"If he can't handle such serious problems that are slipping out of his hands such as electricity ... how can it be explained that he's going to help other countries?" Romero said. She said elsewhere in Latin America, "They see he's weak."
The leftist leader has long reinforced his alliances selling oil on credit and offering investments to build refineries in countries such as Ecuador and Brazil. The refinery projects, however, have been delayed for years, and other Chavez ideas such as a natural gas pipeline across South America have yet to get off the ground.
During more than 12 years in office, Chavez has been joined by increasing numbers of left-leaning leaders in Latin America, and has enjoyed close ties with presidents from Bolivia's Evo Morales to Argentina's Cristina Fernandez.
Yet Chavez has also increasingly faced unfavorable public opinion in countries such as Peru, where President-elect Ollanta Humala, once an open admirer of Chavez, has since distanced himself and indicated he favors the moderate, business-friendly policies of former Brazilian President Luiz Inacio Lula da Silva.
A poll in 18 countries last year by Latinobarometro, an independent Chile-based organization, found that on average people gave Chavez a 3.9 on a scale of 1 to 10 -- the second-worst score on the list after his ally and mentor Fidel Castro.
Chavez scored 5 on the same annual survey in 2005, and has declined steadily since, said Carlos Macuada, a Latinobarometro researcher in Chile.
"As the years have passed, his image has been viewed more negatively by people in Latin America," Macuada said.
The poll in September and October surveyed more than 20,000 people and had a margin of error of about plus or minus 3 percentage points, he said. Public opinion toward Chavez varied widely by country, with 69 percent in the Dominican Republic and 55 percent of Venezuelans saying they view Chavez favorably. In Colombia and Mexico, in contrast, only 14 percent expressed a favorable view of Chavez, and in Peru, 18 percent.
Chavez's approval ratings at home have slipped in the past few years as the country weathered a recession, and have been hovering in the 50-percent range. Polls suggest he remains the country's single most popular politician, and in recent months the economy has returned to positive growth. Still, other woes weighing on him include Latin America's highest inflation, one of the region's highest murder rates and corruption that critics say is among the worst in the world.
While Chavez has been away in Cuba, a deadly prison riot left 22 dead, and at least two soldiers and one prisoner were killed days later when troops stormed the prison trying to disarm inmates. The bloody riot prompted the government to announce plans for a new ministry dedicated to prison issues.
It's unclear how soon Chavez could return from Cuba, where he underwent surgery June 10 to have a pelvic abscess removed. Cuban state media published photos of him on Saturday standing next to his hospital bed and smiling beside Fidel and Raul Castro.
Chavez clearly wants to be back in Caracas in time for a July 5-6 summit of presidents from across the hemisphere on the 200th anniversary of Venezuela's independence. He has promoted it as an event to lay the groundwork for a new bloc, the Community of Latin American and Caribbean States, which would exclude the United States and Canada.
Chavez has kept up his vociferous antagonism toward the U.S., especially after Washington imposed sanctions on Venezuela's state oil company last month for supplying fuel to Iran.
Aside from his long-running feud with the U.S., though, Chavez has taken a less confrontational approach recently with other Latin American leaders, and in particular has opted for a cordial relationship with Colombian President Juan Manuel Santos, a U.S. ally whose predecessor, Alvaro Uribe, was a staunch Chavez adversary.
Steve Ellner, a political science professor at Venezuela's University of the East, said he doesn't think Chavez's international influence is weaker, but rather that "he is following a more cautious approach than he did a few years back with regard to inter-American relations."
Ellner said he thinks the pending creation of a new bloc of Latin American and Caribbean countries furthers Chavez's international aims.
"Chavez's main goal has been to isolate the United States," Ellner said, adding that Chavez views the U.S. "as the main impediment to his vision of change for the region."
However, Romero said Chavez is clearly focusing first on Venezuela's internal problems, while being more moderate internationally and trying to avoid the verbal spats he had in years past with leaders of Colombia, Mexico and other nations.
"He hasn't really fought again with anyone, and I don't think he'll do it from now until the 2012 elections," Romero said. "He's taking a lower profile."
The Associated Press contributed to this report.