HEALTH PROGRAM
Improved Health of Bolivians

USAID supports the Government of Bolivia's emphasis on community health as a key element in improving the quality of life for the country's most disadvantaged populations. Accordingly, USAID collaborates with the Ministry of Health and with local and international organizations to improve access to quality health services for Bolivia's rural and peri-urban poor. The Program directly supports the Bolivia Digna pillar of the Bolivian Government's National Development Plan (PND).

USAID's program strives to achieve three key results:

• Increased ability of individuals, families and communities to take action to improve health.
• Expanded delivery of quality, high-impact services through community and private health networks.
• Strengthened institutional capacity for healthcare management within targeted institutions.

These results will be accomplished by empowering people to protect and promote their health by improving health practices in the home, encouraging prompt care-seeking behavior, and enhancing the quality of community and clinical health services. Efforts to reinforce health sector management capacity at all levels are also critical to achieving and sustaining results. All activities are carried out through coordinated efforts with the Ministry of Health under the framework of Bolivia's new National Health Policy.

Increased Ability of Individuals, Families and Communities to Take Action to Improve Health

Within the framework of the Ministry's policy for Family, Intercultural and Community Health, USAID's community-level interventions focus on rural and other underprivileged populations and are intended to help individuals, families and communities recognize the value of making their own health a priority. Activities aim to improve immunization coverage, access to maternal and child health services, family nutrition, and responses to pregnancy complications. Activities are also increasing access to reproductive health services and reducing the number of new cases of Chagas, respiratory illnesses and diarrheal disease.

Activities contributing to this program area are implemented primarily by four Bolivian organizations: PROCOSI, PROSALUD, CIES and Socios Para el Desarrollo/PROSALUD. Through the work of these NGOs, the program seeks to improve the health of disadvantaged populations by promoting healthy behaviors, providing basic services through community health agents, and strengthening community capacity to identify, prioritize and develop innovative solutions to local health problems.

Expanded Delivery of Quality, High-impact Services through Community and Private Health Networks

To increase access to preventative and curative services for the poor, USAID is strengthening health service delivery and management.

USAID provides training to public sector and NGO health workers in maternal and child health, reproductive health, family planning, and control of infectious diseases. These activities are designed to build bridges between health service providers and the communities they serve. In addition, USAID is providing technical assistance to improve supervision, clinical procedures, bio-safety, and the quality and efficiency of services, while – at the same time – improving the capacity of health care providers to address community health needs. USAID's support for prevention and control activities for HIV/AIDS and sexually transmitted infections is helping to keep the national HIV prevalence rate below one percent.

Strengthened Institutional Capacity for Health Care Management and Sustainability

To achieve the fundamental long-term goal of building capacity to maintain, replicate and sustain health system improvements, USAID is providing technical assistance to strengthen the managerial capacity of national, regional and local authorities in target areas. In addition, USAID provides support for the national health information system, the pharmaceutical and commodity logistics system, the reference laboratory network and the epidemiological surveillance system in order to improve capacity to collect and use information and to plan appropriate interventions.

The Health Program also supports key Bolivian NGOs in their efforts to achieve financial sustainability so that they may continue offering health services to underserved populations across the country.

Program Impact

• PROSALUD and CIES, Bolivian NGOs receiving USAID support for service delivery and institutional capacity building, conduct over 930,000 health consultations per year in their 41 health centers and mobile units in eight of Bolivia's nine departments.
• PROCOSI, a network of 34 local and international NGOs, works in 40 municipalities of Bolivia, facilitating access to quality services for over 850,000 people.
• In support of the National Chagas Prevention Program, USAID has helped rebuild or refurbish over 12,000 homes in areas affected by the disease.
• USAID provides support to 10 national HIV/AIDS surveillance and reference centers (CDVIRs) to improve the diagnosis and treatment of sexually transmitted infections and increase access to HIV voluntary counseling and testing services.
• With USAID support, in fiscal year 2008, nearly 35,000 children were immunized with the third dose of the Pentavalente vaccine, achieving 81% coverage of the target population in program intervention areas.