Health Sector Reform in Bolivia : A Decentralization Case Study

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dc.creatorWorld Bank
dc.date2013-08-20T16:44:20Z
dc.date2013-08-20T16:44:20Z
dc.date2004
dc.date.accessioned2026-07-01T01:30:57Z
dc.descriptionBolivia made progress in health status and equity in the last decade, thanks to the implementation of a series of health policies directed primarily at reducing maternal and infant mortality and controlling communicable diseases. These policies include the introduction of a focus on health outcomes in the context of decentralization, the implementation of a public health insurance, the strengthening of vertically-financed public health programs and to a lesser extent, an increase in the size of the sector's workforce and greater participation of indigenous peoples for health. This report analyzes these policies, draws lessons from their implementation, discusses remaining challenges, and provides recommendations in the context of the country's latest policy developments. Findings show that while coverage has increased in almost all municipalities, significant equity gaps remain between the rich and the poor, the urban and rural, and the indigenous and non-indigenous. The analysis suggests that the Ministry of Health should concentrate on three key issues: first, maintaining the focus on national priorities in the context of the new, expanded maternal and child insurance; second, strengthening efforts to extend care to poor rural areas; and third, improving the effectiveness of the system in the context of the new management model.
dc.formatapplication/pdf
dc.formattext/plain
dc.identifierhttp://documents.worldbank.org/curated/en/2002/01/2971132/health-sector-reform-bolivia-decentralization-case-study
dc.identifier0-8213-5703-4
dc.identifierhttps://hdl.handle.net/10986/15209
dc.identifierhttps://doi.org/10.1596/0-8213-5703-4
dc.identifier.urihttp://hdl.handle.net/123456789/418806
dc.languageEnglish
dc.languageen_US
dc.publisherWashington, DC
dc.relationWorld Bank Country Study;
dc.rightsCC BY 3.0 IGO
dc.rightshttp://creativecommons.org/licenses/by/3.0/igo
dc.rightsWorld Bank
dc.subjectHEALTH SECTOR
dc.subjectPOLICY REFORM
dc.subjectHEALTH ISSUES
dc.subjectDECENTRALIZATION
dc.subjectFINANCING INSTRUMENTS
dc.subjectPUBLIC HEALTH EXPENDITURES
dc.subjectSOCIAL SECURITY BENEFITS
dc.subjectMANAGEMENT OPERATIONS
dc.subjectHEALTH INSURANCE PLANS
dc.subjectGOVERNANCE
dc.subjectINCENTIVES
dc.subjectVECTOR BORNE DISEASES
dc.subjectEPIDEMIOLOGICAL INFORMATION
dc.subjectINDIGENOUS ACTIVISTS
dc.subjectPOVERTY & HEALTH
dc.subjectRURAL AREAS ADAPTATION
dc.subjectANTENATAL CARE
dc.subjectCHILDBIRTH
dc.subjectCOMMUNICABLE DISEASES
dc.subjectCOMMUNITIES
dc.subjectCOMMUNITY HEALTH
dc.subjectCOST EFFECTIVENESS
dc.subjectDEATHS
dc.subjectDECENTRALIZATION
dc.subjectDOCTORS
dc.subjectEPIDEMIOLOGICAL SURVEILLANCE
dc.subjectEQUIPMENT
dc.subjectEXTENSION
dc.subjectFIXED COSTS
dc.subjectHEALTH CARE
dc.subjectHEALTH CARE SERVICES
dc.subjectHEALTH EXPENDITURE
dc.subjectHEALTH EXPENDITURES
dc.subjectHEALTH FACILITIES
dc.subjectHEALTH FINANCING
dc.subjectHEALTH INDICATORS
dc.subjectHEALTH INSURANCE
dc.subjectHEALTH NEEDS
dc.subjectHEALTH OUTCOMES
dc.subjectHEALTH POLICIES
dc.subjectHEALTH PROGRAMS
dc.subjectHEALTH PROMOTION
dc.subjectHEALTH REFORM
dc.subjectHEALTH REFORMS
dc.subjectHEALTH SECTOR
dc.subjectHEALTH SERVICES
dc.subjectHEALTH STATUS
dc.subjectHEALTH SYSTEM
dc.subjectHEALTH TARGETS
dc.subjectHEALTH WORKERS
dc.subjectHOSPITALS
dc.subjectHOUSEHOLDS
dc.subjectHOUSING
dc.subjectINCOME
dc.subjectINFANT MORTALITY
dc.subjectINFANT MORTALITY RATE
dc.subjectINHABITANTS
dc.subjectINSTITUTIONALIZATION
dc.subjectLOCAL HEALTH PLANS
dc.subjectMALARIA
dc.subjectMIDWIFES
dc.subjectMORBIDITY
dc.subjectMORTALITY
dc.subjectMOTHERS
dc.subjectNURSES
dc.subjectNUTRITION
dc.subjectOCCUPANCY
dc.subjectOCCUPANCY RATES
dc.subjectPOPULATION GROUPS
dc.subjectPREGNANT WOMEN
dc.subjectPRIMARY CARE
dc.subjectPRIMARY HEALTH CARE
dc.subjectPUBLIC HEALTH
dc.subjectPUBLIC HEALTH EXPENDITURES
dc.subjectPUBLIC SECTOR
dc.subjectRURAL AREAS
dc.subjectSERVICE DELIVERY
dc.subjectSOCIAL EXCLUSION
dc.subjectSUSTAINABLE FINANCING
dc.subjectWORKERS
dc.subjectWORKING CONDITIONS
dc.titleHealth Sector Reform in Bolivia : A Decentralization Case Study

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