In 1999 confronted by some of the most bleak health indicators in Latin America, the Bolivian government asked the World Bank to help it with a program to bring better health care to poor families throughout the country.
The World Bank responded by approving a $25 million Health Sector Reform Program that had as its priority reducing high maternal and infant mortality rates.
Adopting a results-based approach centered on yearly targets for eight basic health indicators, the project quickly made immunization more widely available and helped the poor gain better access to health care services. Coordination between Bolivian officials and donor agencies improved, resulting in more effectively targeted health care delivery.
Immunization coverage jumped to 86 percent in 2000 from 75 percent in 1998, with government spending on vaccines soaring to $3 million in 2000 from $500,000 in 1999. At the same time, the number of births attended by trained health workers climbed to 51 percent from 36 percent, and the number of children treated for pneumonia increased by 65 percent.
In response to these results, the World Bank in June 2001 approved $35 million for the project’s second phase. This second phase of the initiative has as its overall goal a reduction of infant mortality to no more than 48 for every 1,000 babies born by 2008, versus 67 for each 1,000 in 1998. The program also will expand health coverage to an additional 25 percent of the population, or about 2 million people, by assigning new health teams supported by indigenous community agents to the poorest regions of the country.
Health Sector Reform Program
Updated: July 2002