Health Sector Reform in Bolivia : A Decentralization Case Study

Bolivia 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 inc...

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Main Author:	World Bank
Format:	Publication
Language:	English en_US
Published:	Washington, DC 2013
Subjects:	HEALTH SECTOR POLICY REFORM HEALTH ISSUES DECENTRALIZATION FINANCING INSTRUMENTS PUBLIC HEALTH EXPENDITURES SOCIAL SECURITY BENEFITS MANAGEMENT OPERATIONS HEALTH INSURANCE PLANS GOVERNANCE INCENTIVES VECTOR BORNE DISEASES EPIDEMIOLOGICAL INFORMATION INDIGENOUS ACTIVISTS POVERTY & HEALTH RURAL AREAS ADAPTATION ANTENATAL CARE CHILDBIRTH COMMUNICABLE DISEASES COMMUNITIES COMMUNITY HEALTH COST EFFECTIVENESS DEATHS DOCTORS EPIDEMIOLOGICAL SURVEILLANCE EQUIPMENT EXTENSION FIXED COSTS HEALTH CARE HEALTH CARE SERVICES HEALTH EXPENDITURE HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH INDICATORS HEALTH INSURANCE HEALTH NEEDS HEALTH OUTCOMES HEALTH POLICIES HEALTH PROGRAMS HEALTH PROMOTION HEALTH REFORM HEALTH REFORMS HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH TARGETS HEALTH WORKERS HOSPITALS HOUSEHOLDS HOUSING INCOME INFANT MORTALITY INFANT MORTALITY RATE INHABITANTS INSTITUTIONALIZATION LOCAL HEALTH PLANS MALARIA MIDWIFES MORBIDITY MORTALITY MOTHERS NURSES NUTRITION OCCUPANCY OCCUPANCY RATES POPULATION GROUPS PREGNANT WOMEN PRIMARY CARE PRIMARY HEALTH CARE PUBLIC HEALTH PUBLIC SECTOR RURAL AREAS SERVICE DELIVERY SOCIAL EXCLUSION SUSTAINABLE FINANCING WORKERS WORKING CONDITIONS
Online Access:	http://documents.worldbank.org/curated/en/2002/01/2971132/health-sector-reform-bolivia-decentralization-case-study http://hdl.handle.net/10986/15209

id	okr-10986-15209
recordtype	oai_dc
spelling	okr-10986-152092021-04-23T14:03:11Z Health Sector Reform in Bolivia : A Decentralization Case Study World Bank HEALTH SECTOR POLICY REFORM HEALTH ISSUES DECENTRALIZATION FINANCING INSTRUMENTS PUBLIC HEALTH EXPENDITURES SOCIAL SECURITY BENEFITS MANAGEMENT OPERATIONS HEALTH INSURANCE PLANS GOVERNANCE INCENTIVES VECTOR BORNE DISEASES EPIDEMIOLOGICAL INFORMATION INDIGENOUS ACTIVISTS POVERTY & HEALTH RURAL AREAS ADAPTATION ANTENATAL CARE CHILDBIRTH COMMUNICABLE DISEASES COMMUNITIES COMMUNITY HEALTH COST EFFECTIVENESS DEATHS DECENTRALIZATION DOCTORS EPIDEMIOLOGICAL SURVEILLANCE EQUIPMENT EXTENSION FIXED COSTS HEALTH CARE HEALTH CARE SERVICES HEALTH EXPENDITURE HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH INDICATORS HEALTH INSURANCE HEALTH NEEDS HEALTH OUTCOMES HEALTH POLICIES HEALTH PROGRAMS HEALTH PROMOTION HEALTH REFORM HEALTH REFORMS HEALTH SECTOR HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH TARGETS HEALTH WORKERS HOSPITALS HOUSEHOLDS HOUSING INCOME INFANT MORTALITY INFANT MORTALITY RATE INHABITANTS INSTITUTIONALIZATION LOCAL HEALTH PLANS MALARIA MIDWIFES MORBIDITY MORTALITY MOTHERS NURSES NUTRITION OCCUPANCY OCCUPANCY RATES POPULATION GROUPS PREGNANT WOMEN PRIMARY CARE PRIMARY HEALTH CARE PUBLIC HEALTH PUBLIC HEALTH EXPENDITURES PUBLIC SECTOR RURAL AREAS SERVICE DELIVERY SOCIAL EXCLUSION SUSTAINABLE FINANCING WORKERS WORKING CONDITIONS Bolivia 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. 2013-08-20T16:44:20Z 2013-08-20T16:44:20Z 2004 http://documents.worldbank.org/curated/en/2002/01/2971132/health-sector-reform-bolivia-decentralization-case-study 0-8213-5703-4 http://hdl.handle.net/10986/15209 English en_US World Bank Country Study; CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank Washington, DC Publications & Research :: Publication Publications & Research :: Publication Latin America & Caribbean Bolivia
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	English en_US
topic	HEALTH SECTOR POLICY REFORM HEALTH ISSUES DECENTRALIZATION FINANCING INSTRUMENTS PUBLIC HEALTH EXPENDITURES SOCIAL SECURITY BENEFITS MANAGEMENT OPERATIONS HEALTH INSURANCE PLANS GOVERNANCE INCENTIVES VECTOR BORNE DISEASES EPIDEMIOLOGICAL INFORMATION INDIGENOUS ACTIVISTS POVERTY & HEALTH RURAL AREAS ADAPTATION ANTENATAL CARE CHILDBIRTH COMMUNICABLE DISEASES COMMUNITIES COMMUNITY HEALTH COST EFFECTIVENESS DEATHS DECENTRALIZATION DOCTORS EPIDEMIOLOGICAL SURVEILLANCE EQUIPMENT EXTENSION FIXED COSTS HEALTH CARE HEALTH CARE SERVICES HEALTH EXPENDITURE HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH INDICATORS HEALTH INSURANCE HEALTH NEEDS HEALTH OUTCOMES HEALTH POLICIES HEALTH PROGRAMS HEALTH PROMOTION HEALTH REFORM HEALTH REFORMS HEALTH SECTOR HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH TARGETS HEALTH WORKERS HOSPITALS HOUSEHOLDS HOUSING INCOME INFANT MORTALITY INFANT MORTALITY RATE INHABITANTS INSTITUTIONALIZATION LOCAL HEALTH PLANS MALARIA MIDWIFES MORBIDITY MORTALITY MOTHERS NURSES NUTRITION OCCUPANCY OCCUPANCY RATES POPULATION GROUPS PREGNANT WOMEN PRIMARY CARE PRIMARY HEALTH CARE PUBLIC HEALTH PUBLIC HEALTH EXPENDITURES PUBLIC SECTOR RURAL AREAS SERVICE DELIVERY SOCIAL EXCLUSION SUSTAINABLE FINANCING WORKERS WORKING CONDITIONS
spellingShingle	HEALTH SECTOR POLICY REFORM HEALTH ISSUES DECENTRALIZATION FINANCING INSTRUMENTS PUBLIC HEALTH EXPENDITURES SOCIAL SECURITY BENEFITS MANAGEMENT OPERATIONS HEALTH INSURANCE PLANS GOVERNANCE INCENTIVES VECTOR BORNE DISEASES EPIDEMIOLOGICAL INFORMATION INDIGENOUS ACTIVISTS POVERTY & HEALTH RURAL AREAS ADAPTATION ANTENATAL CARE CHILDBIRTH COMMUNICABLE DISEASES COMMUNITIES COMMUNITY HEALTH COST EFFECTIVENESS DEATHS DECENTRALIZATION DOCTORS EPIDEMIOLOGICAL SURVEILLANCE EQUIPMENT EXTENSION FIXED COSTS HEALTH CARE HEALTH CARE SERVICES HEALTH EXPENDITURE HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH INDICATORS HEALTH INSURANCE HEALTH NEEDS HEALTH OUTCOMES HEALTH POLICIES HEALTH PROGRAMS HEALTH PROMOTION HEALTH REFORM HEALTH REFORMS HEALTH SECTOR HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH TARGETS HEALTH WORKERS HOSPITALS HOUSEHOLDS HOUSING INCOME INFANT MORTALITY INFANT MORTALITY RATE INHABITANTS INSTITUTIONALIZATION LOCAL HEALTH PLANS MALARIA MIDWIFES MORBIDITY MORTALITY MOTHERS NURSES NUTRITION OCCUPANCY OCCUPANCY RATES POPULATION GROUPS PREGNANT WOMEN PRIMARY CARE PRIMARY HEALTH CARE PUBLIC HEALTH PUBLIC HEALTH EXPENDITURES PUBLIC SECTOR RURAL AREAS SERVICE DELIVERY SOCIAL EXCLUSION SUSTAINABLE FINANCING WORKERS WORKING CONDITIONS World Bank Health Sector Reform in Bolivia : A Decentralization Case Study
geographic_facet	Latin America & Caribbean Bolivia
relation	World Bank Country Study;
description	Bolivia 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.
format	Publications & Research :: Publication
author	World Bank
author_facet	World Bank
author_sort	World Bank
title	Health Sector Reform in Bolivia : A Decentralization Case Study
title_short	Health Sector Reform in Bolivia : A Decentralization Case Study
title_full	Health Sector Reform in Bolivia : A Decentralization Case Study
title_fullStr	Health Sector Reform in Bolivia : A Decentralization Case Study
title_full_unstemmed	Health Sector Reform in Bolivia : A Decentralization Case Study
title_sort	health sector reform in bolivia : a decentralization case study
publisher	Washington, DC
publishDate	2013
url	http://documents.worldbank.org/curated/en/2002/01/2971132/health-sector-reform-bolivia-decentralization-case-study http://hdl.handle.net/10986/15209
_version_	1764425478148456448

Health Sector Reform in Bolivia : A Decentralization Case Study

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