ABRIR SALUD- Health Transformation project, Bolivia
Since March 2000, HLSP has managed this DFID-funded project, which
aims to assist the Bolivian Ministry of Health in implementing
healthcare reforms linked to the municipal, capitation-based model
for provision of healthcare and other basic services. The project
specifically assists the Ministry of Health with two key aspects of
the reform:
- the Family and Community Health policy
- the Participatory Municipal Health Management model
These were developed and implemented in the Azanake Association of
Municipalities in the department of Oruro, one of the most deprived
regions of the country with the worst health indicators.
Participatory municipal health management model
The Mancomunidad Azanake is an association of five
municipalities, focusing on health issues. It was set up as a
result of an Abrir Salud initiative to improve coordination between
health authorities, health service staff, municipal authorities and
representatives of civil society. The association was formed in
2000, with the objective of "improving the health of the population
living in its jurisdiction" and developing a participatory model of
municipal health management.
One of the Mancomunidad Azanake’s main achievements over the last
four years (with Abrir Salud support) is that health is now seen as
a priority in its five member municipalities. One hospital has been
upgraded, and new joint projects have been implemented. Azanake
also stands out from the rest of Bolivia’s associations of
municipalities for its innovative work. It is the first association
set up exclusively for health, and the participatory municipal
management model has led to work on intercultural health and
citizen participation in the fight against corruption.
Work is currently underway to ensure the sustainability of the
Mancomunidad Azanake and Participatory Municipal Health Management
model. In agreement with the authorities and the community, the
Abrir Salud project has taken various steps to keep health as a
priority in municipal policies. Joint bank accounts, committed
resources, campaigns with candidates for mayors and other
activities are also strengthening this work.
