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Bolivia: Child Survival with Dignity

Bolivia: Child Survival with Dignity. Dr. Álvaro Muñoz-Reyes Navarro Minister of Health and Sports London, December 2005. Overview of the presentation. The state of child health in Bolivia Response of the health system Removing financial barriers to access

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Bolivia: Child Survival with Dignity

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  1. Bolivia: Child Survival with Dignity Dr. Álvaro Muñoz-Reyes Navarro Minister of Health and Sports London, December 2005

  2. Overview of the presentation • The state of child health in Bolivia • Response of the health system • Removing financial barriers to access • Increasing coverage through neonatal and Community IMCI • Building national and local alliances for sustainability • Implications for health policies

  3. Trends in Child Mortality in Bolivia The state of child health in Bolivia MDG 4, Objective 5 Source: DHS 1989,1994,1996,2003

  4. National Insurance for Motherhood, Infancy and Childhood (SNMN) May 1996 Response of the health system Evolution of the Public Health Insurance Model to SUMI Maternal and Child Universal Health Insurance 21 November 2002 Basic Health Insurance 31 December 1998 2005 1996 Beginning with SBS (1998), the IMCI strategy was completely incorporated

  5. State and Local Governments with greater social responsibility and financial resources Greater efficiency and efficacy in management Redistribution of public revenues Greater participation and control by social stakeholders The importance of an effective legal framework Law of Administrative Decentralization Law of Popular Participation Hydrocarbon Tax Law of National Dialogue Law of SUMI

  6. Municipalities 2% 90% Investment 10% SUMI 8% Financing of SUMI 100% National Revenues National Customs and Internal Taxes Complementary Resources • National Liability Fund • -Dialogue Account 2000- • Direct Taxes on Hydrocarbons Source: Bolivia MOH

  7. Maternal and Child Universal Health Insurance (SUMI) • Is a State Policy created to reduce the morbidity and mortality of mothers and children • Improves access and eliminates economic barriers to health services • Is the main prioritized policy of the Ministry of Health and Sports • Is a component of the Bolivian Poverty Reduction Strategy • Is the principal means to reach the MDG objectives in health

  8. SUMI coverage according to place of residence, Bolivia - 2004 Urban Population: 62.4% Source: Bolivia MOH 2005

  9. Conceptual elements in Community - IMCI Community Context Health System Individual Change SUMI Community Dialogue Collective Action Impact Social Change Application of key practices in the care of the child and the newborn

  10. Strategic action lines in Community-IMCI • Strengthening the • link between the • community • and health facilities • Engagement of • social agents • Development of alliances • within and between • sectors Families and the community apply the key practices in the care of the child and the newborn • Home visits • Community mobilization • and surveillance

  11. Results from the Community- IMCI component • Achieved the participation and empowerment of social agents in the promotion of key practices • Strengthened the link between health facilities and the community • Stimulated intersectoral efforts A focus only on Community Health Workers (CHW) is not sufficient to improve family practices Source: Red Cross, PAHO/WHO. Community IMCI Evaluation. 2005. Plan International Bolivia, BASICSII. 2002

  12. Neonatal Community-IMCI: Selected Results Source: Save the Children/SNL, 2004

  13. The alliances in support of children and newborn Inter-Agency Coordination Committee MOH- bilateral and multilateral cooperating agencies National Alliance for the Community IMCI scale-up MOH- PAHO/WHO-UNICEF-USAID:PROCOSI (Network of NGOs) and PROSIN/USAID - Red Cross - Plan International Central and Departmental Levels Inter-Institutional Council of Safe Motherhood The First Lady's Office-MOH-Other ministries-NGOs-Cooperating Agencies-Women’s organizations Education- Neighborhood Groups- Community health workers- Municipalities-Mothers’ Clubs NGOs, other local organizations Community IMCI and Newborn Local Level

  14. The alliances in support of children and newborns have facilitated: • Mobilization of human and economic resources • Synergy of efforts and harmonization of interventions • Greater possibility of sustaining the key interventions • Incorporation of new social agents and other sectors • Promotion of local development

  15. Implications for health policy • Access • Elimination of economic barriers improves access to healthcare • Prioritization of excluded population groups (indigenous, rural area habitants and others) • Coverage • One must seek to improve the quality of care in order to increase utilization of services • Strategies should be oriented toward user (client) satisfaction and focused on intercultural, gender or generational perspectives • Policies should prioritize interventions in favor of neonatal health integrated with maternal health • Sustainability • Alliances should be in harmony with national policies of health • SUMI should motivate greater social participation Boys and Girls Have the Right to a Life….a Life with Dignity

  16. Thank You

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