World Bank Country Studies

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Country Studies are published with approval of the subject government to communicate the results of the Bank's work on the economic and related conditions of member countries to governments and to the development community. This series as been superseded by the World Bank Studies series.

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  • Publication
    Health Sector Reform in Bolivia : A Decentralization Case Study
    (Washington, DC, 2004) World Bank
    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.
  • Publication
    Poverty and Nutrition in Bolivia
    (Washington, DC, 2002-12) World Bank
    Malnutrition is crippling Bolivia, and the country must now face the political, and bureaucratic failure in addressing malnutrition. This study defines the nature, and extent of the malnutrition problem in the country, identifies the underlying reasons for the failed response, and outlines actions for both immediate, and more long-term results. The study further estimates that less than ten percent of government, and non-government expenditures, with an explicit nutrition, or food security component, is devoted to effective programs serving the neediest - poor pregnant women, and malnourished children under two. Public and private expenditures on nutrition are often misdirected, for although Bolivia did achieve successes in the advancement of nutrition over the past twenty years, the problem of malnutrition still requires action on several fronts. Primarily, nutrition needs a national strategy, and functional leadership, able to provide the population with accurate, and practical nutritional knowledge, prioritizing effective interventions for the most vulnerable. The study suggests improvements in program design, by targeting assistance, and exploiting the opportunities to improve nutrition through water and sanitation, rural development, roads, and education projects, which can have a profound effect on nutrition. Recommendations include the development of nutrition education focused on high-priority population, towards creating a private commission to demand continuity of Government attention to nutrition, as well as community participation in nutrition programming.