Women, The Family And Health
Maternal and infant health in Bolivia
One of the biggest national problems that afflicts the Bolivian State is Poverty and the key challenge is the application of a strategy to Fight Poverty to achieve larger levels of economic growth, generation of employment, and energizing of the national economy.
The United Nations Representative in Bolivia has stated that 74 Bolivian provinces are at the level of Sub-Saharan Africa, which is the expression of extreme poverty. We have indices of human development below the fourth quartile. Even though there have been important improvements in the last 30 years in the indices of human development in the country, these are still unstable in relation to the average development.
Urban poverty results due to the rapid process of urbanization, because of the migratory influx from the country to the city caused by the existence of extreme poverty in the most depressed areas. The growth of the urban population is measured at 4.2% in relation to 0.1% of the rural population.1 One of the causes of rural poverty is the low agricultural output, due to technological backwardness, the lack of an irrigation infrastructure, roads, illiteracy and land ownership.
Of the 94% of the rural population that lives in poverty conditions, 90% find themselves below the extreme poverty line. The homes whose head of household is a woman or a monolingual native have a higher incidence of extreme poverty. Of the total of rural women who are heads of household (40%) it is estimated that around 65% are illiterate in contrast to the 28% of rural men who are heads of household in the same condition.2
Additionally, the economic development of women is seen to be limited by their lack of access to land ownership, to agricultural/fishery credit because of their low technical capacity. Adult people in rural areas have an average of 3.5 years of schooling, in contrast to 9.8 in urban areas. Access to services for potable water and basic health is extremely limited. The highest rates of mortality for mothers, infants, and children under 5 years of age and malnutrition are found in the rural areas of the high plains.
Health is one of the expressions of this dramatic situation that affects mothers and children as the most vulnerable groups. The causes of infant mortality are the traditional causes that derive from the situation of poverty on the one hand, and from the still insufficient sanitation system, and social service benefits to the most depressed areas on the other hand.
Infant mortality continues to be caused by illnesses related to diarrhea, acute respiratory infections, and neonatal afflictions, the principal sources that lead to the early death of our youngest inhabitants.
Malnutrition is the principal cause associated with the death of children. As are, on a lesser scale, the preventable immuno-diseases such as chicken pox, poliomelitis, tetanus, whooping cough, tuberculosis and others.
There exists a very pronounced gap in malnutrition in urban and rural areas, in all of the departments of the country. The major prevalence of malnutrition occurs between 6 and 23 months of age, attributable principally to inadequate practices of supplemental feeding to mother’s milk and to the influence of infections such as diarrheas and acute respiratory infections. Deficiency in nutrition in the first two years of life can have an irreversible effect on the psychomotor development of the child, since the brain grows from 35 grams at birth to 900 at 14 months.
The Bolivian health system is in the process of reform, just as are other sectors of the state such as the educational and housing systems.
Today public health policy subsists on Social Security that covers 25% of the population, that is to say 2,000,000 Bolivians, of whom only 50% (12% of the total population) regularly show up and use these services. The remaining 50%, in spite of being insured, do not show up for the services principally because of lack of offering and also due to the lack of quality of attention.
The public health system attends to 34-40% of Bolivians and the NGO’s jointly with the private sector attend to 9-10%. It is estimated that between 9 and 11% of the population resort to self-medication and the rest of the population, although in less and less proportion, resorts to traditional medicine.
The principal objective of the Basic Social Security plan is to reduce mortality of children and of mothers, but also it is directed to reduce the risk, the duration and the severity of the principal causes of illness and death in all of the population. Its purpose is to guarantee to all Bolivians permanent access to a selection of preventative and curative benefits.
The health establishments offer the services free to the user and are reimbursed by the Municipalities, from Local Compensation Funds.
Last Modified: November 29, 2002