In Bolivia, MSF continues to focus on improving maternal healthcare through a project in El Alto, the second largest city

Bolivia is one of the countries with the lowest health indicators in Latin America. Despite increased investment in public health facilities in recent years, availability and quality of care remain poor. 

Around two-thirds of the Bolivia's 10.2 million people are indigenous, and the country elected its first indigenous leader - Evo Morales - in 2005.

Bolivia is affected by Chagas, a parasitic disease endemic in Latin America, which is most commonly transmitted through the bites of infected vinchuca bugs, often found in cracks in the walls and roofs of rural adobe houses.

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The disease can be asymptomatic for many years, but if left untreated it may affect internal organs and can lead to heart failure and even death.

MSF has worked intermittently in the country to battle Chagas since 1986. In 2013 we handed over our programmes but returned in 2015 to work alongside the Ministry of Health.

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MSF's work in Bolivia in 2021:

The situation is especially serious in El Alto, Bolivia’s second-largest city, where the rates are among the worst in the world. In addition, Bolivia has a high proportion of teenage pregnancies – the last health survey showed that 30 per cent of 19-year-old women were already mothers. However, despite increased investment in public health facilities in recent years, the availability and quality of care in this region remain poor.

Furthermore, the COVID-19 pandemic has had a severe impact on the Bolivian health system’s provision of maternal, neonatal and paediatric health services, making it even more difficult for women to access adequate medical care for themselves and their children.

In 2018, we launched a project to improve maternal care in El Alto, by supporting two maternity wards in public health facilities. Our teams increased access to safe deliveries and provided high-quality, culturally adapted services, especially for Aymara indigenous communities, who have specific beliefs around childbirth. In 2021, these activities were transferred to the local authorities, who recruited additional staff to ensure continuity of this 24-hour service for local communities.  

Nurse Feliza Merma at San Roque Health Center, in the city of El Alto, preparing a  newborn baby in the delivery room. MSF built the maternity area and installed a heating system, the city of El Alto is located at 4200 meters above sea level (April, 2021)

Between March and September, our teams supported the Bolivian health system’s response to the COVID-19 pandemic in the city of Cochabamba and in five health facilities in Beni region. We implemented infection prevention and control measures, provided mental health services, health promotion, and training for frontline workers.

MSF teams explaining prevention and infection control measures to local health workers in Cochabamba (maybe you can add the specific district health structure). (August, 2021).

MSF's work in Bolivia: 2020

Bolivia has the highest maternal death rate in South America and some of the worst health indicators in the whole Latin American and Caribbean region. Despite investments in public health in recent years, the national health system is still not equipped to cope with the needs of the population. In 2020, the situation deteriorated with the onset of the COVID-19 pandemic, especially in El Alto.

Since 2019, MSF has been providing maternal care in two general healthcare centres in El Alto. This fast-growing city is home to almost a million people, most of whom have migrated from the countryside over recent years. In 2020, we assisted births and, despite COVID-19, managed to maintain essential services such as family planning and ante- and postnatal care.

As increasing restrictions were imposed due to the pandemic, and people were unable to access the centres, we decided to send teams into the community to offer care. Between October and December, we carried out 493 family planning consultations at community level. 

We also conducted individual mental health consultations, group psychoeducation sessions and health promotion activities, including talks on sexual and reproductive health that reached almost 8,200 participants. In addition, our teams offered medical and psychological assistance to victims of sexual and gender-based violence.

To support the national COVID-19 response, MSF trained healthcare workers in infection prevention and control measures, and detection and treatment. We also supplied medicines and personal protective equipment in the departments of La Paz, and Beni, in the northeast. 

find out more in our international activity report