Celebrating 25 Years of Community Partnerships in Bolivia

Celebrating 25 Years of Community Partnerships in Bolivia

At a time when many are looking for examples of lasting local success in international development and sustainable approaches to healthcare for low income populations, PROSALUD, Bolivia’s largest health nongovernmental organization (NGO), embodies this success.  PROSALUD just celebrated its 25th anniversary last week – and MSH was there to help celebrate. For over two decades, PROSALUD has contributed to the unmet health needs of low-income populations in Bolivia, working with the active participation of the communities it serves.

Last August, while looking in on current MSH work in Bolivia, I had the great pleasure of spending a day in Santa Cruz with Dr. Luis Fernandez Ortiz, the Executive Director of PROSALUD.  A warm-hearted clinician by nature, Dr. Fernandez took over as Executive Director several years ago at a time when some in the organization were questioning PROSALUD’s non-profit philosophy.   It was inspiring to see his vision for PROSALUD’s public service mission and how his passion revitalized PROSALUD’s founding spirit through its staff and the breadth of its activities.  My last time in Bolivia was in 1985, as director of MSH’s drug management program, to carry out a pharmaceutical services design for PROSALUD.  So I found it a telling sign that PROSALUD has developed as Bolivia has developed and to see that Santa Cruz had grown far beyond one of the first PROSALUD health centers, which had been at the edge of town in the mid-1980s.

PROSALUD started as a pilot project consisting of ten health centers, it has grown into a three-tier organization operating at the national, regional, and local levels, representing the largest private provider of health services in the country. At its core, PROSALUD is an innovative network of high quality and low cost services that is fully compatible with the national health system.

Founded in 1985 with funding from the US Agency for International Development (USAID) and the Bolivian government, PROSALUD has achieved a high level of self-sufficiency through cost recovery and cross-subsidization for integrated health care. Preventative services are free of charge and fees for other services have been set so that clients who can afford to pay help to subsidize services for lower income clients. In short, PROSALUD provides the Bolivian population with the highest quality of health services possible at an affordable cost – key factors for fulfilling the right to health.

Since its founding, a hallmark of PROSALUD is its partnership with communities in order to improve quality of life.  All of PROSALUD’s centers, including the peri-urban center in La Paz, include facilities for community meetings in order to encourage active and responsible participation in the structuring of new centers and their services. This community participation constitutes a key element of PROSALUD’s success because it allows the institution to build its services in direct response to people’s demands and makes its beneficiaries invested in the institution and comfortable using its services.

PROSALUD has not only changed the way that health services are delivered in Bolivia, but it has inspired leaders in health services around the region.  Its model can be adopted successfully, in whole or in part as it has been the case with Profamilia in Nicaragua, Aprofam in Guatemala, and Ashonplafa in Honduras, as well as the MaxSalud Project in Chiclayo, northern Peru, and the City+Med organization in Haiti. These organizations and projects have been inspired by PROSALUD’s core values of sustainability and equality, always reaching out to those in need, without discrimination and while empowering local communities.

It is truly inspiring to see an organization that has been working so long to improve the health of its community.