Document Detail


Organizational development and privatization: a Bolivian success story.
MedLine Citation:
PMID:  10107479     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This article presents a case study of a US Agency for International Development-sponsored privatization effort in Bolivia. This privatization effort differs from AID's more common approach in that rather than merely helping already existing organizations to expand, this project has created a new organization. More ambitious and encompassing, this approach is also preferable because it directly addresses one of the most serious bottlenecks to economic development, viz., organizational development. The article describes the evolution of PROSALUD, a private, non-profit network of 17 community-sponsored health centers. The article describes factors and characteristics which have either conditioned or have directly contributed to PROSALUD's success. First, PROSALUD's health care environment is analysed, starting with a broad brush profile of select characteristics and trends which exist throughout the health sector of Bolivia, then narrows the focus to the local health sector. The structure and operations of PROSALUD are then analysed, focusing on the organization's managerial practices and financing and the series of tradeoffs it has been forced to strike: in its pricing strategy, between striving for financial viability and maintaining access to care; between, on the one hand, responding to community needs and demands and improving coverage by opening more facilities, and, on the other hand, focusing managerial efforts and outreach on a more limited number of clinics and neighborhoods; between providing a socially desirable mix of services--in particular, continuing to provide a great deal of free preventive care--and focusing care on more lucrative curative services; between maintaining commitments to neighborhoods and communities and eliminating the less economically viable (especially rural) clinics.
This article presents a case study of a USAID sponsored privatization effort in Bolivia. This privatization effort differs from AID's more common approach in that rather than simply helping already existing organizations to expand, this project has created a new organization. More ambitious and encompassing, this approach is also preferable because it directly addresses 1 of the most serious bottlenecks to economic development, i.e. organizational development. The article described the evolution of PROSALUD, a private, nonprofit network of 17 community-sponsored health centers. Also discussed are factors and characteristics which have either conditioned or directly contributed to the success of the organization. 1st, PROSALUD's healthcare environment is analyzed, beginning with a broad brush profile of select characteristics and trends which exist throughout the health sector of Bolivia, then narrows the focus to the local health sector. The structure and operations of PROSALUD are then analyzes, focusing on the organizations managerial practices and financing and the series of tradeoffs it has been forced to strike. In its pricing strategy, there has been striving for financial viability and maintaining access to care; between on the 1 hand, responding to community needs and demands and improving coverage by opening more facilities, and, on the other hand, focusing managerial efforts and outreach on a more limited number of clinics and neighborhoods. There has also been an attempt to provide a socially desirable mix of services, in particular, continuing to provide a great deal of free preventive care and focusing care on more lucrative curative services, between maintaining commitments to neighborhood and communities, and eliminating the less economically viable (especially rural) clinics.
Authors:
J L Fiedler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The International journal of health planning and management     Volume:  5     ISSN:  0749-6753     ISO Abbreviation:  Int J Health Plann Manage     Publication Date:    1990 Jul-Sep
Date Detail:
Created Date:  1990-12-12     Completed Date:  1990-12-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8605825     Medline TA:  Int J Health Plann Manage     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  167-86     Citation Subset:  H; J    
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MeSH Terms
Descriptor/Qualifier:
Bolivia
Community Health Centers / organization & administration*
Financing, Organized / organization & administration
Government Agencies
Humans
Primary Health Care / organization & administration*
Privatization*
World Health

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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