Description
In 1999, Bolivia started an evidence based health reform. The case describes the efforts, the Ministry of Health and Social Provision undertook to generate and institutionalize a management culture based in results by establishing management contracts with the departmental authorities, with objectives and related indicators. The objectives concern the Basic Health insurance (SBS), the extended immunization program (PAI). The case describes the results and difficulties met in the implementation of the policies, and the actual challenges related with the continuation of the process, especially in the application at the local level. The case shows how the Ministry of Health strengthen its regulation and enforcement role, by creating instruments which allows to assure the implementation of agreed upon health policies.