Poverty is
intimately associated with chronic malnutrition, which is a contributing
factor in 28% of all childhood deaths in Bolivia. Chronic malnutrition
is also called stunting and is identified by the ratio of height
for age. Children with chronic malnutrition are more likely to
die from infectious diseases such as diarrhea and pneumonia, since
their immune system is weak and they lack caloric reserves to
fight off illnesses. FHI/Bolivia’s goal is to provide the
education, resources, and training communities need to transform
this reality long term. Food rations are used short term to supplement
the nutritional requirements of children, functioning as a bridge
to help prevent malnutrition until families are better trained
in nutritional practices and communities are more food-secure
through improved agricultural practices and income.
FHI/Bolivia´s
Integrated Health Program focuses on child survival, maternal
health, nutrition education, and improved water and sanitation.
The program operates in coordination with municipal and governmental
health bodies, and works directly with leaders and families in
marginalized communities. In order to transform the precarious
living conditions that frequently characterize these communities,
local health care capacity is enhanced through collaboration with
a newly established network of Community Health Promoters and
Women Leaders, who are trained in nutrition and hygienic practices,
the importance of child immunization, and related principles.
Diarrhea causes
36% of deaths in children under 5 in Bolivia. Chronic diarrhea
is associated with and contributes to chronic malnutrition as
well. Lack of access to potable water and lack of basic sanitation
services are major causal factors of many health problems. Contaminated
water causes a number of serious illnesses and many communities
draw water from nearby rivers or lakes. Studies show that provision
of potable water and sanitation facilities can reduce deaths from
diarrhea by 65% and overall childhood mortality by 55%. Thus,
as a part of FHI/Bolivia’s Health
strategy, the Water and Sanitation component works to increase
the quantity and quality of potable water and improve general
sanitation conditions. This is accomplished by constructing community
and household water systems, showers and household bathrooms,
as well as training beneficiaries in water system maintenance
and basic sanitation and hygiene. In addition, leaders of Water
and Sanitation Committees are trained in management and administration.
A new health
initiative is working with communities in the Toro Toro Municipality
that have been affected by Chagas disease—one of the most
serious parasitic problems in Bolivia. The project facilitates
low-cost improvement and treatment of homes in the targeted communities
to eliminate vector infestation of the vinchuca—the nocturnal
bug which carries the causative agent of the disease and that
thrives in the thatch and adobe homes that are commonplace in
rural Bolivia. This is complemented by the introduction of educational
materials and training to increase preventive knowledge and practices
in the participant communities, and the establishment of a network
of community surveillance mechanisms to prevent possible re-infestation
of dwellings.
Specific Health Interventions:
Integrated management of childhood illness
Nutritional support through food rations
Health and nutrition education
The strengthening of local and community health systems
Construction of water and sanitation infrastructure and the training
and organization of water committees
Chagas prevention
