Center for Health Market Innovations (CHMI)

Programs

PROSALUD

last updated Apr 23, 2013

Overview

Implementation Partner(s): 
National and Local goverments, PROCOSI, CIES, Bisa Insurace, MSH, PSI, Banco Sol, Pfizer, Bayer, Institute for Reproductive Health- Georgetown University
Legal Status: 
Private (not-for-profit)
Year Launched: 
1985
Stage: 
Existing/expansion stage
Income Level of Target Population: 
20-60% (lower to lower-middle)

Funding

Primary Source of Funding: 
Out-of-pocket payments
Additional Source(s) of Funding: 
Donor, Revenue (e.g., interest on loans)
Funders: 
ANESVAD Foundation, Ibis/Hivos, USAID

Scale

Personnel Employed: 
100<
Number of Clients Served: 
In 25 years: 7.298.397 medical atentions, 77.994 births, 2.263.075 Inmunizations, 3.839.808 lab works, 911.236 children growth control.
Number of Facilities Operated/Networked: 
23 primary care centers, 5 secondary care clinics
Upscaling: 
From 2006-2009, when the PROSALUD franchise network held 27 centers and did not grow in size, the uptake of PROSALUD services grew from 1,422,293 activities in health (2006) to 1,609,402 activities in health (2009). (Source: Internal Monitoring)
Summary: 

PROSALUD is a private, non-profit, Bolivian Civil Association that works faithfully for more than 25 years in Bolivia with the mission of “Contributing to the protection of health in a socially-responsible manner as an aid to human development.”

Key program components: 

As a pro-poor targeting strategy, the PROSALUD health care model implements a system of cross-subsidies to offer economically accessible prices to lower-income sectors: 6 PROSALUD centers charge less than USD 2.90 for an appointment with a general practitioner, 14 PROSALUD centers charge between USD 2.90- 4.30 for this same appointment and 7 PROSALUD centers charge between USD 4.30 – 5.70 for the same appointment. PROSALUD makes use of a system of cross-subsidies on three levels: utilize the money paid for care related to existing conditions to subsidize preventative care; centers in the network with a budget surplus subsidize centers with deficits; and clients able to pay subsidize clients unable to pay.

This system of cross-subsidization is the basis for the success of the PROSALUD model, and it is the key for PROSALUD to offer high quality health care and services at a very low cost, and, which cares for more than 500,000 people every year (5% of the Bolivian population). PROSALUD has become both an important partner in the public health sector and an alternative to the private sector.

PROSALUD is in 6 of the 9 Bolivian states made up of a network of 23 primary care centers and 5 secondary care clinics. PROSALUD has developed and maintained partnerships with both the local and national government, in addition to international organizations and community leaders, in order to implement community outreach strategies. This has allowed them to expand their services to include a variety of priority issues, including sexual and reproductive health, tuberculosis and diabetes.

Due to their unique structure, and thanks to their network of partnerships, PROSALUD has been able to develop a variety of activities and projects, including:

  • Social Marketing Program, which distributes and sells contraceptives and maternal health in a national level at a subsidized cost;

  • Strengthening programs for HIV awareness and voluntary testing for HIV, this program is integrated into their 5 clinics.

  • Awareness raising and training of reproductive and sexual rights in young people

  • manages USAID-Bolivia funds for health areas.

PROSALUD model has been replicated in several countries. In Nicaragua, as an example, they started with a health centers network that ended to be part of Pro-Familia Nicaragua.

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