FIFTH REPORT - World Health Organization

REGION OF THE AMERICAS 83
The per capita government expenditure on health was
$84.5. The government health expenditure included
the following items: $1.7 million for administration
and government personnel; 44 066 for immunization
and vaccination activity; 30 944 for laboratory services;
188 368 for environmental health services; 12 952 for
occupational health services; 53 924 for education
and training of health personnel. The government
expenditure on hospitals and clinics included EC$8.5
million for general hospitals and clinics, 2.1 million
for specialized hospitals and 2.4 million for other
health establishments.
BOLIVIA
Population and other statistics
At the last census, taken in September 1950, the
population of Bolivia was 3 019 031. Population
estimates and some other vital statistics for the period
under review are given in the following table :
1969 1970 1971 1972
Mean population 4 800 000 4 930 000 5 060 000 5 190 000
Number of live births . 88951 87 887 85 270 ...
Birth rate (per 1000 population
18.5 17.8 16.9
Number of deaths 24491 29912 19264
Death rate (per 1000 population)
5.1 6.1 3.8
Natural increase (%) . . . . 1.34 1.17 1.31
Number of infant deaths . 5 372
Infant mortality rate (per 1000
live births) 60.4
Number of deaths, 1 -4 years 4496
Death rate, 1 -4 years (per 1000
population at risk) 6.5
Number of maternal deaths 1 091
rate
1000 live births) 12.3
Of the 19 264 deaths recorded in 1971, the main
causes were :1 symptoms and ill- defined conditions
(5316), pneumonia (2290), whooping -cough (889),
tuberculosis, all forms (851), birth injury, difficult
labour and other anoxic and hypoxic conditions,
other causes of perinatal mortality (662), streptococcal
sore throat and scarlet fever (448), influenza (446),
measles (324), malignant neoplasms (308), bronchitis,
emphysema and asthma (267), anaemias (248), bacillary
dysentery and amoebiasis, enteritis and other
diarrhoeal diseases (185).
The communicable diseases most frequently notified
in 1972 were: influenza (16 507), tuberculosis, all
forms, new cases (8739), measles (8334), malaria (8080
in 1971), whooping -cough (3294), gonorrhoea (1695),
bacillary dysentery and amoebiasis (1538), syphilis,
new cases (1109), infectious hepatitis (702), typhoid
fever (521), paratyphoid fevers (335), scarlet fever
and streptococcal sore throat (656), diphtheria (71),
typhus, louseborne (53), poliomyelitis (45).
Organization of the public health services
The health services in Bolivia are provided by the
Ministry of Social Welfare and Public Health, by the
1 International Classification of Diseases, 1965 Revision.
social security and by other institutions which provide
health services for their employees. The Ministry of
Social Welfare and Public Health is the supreme
health authority in the country and coordinates all
health activities. It is organized on a decentralized
basis with a wide delegation of functions to the 11
health regions.
Hospital services
In 1970 Bolivia had 269 hospitals, providing 9674
beds, of which 6008 were in 145 government hospitals.
The bed /population ratio was thus 2.0 per 1000. The
6008 beds in the 145 government hospitals were distributed
as follows:
Category and number
Number of beds
General hospitals 26 3 327
Rural hospitals 94 1 114
Maternity hospitals 6 242
Paediatric hospitals 5 219
Tuberculosis hospitals 8 508
Psychiatric hospitals 3 452
Ophthalmology hospital 1 33
Cancer hospital 1 28
Leprosarium 1 85
Outpatient facilities were available in 1972 at 87
hospital outpatient departments; at 45 polyclinics
operated by the social security; 94 health centres, of
which 83 had some inpatient facilities; 71 dispensaries;
61 medical aid posts in rural areas; three mobile
health units; and 369 health posts.
Medical and allied personnel and training facilities
In 1970 Bolivia had 2143 doctors, or one doctor
for 2300 inhabitants. Other health personnel included:
Dentists 903
Pharmacists 1 600
Veterinarians 250
Midwives 45
Assistant midwives 40
Nurses 542
Auxiliary nurses 1 264
Sanitary engineer 1
Sanitarlans 74
X -ray technicians 9
Health educators 12
Nutritionists 24
The arrangements for the training of medical and
health personnel were as follows: