Embassy of the United States La Paz, Bolivia

Wayne Nilsestuen, USAID Director in the inauguration

PROSALUD is a non-governmental organization, initially created with USAID support in 1985.  USAID and PROSALUD have successfully implemented a series of Cooperative Agreements over the past 26 years, with decreasing USAID financing as PROSALUD has successfully increased its cost-recovery over time reaching self-sustainability.  PROSALUD has grown into a national network of primary and secondary care centers.  It currently operates a network of 23 primary health care centers and 6 secondary health clinics serving 600,000 people in 6 departments of Bolivia (Santa Cruz, La Paz, Oruro, Cochabamba, Beni and Tarija).   Investments by USAID in PROSALUD since 1985 total some $29 million, through FY 2010, including the cost of this clinic.  The clinic in Cochabamba has a cost of US$1.7 million, US$1.2 million from   USAID and the rest from PROSALUD.  The new clinic is expected to provide services to approximately 80,000 persons every year.
PROSALUD’s health services strategy is based on the concept of internal cross-subsidy, whereby user fees for clinical services from high volume clinics are used to subsidize preventive care as well as clinical services in low volume clinics.  In addition, slightly higher user fees in some neighborhoods help underwrite lower user fees in poorer neighborhoods.  This allows PROSALUD to serve low-income urban populations while advancing toward financial sustainability. 2012 PROSALUD’s Health Services financial reports show 97% of cost recovery.