The mental health system in Bolivia is for the most part limited to institutional care provided in the capital of La Paz. Afro descendant Bolivian communities (or Afro Bolivians) are mainly found in the provinces of South and North Yungas, in the department of La Paz.

Mental health services in the region of Yungas are nearly non-existent, as people need to travel over 8 hours to reach the closest specialized mental health services in the capital of La Paz. The main findings point to high levels of misunderstanding and stigma towards mental health issues in target communities and low availability of mental health services. Moreover, there are no specialized mental health services nor were there any non-specialized workers trained in mental health prior to the trainings carried out by the project. Bolivia's health system is facing major challenges due to low staff numbers, limited resources, and difficulties in the Health Information System.

Implementation and Achievements

The needs assessment and resource mapping exercise in Bolivia focused on the areas of North and South Yungas, where most of the Bolivia's Afro-descendant population is located. Ministry of Health officials are planning to build a community-based mental health center in this area to bring specialized services to the population and allow for supervision of trained non-specialized workers. PAHO liaised with the existing Health Emergency Cluster and Ministry of Health to create a core group of interested actors to develop a Terms of Reference and an Action Plan. The implementation plan was developed by the project’s national coordinator in collaboration with national-level Ministry of Health representatives in charge of mental health. The strategic direction of the plan was based on a series of recommendations made by afro descendant communities leaders during a national-level meeting that took place in La Paz to better understand the target population needs and priorities related to mental health.

The project’s mhGAP strategy in Bolivia was designed to cover multiple levels of the health system. Through this national-level effort, a commitment to increase mental health service coverage to the entire Bolivian population was made, with a special focus on Indigenous communities.

Training was carried out in the North and the South areas of Yungas. A total of 58 health workers (35 women and 23 men) from 46 primary health centers were trained in the departments of Coroico and Chulumani, of whom 29 were general practitioners, 8 were nurses and 21 were nursing assistants. An extensive communications campaign was also developed by a collaboration between the Ministry of Health, community leaders and PAHO communications team at national and regional level. The project also provided training in psychosocial support for Community leaders. Trainees were mainly members of CONAFRO and the Organization of the Cimarronas, a community-based woman-led organization active in social causes related to women.

PAHO will continue supporting Ministry of Health in its mission to increase access to mental health services in the North and the South of Yungas, through continued capacity building efforts as well as supporting the creation of solid monitoring and evaluation systems.

Communication materials