Evaluating the Impact of the ‘Basic Health Insurance’ Program on Skilled Birth Attendance in Bolivia: Evidence from the Household Surveys

Cecilia Vidal, Harvard University

The Basic Health Insurance (BHI), implemented in Bolivia in 1999, was created to reduce the financial barriers of access to the health system of uninsured populations by offering a basic package of free health services. This study examines the impact of the BHI on the coverage of skilled birth attendance. Under the assumption that the availability of medical personnel is correlated with the probability of being exposed to the program, the identification strategy consists of comparing the change in coverage of skilled birth attendance among women in municipalities with high and low ratio of doctors, before and after the BHI. The results indicate that coverage of skilled birth attendance increased more among women in municipalities with higher probability of receiving the benefits of the program. This increase was larger among poor indigenous mothers living in the rural areas, and provides evidence of the success of the program in Bolivia.