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Cited by 59Public Health and Social InequalitiesCommunity Health and DevelopmentHealthcare Systems and Practices

Attaining health for all through community partnerships: principles of the census-based, impact-oriented (CBIO) approach to primary health care developed in Bolivia, South America

Perry, Henry, Robison, Nathan, Chavez, Dardo, Taja, Orlando, Carolina Hilari, Shanklin, David, Wyon, John·1999·Social Science & Medicine
DOI 10.1016/s0277-9536(98)00406-7
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Abstract

This article describes a flexible primary health care methodology which was developed by Andean Rural Health Care and its colleagues in Bolivia, South America. This methodology, the census-based, impact-oriented (CBIO) approach to primary health care, involves determining local health priorities as defined both by locally acquired epidemiologic information and by the local people themselves. The CBIO approach to primary health care is now functioning successfully at seven program sites in Bolivia, which together serve 75,000 people in urban and rural communities in three distinct cultural and ecological regions of the country. High levels of coverage of basic health services can be achieved through a system of 'epidemographic' surveillance of all families and through home delivery, when needed, of priority services to those at risk. When the services provided are based on local health priorities, when they are provided in a technically effective manner, and when the community has a strong partnership in planning, implementation and evaluation, then the CBIO approach to primary health care will lead to measurable health improvements as defined by changes in population-based rates of mortality and illness in the community. On the basis of our experience, we believe that the CBIO approach offers great potential for strengthening the effectiveness of local health programs in impoverished communities around the world in a way which fosters community ownership and, hence, long-term sustainability.

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  • CHWs have the potential to identify local epidemiological priorities based on routine home visitation, including detection of disease outbreaks and registration of vital events, with support from mobile devices.

    “CHWs have the potential to identify local epidemiological priorities based on routine home visitation, including detection of disease outbreaks and registration of vital events (which can also be entered into the civil registration system), with support from mobile devices, as may be appropriate to the context [114–116].”

    From Community health workers at the dawn of a new era: 11. CHWs leading the way to “Health for All” (2021) · cites this paper as [114]

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Authors
Perry, H., Robison, N., Chavez, D., Taja, O., Hilari, C., Shanklin, D., & Wyon, J.
Affiliations
  • Universidad Tecnológica Boliviana (BO)
  • Harvard University (US)
Corresponding author
Perry, Henry
ORCID
Perry, Henry
Venue
Social Science & Medicine
Publisher
Elsevier BV
Published
1999-04
Volume
48
Issue
8
Pages
1053-1067
ISSN
0277-9536 (ISSN-L)
DOI
10.1016/s0277-9536(98)00406-7
OpenAlex
W2051200275
Cited by
59
References
46
Citations by year
2025: 1 · 2023: 8 · 2022: 1 · 2021: 3 · 2020: 1 · 2019: 2 · 2018: 3 · 2017: 4 · 2016: 1 · 2015: 2 · 2014: 3 · 2012: 3
FWCI
2.69
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Social Science & Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
Topics
  • Social Sciences › Health › Public Health and Social Inequalities
  • Health Sciences › Health Professions › General Health Professions › Community Health and Development
  • Health Sciences › Health Professions › General Health Professions › Healthcare Systems and Practices
Keywords
primary care, community partnerships, community participation, disease surveillance, community ownership, rural health, Bolivia
MeSH terms
Bolivia, Community Participation, Delivery of Health Care, Humans, Patient Acceptance of Health Care, Primary Health Care, Rural Health, Program Evaluation, Program Development

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