Challenge

COMBASE (the Bolivian Evangelical Commission) is a faith-based organization that provides health services to the low income population in the city of Cochabamba, 250 miles east of the capital, La Paz. USAID has supported the organization’s reproductive health program since 1991. COMBASE’s small hospital and five clinics offer maternal and child health services to approximately 65,000 people every year. For many, this institution is one of the few affordable medical facilities within their neighborhoods. An internal evaluation showed that the organization was in a difficult financial situation and lacked the systems needed to effectively evaluate its services, costs and sustainability prospects.

Initiative

USAID started a management evaluation program with COMBASE. The outcome showed the absence of a strategic plan and institutional information system, as well as insufficient administrative and financial processes. Based on this diagnosis, a plan was developed and implemented with USAID providing support for COMBASE’s infrastructure and relevant training to key personnel. The technical assistance allowed for the preparation of COMBASE’s first strategic plan, where fundamental issues, such as the establishment of norms and procedures, and the design of new management systems were addressed. The support also included working on marketing programs for services, improving service quality, and establishing new financial policies in support of sustainability.

Results

COMBASE has balanced its budget, is much closer to sustainability, and attends to more than 200 patients daily. Its success bodes well for Bolivia, a country where the health indicators, though improving, are still among the worst of Latin America.