How does the healthcare system work in Bolivia?

What is the quality of healthcare in Bolivia?

• Bolivia was one of the last countries in Latin America to develop a free public health care system. The country is working on improving health, but the system is very overloaded due to the high pressure on health care due to the presence of many diseases.
• Health care in Bolivia varies in quality. In the larger cities of La Paz, Santa Cruz and Cochabamba there are relatively good hospitals with good doctors, but in rural areas the care is often outdated.
• The country has a hybrid health care system. This means that care is divided over different sectors, namely public (Seguro Universal de Salud - SUS), social (Caja Nacional de Salud - CNS) and private care.
• In each sector you will also find three levels of care: primary care with health centres for basic care, secondary care with hospitals that provide more extensive care and tertiary care for specialist treatments.
• It is wise to learn some Spanish before visiting a doctor in Bolivia, especially in rural areas and small towns.
• Pharmacies are easy to find. Many medicines are available here without a prescription. The emergency number for the ambulance is 118.

How does the public healthcare system work in Bolivia?

• In 2019, the Seguro Universal de Salud (SUS) was set up to make basic healthcare free and accessible to Bolivian residents. The system covers around 70% of the population. For foreigners living in Bolivia, the system offers access to free medical care under certain conditions.
• There are often long queues in public healthcare and the equipment and facilities can be outdated, especially outside the city. There may also be shortages of medicines.
• Working residents of Bolivia are required to be part of the public social security system, in which both employer and employee make a contribution (10% of the salary). People who fall under this system are entitled to subsidised healthcare, just like people who fall under the SUS.
• In recent years, foreigners have sometimes been refused access to public healthcare without valid reason, even in emergencies. So be careful…

How does the private healthcare system work in Bolivia?

• About 10% of the population uses the private healthcare system, these are mostly the wealthy Bolivians. Foreigners also generally choose private healthcare because of the much better facilities and shorter waiting times.
• Private healthcare is mainly concentrated in the big cities such as La Paz, Santa Cruz and Cochabamba.
• The costs are of course a lot higher. It is therefore important to have good insurance.

How is the general practitioner arranged in Bolivia?

• There is no general practitioner system in Bolivia. People generally go directly to a specialist or clinic.
• In private healthcare, you can find general practitioners at clinics who act as a kind of general practitioner.

How is the dentist arranged in Bolivia?

• Dental care varies greatly, depending on whether you choose public or private care. Public dental care is limited and often outdated, while private dental care is relatively good and cheaper than in Europe, for example.
• Ask other expats for advice on a good dentist. Most private dental care, like the rest of the private healthcare, is concentrated in the big cities.

How is pregnancy care arranged in Bolivia?

• Public maternity care is being developed in Bolivia, but there are still problems. Infant mortality is around 20 per 1,000 births (2022), higher than in many other countries, especially in rural areas.
• Public care offers free pregnancy check-ups and deliveries, but with basic facilities and not of the quality that expats are usually used to.
• Private care has more modern facilities and more personal guidance. Caesarean sections are more common in private hospitals.
• Note that there are quite a few health risks in Bolivia that can also impact the pregnancy.
• Abortion is only legal under certain circumstances, such as rape, incest or health risks for the mother.

How safe or unsafe is a trip or stay in Bolivia?

What should you pay attention to in terms of safety in Bolivia?

• Bolivia is not the safest country. There is often political unrest, with tensions that can be felt throughout society. There are regular political demonstrations that can get out of hand.
• There is also violent crime, often related to drugs. This is particularly common in the Chapare region.
• Pickpocketing is a common problem in tourist areas. It is also important to keep a close eye on your belongings on buses and at bus stations. More violent robberies of tourists also sometimes occur.
• In terms of natural disasters, severe weather mainly occurs in the rainy season from November to March. During this period, there are regular landslides and floods. In the dry season, wildfires are common, which also has a negative impact on air quality.

What should you look out for in terms of diseases in Bolivia?

• There are quite a few health risks in Bolivia, including mosquito-borne diseases such as dengue, malaria and zika. Protect yourself well against mosquito bites!
• Because Bolivia has some very high-altitude areas, altitude sickness is also a risk. Be aware of the symptoms (including nausea, headache, fatigue, loss of appetite) and respond appropriately.
• There are several serious diseases that are common, such as typhoid, hepatitis and tuberculosis.
• Drink only boiled or filtered water and avoid food that is raw or undercooked to prevent illness and traveler's diarrhea.
• Beware of rabies. Always seek medical help immediately if you are bitten or scratched by an animal.

What should you pay attention to when it comes to traffic in Bolivia?

• Driving in Bolivia is not child's play. Outside the highways that connect La Paz, Santa Cruz and Cochabamba, the conditions are often dangerous. There is no good road protection and roads are often unpaved. It is therefore recommended to drive with a four-wheel drive.
• Also, most drivers have not had proper driving lessons, traffic rules are ignored (drunk driving is common), pedestrians usually do not get a front edge and the vehicles are often poorly maintained.
• Traveling during the rainy season is difficult and more dangerous because the rain deteriorates the road quality and many roads become impassable.
• Public transport is also not without risks, bus drivers often drive overtired, sometimes even drunk and in outdated vehicles. Bus accidents are not uncommon in the country.
• Pickpocketing and bag theft are quite common on public transport.
• Criminals sometimes pose as taxi drivers. So make sure you choose reliable taxi companies.

What work and travel insurance policies are suitable for short and long stays in Bolivia?

• Is the trip to Bolivia and your return sufficiently covered? Are you sufficiently covered before, during and after your activities? Which insurance best suits your trip and your activity? Read more about insurances for abroad on JoHoinsurances.org.

What emigration and expat insurance can you take out for Bolivia if you are going to live there for a while?

• Good international health insurance is a must to ensure that you are not faced with financial surprises such as private care, medical evacuations or repatriation.
• Make sure your insurance covers medical evacuation as well as coverage in neighboring countries. Read more about insurances for abroad on Expatinsurances.org.