Comparative Analysis Of Primary Health Care Facilities With Participation Of Civil Society In Venezuela Y Peru

The writing of this document was solicited by the Division of State and Civil Society (DPP/SCS) of the Inter-American Development Bank (IDB), for presentation at the annual meeting of the Assembly of Governors of the Bank in Cartagena, Colombia in March, 1998.

The broad vision of the meeting’s organizers to identify and analyze experiences of the interface between the public sector and civil society in the delivery of human services fits within social sector reform movements and decentralization occurring in many Latin American countries. It is also in perfect accordance with a framework of ideas on poverty and social development that have been developing over the past years among major international agencies which stress the balance between what governments can do and what people can do for themselves.

The accumulated experience of the Bank and other international agencies has demonstrated that participation of civil society in the design, implementation, and monitoring of social programs makes an important contribution to the impact and sustainability of those programs. However, there is a great need for this rich experience to be analyzed, evaluated, and disseminated in a systematic way that would allow for its wider and more objective discussion. In this way, there could be a more frequent utilization of the strategy as a more transparent and effective mechanism for using social sector resources.

This is a comparative case study of two programs, one in Peru and the other in Venezuela, which have as a common element the active participation of organized civil society in the administration of primary level health care facilities.

In the case of Venezuela, a study was commissioned by IDB to collect primary data from a random sample of public health facilities with participation of civil society in management and administration and others under traditional public sector administration. Interviews and secondary data sources were also utilized. The Venezuela study, focusing on an experience in the State of Lara, was conducted by Carlos Mascareño, and is reported on in a separate document cited in the bibliography.

The Peru case study, also commissioned by IDB, was based exclusively on existing reports, evaluations, secondary data sources, and interviews. The author of the current report was responsible for assessing the Peru experience and developing the comparative analysis between the two country programs.