[Situation of essential conditions for the delivery of care for noncommunicable diseases in the Bolivian Chaco regionSituação das condições essenciais para a atenção a doenças não transmissíveis na região do Chaco boliviano].

Abstract

As part of a regional initiative to improve care for noncommunicable diseases (NCD) in vulnerable territories, a specific module of the Essential Conditions Evaluation (ECE) tool of the Pan American Health Organization (PAHO) was developed and implemented in 15 health facilities in Camiri and the Guaraní Kereimba Iyaambae Indigenous Autonomous Government (GAIGKI) in the Bolivian Chaco region between February and May 2024. The objective was to detect gaps, document strengths, and generate useful evidence for territorial planning.The instrument included 50 variables grouped into 10 key dimensions, in line with the technical frameworks of the World Health Organization (WHO) and PAHO. It was implemented through a participatory methodology, led by PAHO and previously trained local teams. The analysis made it possible to tailor the assessment to the priorities of the territory, focusing on hypertension, diabetes, cancer, and mental disorders.The results revealed gaps in governance, financing, human resources, and information systems in both municipalities. Camiri stood out for its basic equipment and clinical follow-up; GAIGKI, for local planning and the availability of specialized personnel. Both municipalities showed progress in basic tests, essential medicines, and the continuity of care.The experience demonstrated the technical feasibility of the module, its cultural relevance, and its potential for integration into national surveillance systems. With technical and financial support from PAHO, intersectoral coordination and community participation were promoted, generating key input to improve the integrated management of NCDs in primary health care in rural and Indigenous contexts.