In Bolivia, women live longer than men but often have significantly lower incomes. A lifetime of disadvantage, and their role as caretakers into old age, can make it harder for older women, especially in rural areas, to register for services in urban centres. The fact that 73 per cent of Bolivian women over 60 are illiterate – compared to 28 per cent of older men – also makes it harder for them to access information about their rights.
Bolivia has a strong record in shaping legislation to promote good health into old age. Since 1992, older people have had access to universal health insurance, and in 2006 the health insurance provisions were redrafted to improve access in rural areas. The new law includes a monitoring framework consisting of Comites de Vigilancia (civil society organisations that monitor the implementation of municipal governments) and organisations of older people, including women, which have a responsibility to identify the principal obstacles to access.
Between 2002 and 2006, HelpAge International led an 'Older Citizens Monitoring' project that trained five older people's organizations to monitor the financing and delivery of services. It identified key shortfalls, helped to improve the quality of medical services, and acted to increase knowledge of insurance among older people, especially women, as well as local government officials and health providers. The projects put an emphasis on training women in leadership. As Doña Catalina from the city of El Alto explained: "I've learned not to be afraid; we can go to offices and coordinate with institutions without any problem."
