Background
The Barrio Adentro program was developed against a background of a public health sector crumbling under long-term financial pressure. As part of the neoliberalisation programme of the early 1990s under President Rafael Caldera, a Venezuela struggling with inflation and a low oil price (oil being its primary export) was forced into spending cuts and privatisation in a number of sectors, including healthcare. A 1989 decentralisation law contributed to the trend; from 1993, state governors could request the transfer of public healthcare in their state to their control, and the inability to cope with the new responsibility encouraged cuts and privatisation. Cost recovery became increasingly prevalent through "voluntary" contributions from users. In addition to the problems with the healthcare system, over the course of the decade health problems caused by poverty (infectious and deficiency diseases) increased. By 1999, 67.7% of the Venezuelan population was living in poverty, from 44.4% in 1990.
In 1999, following the election of Hugo Chávez, the Ministry of Health planned to develop a new National Public Health System, with a particular focus on health promotion, disease prevention, community participation, and the strengthening of the primary health care infrastructure. The 2000/1 annual report by PROVEA highlighted a number of positive features of the new approach, including a wider availability of health services through progressive elimination of users’ fees.
Read more about this topic: Mission Barrio Adentro
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