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Health Reform, Decentralization, and Participation in Latin America: Protecting Sexual and Reproductive Health

Much of the work undertaken by the USAID-supported POLICY Project in Latin America and the Caribbean (LAC) has been based on the premise that improving partnership between governments and civil society and strengthening participatory processes in the region can help improve the decentralization of the health sector. Working in Bolivia, Peru, Mexico, and Guatemala, the project has helped governments and civil society clarify their roles and strengthen decision making at the central, state, and municipal levels. The project has used its limited funds to intervene strategically to motivate citizens and build capacity of civil society organizations to participate as partners with governments in policymaking and governance and to convince government officials that sharing power and collaborating with civil society serves the interests of the country and its government. The POLICY Project's overall goal in the LAC region has been to strengthen participatory processes as a means of creating a policy environment favorable to sexual and reproductive health. POLICY's experiences in the region reflect differences in the degree to which governments have decentralized and the degree to which citizens are accustomed to participating in policymaking and civil society organizations.