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Bolivia is a lower-middle-income country in South America with a population of just over 9 million and a Gross Domestic Product (GDP) per capita of $2,819 in 2005. It is one of the poorest countries on the continent. Life expectancy at birth is 64.7 years. According to official estimates, 32 percent of the population lives on less than $1 per day, and 65 percent of the population lives below the national poverty line. A high percentage of the population is of indigenous origins: 61 percent at the last census in 2001.

Bolivia signed the Convention on the Elimination of All Forms of Discrimination Against Women in 1990. However, gender-based discrimination continues to be widespread. Life expectancy for women is only 62.6 years, 4.3 years lower than men's. Women are also less likely to have attended school. Women's labor market participation has been increasing steadily, and 62.6 percent of all women are now in paid employment. Women on average earn just over half of men's average income ($2,059 as opposed to $3,584) and are overrepresented in the informal sector. According to one study, motherhood does not have negative effects on women's wages.

Most Bolivian women are mothers. Despite the fact that there has been a marked increase in the percentage of women who place education and paid work as their top priority, motherhood and marriage continues to be a fundamental part of women's identity. The fertility rate currently stands at 4 births per woman, down from 6.5 during the 1970s. According to a survey carried out in 2003, 12.6 percent of surveyed teenage girls already had a child, while 3.6 percent were pregnant.

Maternal Health

Maternal mortality continues to be the highest in the region: 650 women die each year because of complications in pregnancy and birth. There are on average 230 maternal deaths per 100,000 live births, but in some rural areas, the rate reaches 887 per 100,000 live births. Maternal deaths are caused by hemorrhage, induced abortion, and hypertension. Abortions are illegal, except for a small minority of cases. Most women who decide to terminate their pregnancy have to do so illegally; between 27 and 35 percent of maternal deaths are abortion related. The remainder of maternal deaths depends on the availability and access to skilled birth attendants.

Between 1997 and 2005, only 67 percent of births were attended by skilled professionals. Access to and use of skilled birth attendants is strongly influenced by the mother's income. Rural and indigenous women are least likely to have access to modern health services. A major problem is that the national health system is not perceived to be sensitive to indigenous beliefs and practices. The United Nations Population Fund is currently working with the Bolivian government and Pan-American Health Organization to develop a culturally sensitive program for midwives. Bolivia celebrates Mothers' Day on May 27.

TanjaBastiaUniversity of Manchester

Bibliography

Armstrong, Kate. Bolivia (Country Guide), 6th Edition. Oakland, CA: Lonely Planet, 2007.
Koblinsky, Marjorie A., ed Reducing Maternal Mortality: Learning From Bolivia, China, Egypt, Honduras, Indonesia,

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