Bilingual Literacy and Reproductive Health

Country Profile: Bolivia


10,671,000 (2013)

Official languages

Spanish, Quechua, Aymara, Guaraní and 33 others

Poverty (Population living on less than 2 US$ per day)

25% (2008)

Access to primary education, net intake rate (NIR)

76.46% (2006)

Youth literacy rate (15 – 24 years, 2015, UIS estimation)

Female: 98.89%
Male: 99.18%
Both sexes: 99.04%

Adult literacy rate (15+ years, 2015, UIS estimation)

Female: 93.57 %
Male: 97.78 %
Total : 95.65 %

Statistical sources

Programme Overview

Programme TitleBilingual Literacy Project in Reproductive Health (Bi-Alfa Programme)
Implementing OrganizationMinistry of Education, Culture and Sport (MECD)
Language of InstructionQuechua and Spanish
FundingUNFPA, Turner Foundation
Programme PartnersVEA (Vice Ministry of Alternative Education), Economic Commission for Latin America and the Caribbean (ECLAC/CEPAL) and the Demographic Centre for Latin America and the Caribbean (CELADE)
Date of Inception1999



Since 1998, the Ministry of Education, Culture and Sport (MECD) has been working in partnership with the UNFPA to implement the Bilingual Literacy Project in Reproductive Health. The project was instituted in response to the high levels of illiteracy and high maternal and infant mortality rates among poor people, particularly those from the indigenous population. In light of this, the project endeavours to promote literacy skills development in order to improve people's living standards as well as reproductive health and child care practices. The project employs a gender-based approach and primarily targets women (85%). The project is aimed at people living in poor urban and rural areas, such as Chuquisaca, Potosí and Cochabamba, which have the highest concentration of indigenous peoples and high levels of illiteracy, as well as maternal and infant mortality. Furthermore, a multicultural approach is adopted to cater for the cultural and linguistic diversity of the participants.

The project is also being implemented in Paraguay, Mexico, Peru, Chile, Argentina and Guatemala with coordination and support from the Economic Commission for Latin America and the Caribbean (CEPAL/ ECLAC).

Context and Background

Bolivia is one of the poorest countries in Latin America. Wealth and socio-economic services are concentrated in urban areas, while about 90% of the rural population, most of whom are from indigenous populations, lives in extreme poverty, with limited access to basic services such as health and education. This has resulted in high levels of illiteracy and poor health standards in rural areas. For example, while the national illiteracy rate for women is 19%, it stands at around 40% in the department of Potosi where 90% of the population belongs to the indigenous population. Similar disparities exist with regard to reproductive health: while the average birth rate is 3.8%, it can be as high as 5.5% in the rural areas. In 2001, the maternal mortality rate in these rural locations was as high as 235 per 10,000 live births, and 62% of the deaths were of women with no access to professional reproductive health care services. Overall, these indicators reveal a strong correlation between a population’s standards of reproductive health (e.g. the use of contraceptives, the rate of maternal and infant mortality) and its level of education.

In this context and due also to the fact that 58% and 25% of Bolivia's population is under the age of 25 and of reproductive age (15–49 years), respectively, it was considered imperative to implement the Bilingual Literacy Project in Reproductive Health in order to address the inter-connected challenges of illiteracy and low reproductive health care awareness. The need for such a programme was even greater within the indigenous population due to the disparities between literacy rates and reproductive health standards detailed above.

Programme Implementation: Approaches and Methodologies

The programme is based on the experiences learned from the pilot project in Peru, which focused on 100 indigenous women from poor communities. In 1999, the Bilingual Literacy Project in Reproductive Health was introduced in Bolivia by the UNFPA and the Ministry of Education. Since then, the programme has been funded by the Ministry of Education, local municipalities and NGOs in areas with high illiteracy and maternal mortality rates, such as Chuquisaca, Potosí and Cochabamba. UNFPA chose literacy training as means of improving participants’ reproductive health and encourages active social participation in the programme’s implementation.

Aims and Objectives

The aims are to:

Training of Trainers (ToT)

Programme facilitators of the Bi-Alfa Programme are mostly teachers in the formal education system but people with at least a secondary education and community leaders have also been engaged. All facilitators attend 16 to 20 days of formal training per year. The training curriculum includes literacy teaching methodologies, programme content and organization, management and evaluation of the learning process. The role of the facilitators is to moderate the learning process while encouraging the learners themselves to learn from each other through active engagement and participation in programme activities. Each facilitator is assigned about 20 learners in order to ensure effective learning.

Teaching/Learning Methods

The teaching methodology used by the programme is based on Paulo Freire’s principles and approaches to education, and thus emphasises the learners’ own life experiences and learning through critical, creative and active forms of teaching and learning. Accordingly, literacy training is conducted bilingually in order to encourage learners’ active participation in group activities, debates and discussions. Moreover, basic literacy courses are designed to be as relevant as possible to learners' lives. For example, the alphabet is introduced and taught using key and relevant thematic words such as health, pregnancy, children or gender relations. This method is designed to provoke and encourage critical thinking and debate.

Facilitators supplement these learner-centred methodologies with relevant visual aids (such as posters and videos) and practical activities (such as painting, group reading sessions, writing on the blackboard, cutting words out of newspapers and working with literacy manuals). An innovative strategy in this context is that most of the learning materials or aids are exclusively developed and produced by the indigenous communities and the learners themselves.

The programme is divided into basic and advanced levels. At both levels, learners attend two or three sessions per week (totalling 144 hours) over a period of six to eight months.

Thematic Focus

Literacy courses focus in particular on promoting: bilingual literacy, reproductive health, gender equality and multiculturalism.


Bolivia is a multicultural and multi-ethnic society. In order to promote and strengthen ethnic relations and cultural identity, the project employs a bilingual approach to literacy training. Hence, learning is conducted in both indigenous languages and in Spanish. The bilingual approach is vital because it not only helps learners to comprehend the issues covered, but also draws on the learners' experiences and cultural sensitivities.

The gender perspective – a dimension that is neglected by many literacy projects – is central to the Bilingual Literacy Project in Reproductive Health. As highlighted above, the high levels of illiteracy among indigenous women means that they need special assistance in matters relating to reproductive health, and this can only be achieved by developing their literacy skills. The project therefore endeavours to increase learners' knowledge and awareness of women’s reproductive health rights and needs in order to empower them to lead healthy lives and make use of the appropriate primary reproductive medical services. This is ultimately intended to reduce the incidence of maternal and infant mortality.

Furthermore, the literacy courses harness the gender perspective in order to hold open discussions on topics such as self-esteem, self-care, violence-free relationships, the empowerment of women, parental roles in the education of children, and decision-making and negotiations within families. The integration of gender-specific topics is intended to promote gender rights awareness, equality and respect. This is particularly important for women given their culturally-designated subservient social position both within the family and in the community as a whole.

However, because the idea of equal rights and opportunities for women defies entrenched traditional value systems, the programme not only encourages mixed groups of women and men to discuss these issues but also employs a community-based learning system and sensitisation activities that involve the entire community.

The programme employs a multicultural approach that reflects the cultural diversity of its learners, particularly with regard to history, language, cosmology, beliefs, forms of production and social structures. Multiculturalism is understood to imply a horizontal examination and mutual recognition of cultural differences, and learners are encouraged to reflect on their own and others’ culture and cultural identity in order to recognise these differences and learn from them. A multicultural approach also involves integrating indigenous knowledge systems into the learning process, and thus strengthening ethno-cultural identities rather than imposing specific worldviews or practices and acting in a protectionist attitude towards cultural traditions. Ultimately, the project aims to empower indigenous people to become full, active and respected members of national society.

Advanced Literacy Training

At the end of the basic literacy level, the programme offers learners the opportunity of starting advanced literacy skills training. The advanced level draws on both scientific and traditional systems of medicine to extend learners’ knowledge of health-related topics, such as community health and hygiene, healthy living (nutrition), family planning, childbirth and postnatal health, child care, and sexually transmitted diseases. The programme also promotes the development of skills for the purposes of income generation.

Programme Impact and Challenges

Monitoring and Evaluation

The project uses a system of ongoing evaluation in which facilitators undertake assessments. Professional external evaluators are also engaged to carry out a quantitative and qualitative evaluation of the programme’s impact on participants and their communities.



The following are some of the key challenges that the programme faces:


Lessons Learned

The following are the key lessons that have emerged from the programme:




Monica Yaksic Prudencio
Avenida del Maestro N° 345
Edificio SEDUCA 1er. Piso
Sucre – Bolivia
E-mail: yaksic (at)
Tel. +591 46 45 61 66

Rolando Encinas Caballero
Maria Martinez Mita
Email: mmartinez_mita (at) / bialfa (at)

Last update: 15 January 2010