Bolivia ranks at or near the bottom among Latin American countries in several areas of health and development, including poverty, education, fertility, malnutrition, mortality, and life expectancy. On the positive side, more children are being vaccinated and more pregnant women are getting prenatal care and having skilled health practitioners attend their births.

Bolivia’s income inequality is the highest in Latin America and one of the highest in the world. Public education is of poor quality, and educational opportunities are among the most unevenly distributed in Latin America, with girls and indigenous and rural children less likely to be literate or to complete primary school. The lack of access to education and family planning services helps to sustain Bolivia’s high fertility rate—approximately three children per woman. Bolivia’s lack of clean water and basic sanitation, especially in rural areas, contributes to health problems.

Between 7% and 16% of Bolivia’s population lives abroad (estimates vary in part because of illegal migration). Emigrants primarily seek jobs and better wages in Argentina (the principal destination), the US, and Spain. In recent years, more restrictive immigration policies in Europe and the US have increased the flow of Bolivian emigrants to neighboring countries. Fewer Bolivians migrated to Brazil in 2015 and 2016 because of its recession; increasing numbers have been going to Chile, mainly to work as miners.