Task: Question Generation
Input (English): Passage: Healthcare expenditures comprise only 4.9% of the GDP. According to the 2013 World Factbook, Bolivia ranks 161st in life expectancy with an average age of 68.2 years. In 2009, the World Factbook estimated 12,000 people are living in Bolivia with HIV/AIDS (0.2%) and less than 1,000 of that population died from it. In 2003, it was estimated by the World Health Organization (WHO) that 31.9% of the adult population (12-64) were smokers. According to 2008 WHO data, 17.9% of the population is obese. In 2011, there were 3,255 healthcare institutions, of which 1,134 are considered "first class" (medical personnel and registered nurses) by the Bolivian Ministry of Health Management. The hospitals employed an estimated 10,000 medical doctors in 2001.
Output (English): How many of the healthcare institutions in 2011 were not considered first class?