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World Health Systems Facts

Costa Rica: Health System Challenges

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Costa Rican Health System Overview
Health System Rankings
Health System Outcomes
Coverage and Costs for Consumers
Health System Expenditures

Health System Financing
Medical Personnel
Health System Physical Resources and Utilization
Long-Term Care
Medical Training
Pharmaceuticals

Political System
Economic System
Population Demographics
People With Disabilities
Aging
Social Determinants & Health Equity
Health System History
Health System Challenges


“The country is facing challenges related to the preservation of water resources, rational use of marine resources, waste management, mechanisms for adaptation to climate change, and the use of clean energy sources to reduce dependence on fossil fuels.

“Natural disaster emergencies are associated with the rains and winds that occur throughout the year.

“Public insecurity is related to social tensions and criminality, associated especially with drug trafficking and organized crime, leading to high rates of homicide, theft, and drug addiction.

“In 2011, immigrants—mostly from Nicaragua—comprised 9.0% of the population.

“In the process of constructing the post-2015 development agenda, the Government conducted a broad-based national consultation in which citizens expressed their main desires for the future: achieving a more inclusive and equitable society; a sustainable health system that meets health needs with user-friendly, high-quality services; comprehensive education; and a secure society.

Source: Pan American Health Organization. Health in the Americas, 2017 Edition. Summary: Regional Outlook and Country Profiles. Washington, DC: PAHO; 2017.


“Over recent decades, Costa Rica has had a clear national consensus on the role of the health care system. In particular, efforts towards increasing access to the primary care were accelerated in the early 1990s, when Costa Rica opened up community clinics called Basic Comprehensive Health Care Teams (Equipos Básicos de Atención Integral de Salud, EBAIS). By 1995 there were 232 EBAIS in Costa Rica, mostly among underserved communities, thus, greatly improving rural access to primary care. The continuing development of EBAIS and other primary care services are described further in Chapter 2.

“The focus on strengthening primary care in Costa Rica was followed by reorganisation of the administrative structure. The Law on Decentralisation in 1998 decentralised the CCSS by creating democratically elected community health boards (Balabanova et al., 2011). These boards supervise the delivery of local health care services and they improved responsiveness since more power was given to local decision makers. It also increased community participation for setting priorities and health-related performance targets. A purchasing division within the CCSS was also created to further separate this function from the functions of financing and service provision. This unit purchases services with health care providers based on performance management contracts. The reform has allowed for improvements in quality and efficiency of services, while enhancing production and user satisfaction. Another institutional reorganisation of the Costa Rican Ministry of Health was implemented during the 2006-11 period. In the scope of this new structure, it was decided that the strategic health policy of Costa Rica would be to go from disease management to a health promotion approach.”

Source: OECD (2017), OECD Reviews of Health Systems: Costa Rica 2017, OECD Publishing, Paris. dx.doi.org/10.1787/9789264281653-en


Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.


Page last updated Nov. 12, 2022 by Doug McVay, Editor.

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