RESEARCH: CLOSING THE GAPS: The Challenge to Protect Costa Rica's Health Care System

Brian Jacob

Since the 1940s, Costa Rica's approach to family health care has made services accessible to a greater part of its population, significantly lowered its infant mortality rate, and increased overall life expectancy. These accomplishments have distinguished the country as a positive example for both the region and the world. However, recent research suggests that the infrastructure that enabled this success is growing increasingly incapable of sustaining momentum, and administrative flaws threaten future progress. Costa Rica cannot afford to rest on its past successes, and must address these concerns before they escalate beyond its control.
 
INTRODUCTION
 
Costa Rica is both a regional and global example of successful health care, with significant achievements in the areas of infant mortality and life expectancy (Sick 1997; Unger et al. 2008). When viewed in comparison with other Central American countries, Costa Rica has the lowest birth rate, lowest infant mortality rate, lowest fertility rate, lowest death rate, and the highest life expectancy. (Table 1).
 
Can this success be attributed to the country's wealth? Costa Rica's gross domestic product (GDP) per capital is significantly lower than that of the United States (Table 2), yet its health care system is ranked higher (Drayton-Brooks 2006). Wealth alone does not determine the quality of a country's health services. When considering a nation's GDP and approach to maternal welfare, Kuwait ranks 3rd in GDP but 50th in mothers' wellbeing; in contrast, Costa Rica ranks 35th in GDP, but 12th in maternal welfare (Althaus 2000). ...