In Costa Rica: integrating public health and primary care
In Part Two of our Costa Rica series, Dr. Tara Kiran takes you inside an EBAIS (Equipos Básicos de Atención Integral de Salud) clinic on the Nicoya Peninsula in Costa Rica to see what it actually looks like to deliver primary care beyond clinic walls. Costa Rica organizes primary care around geography. Each clinic is accountable for a defined population — and community health workers play a central role in making sure no one is missed. They visit households, provide education on prevention and chronic condition management, deliver vaccines, identify risks early, and act as a bridge between public health and clinical care. It isn’t a perfect system. But it is an ambitious one. And it offers a powerful contrast to Canada’s often fragmented approach to primary care and public health — reminding us that building a system where everyone has care is not just a matter of funding, but of design.
Further reading:
Listen to Part 1 of our series on Costa Rica with Dr. Madeline Pesec
Take a look at the research article that first introduced me to Madeline (co-authored by Dr. Atul Gawande)
Explore this brief Commonwealth Fund case study on the Costa Rican primary care system or dive deeper into this more detailed case study from Ariadne Labs
Read the article “Costa Ricans Live Longer Than We Do. What’s the Secret?” in the New Yorker magazine by Dr. Atul Gawande
Read the BBC article Tara mentioned about how Nicoya Peninsula is home to a large number of centenarians
Learn more about rising violence in Costa Rica related to femicide and gang violence
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