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Implementing sustainable primary healthcare reforms

Strategies from Costa Rica

Dados Bibliográficos

ID21879788
AutoresLauren Spigel (0000-0001-7846-4890, Ariadne Diagnostics (United States)), Madeline Pesec (0000-0001-6593-200X, Brown University), Oscar Villegas del Carpio (Costa Rican Department of Social Security), Hannah L Ratcliffe (0000-0003-4134-5112, Ariadne Diagnostics (United States)), Jorge Arturo Jiménez Brizuela (Costa Rican Department of Social Security), Aurora Mateos Montero (0000-0001-8114-8039, Costa Rican Department of Social Security), Andres Madriz Montero (Caja Costarricense de Seguro Social, San José, Costa Rica), Eduardo Zamora Méndez (Costa Rican Department of Social Security), Dan Schwarz (0000-0002-6975-4519, Brigham and Women's Hospital), Asaf Bitton (0000-0002-3633-3806, Brigham and Women's Hospital), Lisa R Hirschhorn (0000-0002-4355-7437, Northwestern University, autor correspondente)
Ano2020
Volume5
Fascículo8
Páginase002674
Data de publicação2020-08-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoBMJ Global Health (JOURNAL)
Identificadores do periódicoISSN: 2059-7908 • E-ISSN: 2059-7908
EditoraBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2020-002674
PMID32843571
OpenAlexW3081334753
IdiomaEN
Citações recebidas5
Referências citadas33

As the world strives to achieve universal health coverage by 2030, countries must build robust healthcare systems founded on strong primary healthcare (PHC). In order to strengthen PHC, country governments need actionable guidance about how to implement health reform. Costa Rica is an example of a country that has taken concrete steps towards successfully improving PHC over the last two decades. In the 1990s, Costa Rica implemented three key reforms: governance restructuring, geographic empanelment, and multidisciplinary teams. To understand how Costa Rica implemented these reforms, we conducted a process evaluation based on a validated implementation science framework. We interviewed 39 key informants from across Costa Rica’s healthcare system in order to understand how these reforms were implemented. Using the Exploration Preparation Implementation Sustainment (EPIS) framework, we coded the results to identify Costa Rica’s key implementation strategies and explore underlying reasons for Costa Rica’s success as well as ongoing challenges. We found that Costa Rica implemented PHC reforms through strong leadership, a compelling vision and deliberate implementation strategies such as building on existing knowledge, resources and infrastructure; bringing together key stakeholders and engaging deeply with communities. These reforms have led to dramatic improvements in health outcomes in the past 25 years. Our in-depth analysis of Costa Rica’s specific implementation strategies offers tangible lessons and examples for other countries as they navigate the important but difficult work of strengthening PHC

Business · Family medicine · Health care · Political science · Primary care · Primary health care · Global Maternal and Child Health · Healthcare Policy and Management · Healthcare Systems and Reforms · Medicine · Nursing · Public Administration

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Obras citantes distintas5
Citações por ano1
Intervalo de citações2021 - 2023 (3)
Velocidade de citaçãohistorical
Altamente citadoNão
Tipos de citaçãoNeutras: 5
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