Lise Charles


As the COVID-19 pandemic continues to have major impacts on the world, careful study of successful health systems is essential. Costa Rica has been identified as a country that has responded well to the pandemic with the proportion of death rates compared to infection rates being the lowest in comparison to other countries in Central America. This paper examines Costa Rica’s relatively successful response to the COVID-19 pandemic as a case study in good public healthcare management. This study also highlights the importance of theory for addressing urgent, practical development challenges to explore what theoretical frameworks can best explain the relative success and failure of healthcare systems. The paper examines two broad, but different, explanations for the relative success of Costa Rica’s healthcare system. The first set of explanations focuses on institutional factors, such as the design of health systems and specific policy decisions. The second set of explanations focuses on broader historical, political and economic factors, including the dismantling of the coffee oligarchy and the abolition of the military, that shaped the context within which Costa Rica’s healthcare system developed. Although the political system in Costa Rica is unique, key lessons regarding leadership, government spending, and preventative medicine, can be drawn from the Costa Rican healthcare sector and the resulting experience with COVID-19.