Brazil & Costa Rica: Service Quality

Population outreach activities have the potential to improve health equity if implemented with a pro-poor focus. By nature, population outreach and community-based activities can improve geographic access to primary health care in areas where patients lack geographic access to facilities. Both Brazil and Costa Rica considered health equity when implementing the outreach activities central to their reforms. In Costa Rica, EBAIS teams were first established in rural communities that had historically experienced inadequate access to health services. Additionally, data collected by the EBAIS teams have been used to identify at-risk populations and effectively allocate resources, ensuring effective service coverage.1 Similarly, a 2011 analysis found that one region in Brazil determined panel sizes for family health teams based on the social vulnerability index, calibrating the size and need of a family health team’s panel to deliver an effective dose of care.2

Learn more about primary health care initiatives in Costa Rica and Brazil.


  1. Pesec M, Ratcliffe HL, Karlage A, Hirschhorn LR, Gawande A, Bitton A. Primary health care that works: the costa rican experience. Health Aff (Millwood). 2017 Mar 1;36(3):531–8. 
  2. Fausto MCR, Giovanella L, de Mendonça MHM, de Almeida PF, Escorel S, de Andrade CLT, et al. The work of community health workers in major cities in Brazil: mediation, community action, and health care. J Ambul Care Manage. 2011 Dec;34(4):339–53.