Costa Rica: Service Quality

In Costa Rica, primary care teams – called Equipo Basico de Atencion Integral de Salud (EBAIS teams) – include a doctor, nurse, CHW, vital registry data clerk, and pharmacist. Each team member has clear and delineated roles resulting in comprehensive curative and preventive care in addition to education and surveillance activities. While EBAIS teams also provide referrals to higher levels of care, they are able to provide care for 75% of all health consultations.1 Team members engage in frequent communication to improve coordination and identify the health needs and gaps in their panel. Additionally, the data clerk collects routine epidemiological surveillance and census data that is used to inform management contracts and team performance as well as local priorities. Together, this clear delineation of roles but strong focus on teamwork and communication has contributed to Costa Rica’s significant achievements in health outcomes and efficiency in care.


  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;36(3):531–8.