WB/Costa Rica: Support to Improve Health Services

March 18, 2016

WASHINGTON, March 15th, 2016 – The World Bank (WB) Board of Executive Directors approved a US$420 million loan today to support the Costa Rican Social Security Administration’s (CCSS, in Spanish) Strategic Agenda to Strengthen Health Insurance (SASHI), with the goal of improving the timeliness and quality of health care and strengthening institutional efficiency.

The loan will contribute to the funding available for the implementation of a comprehensive, medium and long-term, plan geared towards improving the institutional management and organization of health care delivery, as well as the financial sustainability of Costa Rica’s universal health insurance.

“This is one of the most important milestones and a demand from Costa Rican society, in the sense that the institution needs to once again have the resources necessary to deal with its responsibilities. The Social Security Administration takes ownership of this project with great responsibility, positioning the project as one of the elements needed to guide the institution towards results-based management,” said Doctor Rocio Saenz, executive president of the CCSS.

The CCSS’ Strategic Agenda to Strengthen Health Insurance was designed to enhance the existing health care model by modernizing primary health care networks with digital data to enable timely decisions by managers at the local and national level. The design is people-centered meaning the population’s health needs are the driving force of the strategic agenda.

“At the request of the Government and the Administration, the Bank has chosen a loan mechanism that differs from traditional loans by using national and executing institution’s systems, as opposed to those of the Bank, in the hope of facilitating its implementation. The loan instrument is called Results-Based Program and organizes the disbursement of financial resources according to goal fulfilment and results, identified by the Administration authorities as keys to the implementation of the Strategic Agenda,” explained Humberto Lopez, World Bank Director for Central America.

Some of the outcome indicators expected to be achieved in terms of improving the timeliness and quality of health care include a 22 percent increase in the priority list for ambulatory major surgeries, and a 40 percent increase in screening in the five cantons with the highest incidence of colon cancer. Additionally, expanding the set of E-Health tools including household and clinical data is to make a qualitative leap in real coverage and the use of digital tools.

In order to facilitate the rapid onset of key activities, the Results-Based Program, which spans a six-year period, includes an advance of 25 percent of the total loan amount, and up to another 25 percent for results that can be verified have taken place by the time of effectiveness of the operation which will take place when the Legislative Assembly approves the Program.


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