Published online by Cambridge University Press: 29 January 2010
Over the last century doctors and public health authorities have gradually asserted their control over the domain of health and medicine in most of the Western world. Since the mid-1970s and the advent of the primary health care movement, however, health planners have ostensibly been trying to reverse this trend, to give back to ordinary citizens some of the responsibility for maintaining health. Promotion of community participation in health, one component of primary health care, has been particularly important in this new strategy. Proponents of community participation envisioned self-motivated rural communities working together with the state to design their own programs to improve health and development. This grand vision has proven difficult to achieve in practice, however, particularly in countries and regions without an existing tradition of joint community-government cooperation.
Costa Rica is a small, Central American country with an international reputation for high standards of public health. In the 1970s, when the Costa Rican government began an ambitious program to extend health services to rural areas, many observers were optimistic about the prospects. They felt that if primary health care and community participation were going to succeed anywhere in Latin America, they would succeed in Costa Rica because of the state's democratic tradition and history of commitment to health care. Community participation was a key feature of the government's primary health care programs between 1973 and 1985, when four different administrations tried, in varying degrees, to promote participation in health. The program flourished, briefly, between 1978 and 1982 under the administration of President Rodrigo Carazo.
To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Find out more about the Kindle Personal Document Service.
To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.
To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.