[Local health systems, strategy for the consolidation of the national health system in Costa Rica]

Costa Rica has a notable record in the field of health care and in the implementation and development of local health systems. The Ministry of Health embarked on its course of local health system development in mid-1986 with the creation of commissions on the subjects of health teams, information, control, management, community participation, and health education. At the same time, administrative decentralization got under way with the shifting of human resources and supplies, finances, accounting, and maintenance functions to the health centers. The Comprehensive Health Program, which defines the Ministry of Health's basic scope of action in the local health system, was established in 1989. A total of 86 local health systems have been established to date, and considerable progress has been made both in defining a political and structural framework for health services integration and in enlisting the community's participation in analyzing the health problems that affect it, as well as in local decision-making for the resolution of such problems.