Background

The program "Hospital Without Walls" is one of the oldest experiences known in Costa Rica. It was created in 1950 by the Health Centre of Palmares; later on it was implemented at national level by the Government. With the participation of communities, several Health Centres were created to facilitate the access of lower classes to health system. The program includes 5 regions located in the province of Alajuela: San Ramon, Palmares, Alfaro Ruiz, Naranjo and Valverde Vega; with projections at national and international levels.

Narrative

The program "Hospital without walls", created in 1950, intended to change the traditional system of a "closed hospital" to a "open doors hospital" towards the communities and accessible to all their members. This program is characterized by community participation in planning and implementation.

With the support of the communities and several other organizations, such as the Association of Communal Development, the Ministry of Health, the Ministry of Education, the Ministry of Infrastructure, and Non Government Organizations, several Health Centres were built in the rural areas of Alajuela. The program covered almost 100% of rural and about 80% of urban population with primary health care, resulting in significant reductions of: infant mortality; malnutrition; cases of parasite; and other diseases such as cholera.

Other programs related to housing, rural aqueducts, peasant settlements and roads were implemented to promote an integrated development of such regions.

Impact

1. Reduction from 19.4 to 11.5% of infant mortality (1973-1995);
2. Reduction of malnutrition;
3. Reduction from 11 to 6.5% of newborn in risk (1970-1985);
4. Reduction from 83 to 33% of cases with parasite.

Sustainability

The creation of small non-traditional health centres could be used as a model for other regions in Costa Rica, promoting a more equal distribution of health resources and services among all citizens. With the participation of the communities and the inter- and intra-sectorial coordination, the project could achieve a larger impact at national level.
Being supported by several Associations of Communal Development and many other organizations, the project is responsible to lead important changes in the communities located in the province of Alajuela. This fact is reinforced by the current social policies of the Government which encourage self-management development projects in health, education and housing.

Contact

Region Central de Occidente
San Ramon
Alajuela
Costa Rica
Tel.(506)445-5872

Sponsor

Regional Associations, Community Organizations and Governmental Agencies
Region Central de Occidente
San Ramon
Alajuela
Costa Rica
Tel.(506)445-5872

Partners

Junta de Proteccion Social de San Ramon
Fundacion Omar Dengo
San Jose
Costa Rica

Local Governments
Carazo, Rodrigo (Defens. de los Habit.)
Costado Norte de la Sabana
San Jose
Costa Rica

Ministry of Agriculture, Ministry of Education, Ministry of Infrastructure