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What will work? the Costa Rican experience using silos in achieving universal health care 2000

By: CAIDEN, Gerald.
Contributor(s): RETANA, German.
Material type: materialTypeLabelArticlePublisher: New York : Marcel Dekker, 1998International Journal of Public Administration - IJPA 21, 12, p. 1863-1884Abstract: The study of comparative and development administration frees governments from their parochial confines. It opens vistas onto global experiences of what has worked well for others elsewhere and enlarges the range of possible choices that might be made to improve domestic performance. After the World Health Organization in 1977 had adopted the goal “Health for All in the Year 2000,” the Pan American Health Organization opted for the strategy of achieving it though local health systems (SILOS). Costa Rica, the most likely candidate for successful implementation, adopted SILOS in the late 1980s but has run into many difficulties in making SILOS a reality. The difficulties and the impact that SILOS have made on the national health service of Costa Rica are examined and several lessons are drawn to illustrate once again how difficult comparative and development administration are in practice.
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The study of comparative and development administration frees governments from their parochial confines. It opens vistas onto global experiences of what has worked well for others elsewhere and enlarges the range of possible choices that might be made to improve domestic performance. After the World Health Organization in 1977 had adopted the goal “Health for All in the Year 2000,” the Pan American Health Organization opted for the strategy of achieving it though local health systems (SILOS). Costa Rica, the most likely candidate for successful implementation, adopted SILOS in the late 1980s but has run into many difficulties in making SILOS a reality. The difficulties and the impact that SILOS have made on the national health service of Costa Rica are examined and several lessons are drawn to illustrate once again how difficult comparative and development administration are in practice.

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