3. Development and characteristics of health and nutrition services for urban and rural communities of Costa Rica

(introductory text...)

Introduction

Background information on community outreach programs

Methodological characteristics of the Costa Rican health programs

Nutrition programs

Impact of the programs on the health of children living in rural areas

Conclusions

References

Bibliography

4. Evolution of an epidemiological profile

(introductory text...)

Introduction

Stages of a process

The first four decades of the century

The period between 1940 and 1970

The decade of the 1970s

The decade of the 1980s

The last decade of the century

Final comments

References

5. Socioeconomic factors for the understanding of health policy during the 1970s

(introductory text...)

Introduction

Recognition of social demands and the regulation of the conflict during the 1930s and 1940s

The social government in the new development strategy of Costa Rica during the 1950s and 1960s

The consolidated social government

Final reflections

Acknowledgement

References

6. Problems and challenges of the health sector during the 1980s

(introductory text...)

Introduction

Some problems of the health sector in the 1980s

Balance of the 1980s and perspectives for the 1990s in the health sector

References

Appendix 1 - Glossary

Appendix 2 - Supplementary reading list

(introductory text...)

English-language supplementary reading list

Spanish-language supplementary reading list

Supplementary reading list - INCAP publications

Appendix 3 - Health conditions in Costa Rica 1994

General information

Specific health problems

Recognition of social demands and the regulation of the conflict during the 1930s and 1940s

During the 1930s and 1940s in Costa Rica there were several
phenomena that provided the basis for the subsequent development in the country.
This section analyzes these series of events. During the 1930s and 1940s,
organizations and social efforts played an important role in Costa Rica. As a
result, the government recognized popular demands and took actions to avoid an
escalation of hostilities that would jeopardize the existence of the regime.

Since the end of the last century organizations for social
improvement had existed in Costa Rica. These became stronger during the 1930s as
a result of the 1929 financial crisis that negatively affected the popular
sectors. Faced with increasing popular demands, the government responded by
mediating and regulating the relationship among different sectors to avoid
worsening the existing social conflict. The result was a style of government
that recognized popular demands and satisfied some of these demands to ensure
its viability.

During this decade the Institute for the Protection of Coffee was
established to regulate the relationship between small owners and exporting
beneficiaries. Other organizations created in this period were Rural Credit
Unions to provide credit for small and medium producers and the Labor and
Employer Council, which sets minimum wages and salary commissions in different
counties of the country. The Law of Associations was approved in 1939, "a
decision that allowed the legalization and creation of many associations in the
cities of Heredia, Alajuela and San José" (Valverde et. al., 1989, p. 73). Other
government actions included the creation of several regulations dealing with
working conditions, open registration for labor organizations, and the
implementation of public projects whose objective was to create jobs, since
unemployment was one of the worst consequences of the crisis.

During the 1940s, Rafael Angel Calderón Guardia, who was President
of Costa Rica from 1940 to 1944, proposed the search for cooperation among
different social sectors and became known as the "social reformer" when he
stated:

"...only through balanced cooperation of all social
forces, within a regime of law that emphatically rejects improper abuses of
power, will it be possible to achieve the conciliation of interests that is
necessary for all members of the community to feel solidarity towards the
supreme task of ever increasing the spiritual and material level of Costa
Rica." (Rojas, 1980, p. 44)

This interest in social reform was presented as an alternative to
communism, since at that time the Communist Party had acquired substantial
strength in the country. However, a series of circumstances that led to the loss
of support from different social sectors forced the government to establish an
alliance with the Communist Party, which supported the measures that had already
been taken in favor of the labor sector and influenced subsequent social
measures. This alliance included the Catholic Church within the framework of
alliances against Nazism during the Second World War. The first measures
included the Costa Rican Social Security Institute (CCSS), which offered
protection during illness, maternity, disability, aging, and death. They also
included the Social Guarantees in the Constitution that addressed the right to
strike, the eight-hour working day, minimum wages, and freedom to unionize and
reach collective agreements. The second set of measures (i.e., those taken in
agreement with the Communist Party) included the approval of the Labor Code that
regulates the Social Guarantees.

Other important measures taken during this period were the Centers
for rural assistance and public health, the opening of the University of Costa
Rica and the Music Conservatory, and other social projects (Rojas, 1980, p. 78;
Salazar, 1982, pp. 84-92). In the field of mediation of social conflicts, the
relationship between tobacco and sugar cane producers and industry was regulated
(Rojas, 1980, p. 50). As can be seen, these two decades were the antecedent of
what would become an advanced social policy during the decades that followed.

First, the social actions taken during these two decades were an
important precedent for the further development of later social policies. This
is not to suggest that were no large social needs that were not being met,
resulting in important social differences, but that it was important to pay
attention to social demands that if unmet would lead to an escalation of social
conflict.

Second, they created the basis for a government style that took
into account some demands of the people it served, recognizing their
organizations in order to maintain social harmony and avoid conflicts and
discontent.

Third, the government showed interest in the regulation of social
conflict, avoiding repressive means (although repression was sometimes used, as
shown during the Banana Strike in 1934 and the expatriation of government
opponents during the 1940s). This allowed the abolition of the Army by the end
of the decade. It was the abolition of the Army in 1949 that released decisive
resources for social actions.

In conclusion, during the 1930s and 1940s, Costa Rica underwent a
process that led to the acknowledgment of autonomous popular organizations as
well as their demands. Also, the government intervened to regulate social
conflict, following a government style that took social measures to avoid the
escalation of social
conflicts.