Table 4.
Strategies for implementing PHC model
| Implementation strategy | Description | Reform | ||
| Governance restructuring | Geographic empanelment | Multidisciplinary teams | ||
| Create technical working groups | Multidisciplinary groups of key stakeholders met to make decisions about each of the reforms. | · | · | · |
| Engage communities | Health leaders engaged communities at every level during each stage of the reform. | · | · | · |
| Sign a formal agreement | Formal agreement between MOH and CCSS leaders solidified commitment to the model. | · | ||
| Foster professional relationships | Relationships between MOH and CCSS staff were intentionally fostered after governance restructuring was final. | · | ||
| Build capacity | Health leaders prioritised training all health personnel in the new model. | · | · | |
| Use existing resources | Whenever possible, health leaders used existing resources to save time and build on existing knowledge. | · | · | |
| Apply an equity lens | Health leaders implemented the new model by prioritising the most vulnerable communities at the outset of the programme. | · | · | |
CCSS, Costa Rica Social Security Administration; MOH, Ministry of Health; PHC, primary healthcare.