The W ashington Consensus and Social Policy: W orld B ank Projects and Health Sector Reform in C osta R ica

Abstract

International financial institutions—namely theInternationalMonetaryFund and theWorldBank—have been central in diffusing neoliberal ideas. However, little is known about theWorldBank's involvement in health policy reform inLatinAmerican countries, and even less about governments' responses to these recommendations and directives.IuseWorldBank project and loan documents together with national policy documents to examine health sector reform inCostaRica between 1980 and 2005.ItraceWorldBank involvement in and discourse surroundingCostaRican health sector reform, including the ideal role of government in health, the shifting relationship between theCostaRican social security system and theMinistry ofHealth, and the focus on primary care. Using the policy paradigm approach,Iidentify two paradigmatic goals apparent inWorldBank and national documents: efficiency and equity.Ifind that, although the government and theWorldBank are consistent in their approach to these goals, they do not emphasize them in the same way, and they describe them in the context of differing logics.Iconclude by assessing the implications of this study for our understanding of the relationship between neoliberalism, international financial institutions, and health sector reform inLatinAmerica.

Cite this work

No public copy is stored for this record, so only the metadata is cited.

Stored only when both papers are in the corpus — 15 citations exist upstream.

Papers that cite the same references — the relational fallback while embeddings are still backfilling.