Health and territorial responsibility
Costa Rica
A team accountable for care in each area
EBAIS
What the evidence shows
The 2004 study associated the reform with a relative reduction of 8% in child mortality and 2% in adult mortality. It used annual data from 420 districts between 1985 and 2001, with controls and fixed effects. Implementation was not randomised. [2]
- Children
- 8%
- Adults
- 2%
Reform estimates for 1985–2001, with controls and fixed effects. These are not percentage points or forecasts for Brazil. [2]
EBAIS are basic comprehensive health care teams. The territorial model links a population to a team, with prevention, treatment and referrals within the network. The reform began in 1995 and reached districts at different times. [1][2]
Link each population to a team
Prevent, treat and refer
Track access and outcomes
Costs and delivery
The model requires permanent teams, data, facilities and a referral network. The sources consulted do not establish a full incremental cost or net savings caused by the reform for this profile. [1]
Limits of the comparison
The percentages are historical estimates for the reform, not forecasts for a Brazilian municipality or the isolated effect of each team. Unobserved differences and non-random adoption limit causal interpretation.
OpenGov3's interpretation
What it can teach Brazil
Who is accountable for access and continuity of care in each area?
What to monitor when adapting it
- Coverage and inequalities between areas
- Time to treatment and continuity of care
- Mortality by group and comparable period
- Full cost of teams and the network
These are criteria for analysis, not commitments already made or estimated outcomes for Brazil. A well-documented practice is not, by itself, causal proof of an entire country's success.
Sources consulted
Consulted on 10/29/2026. Each result retains its observed period; institutional descriptions and impact evaluations have different scopes.
- WHO Collaborating Centre — Comprehensive Primary Health Care Reform in Costa Rica (opens in a new tab)
Description of EBAIS teams, assigned population and integrated care; separate from the mortality estimate.
- Rosero-Bixby — Evaluación del impacto de la reforma del sector de la salud en Costa Rica (2004) (opens in a new tab)
2004 article, abstract: 420 districts, 1985–2001, mortality and non-random implementation.