Policy, planning, and administrative improvement -- Caja Costarricense de Seguro Social (CCSS)

PES covers the period 5/83-10/85 and is based on an attached external mid-term evaluation (XD-AAT-128-A) based on document review, site visits, and interviews. Significant improvements have been made in CCSS"s financial and administrative systems. The Investments Department, for example, has substantially increased rates of return, reduced funds held in non interest-bearing accounts, and programmed the portfolio on a microcomputer. Considerable cost savings have been realized in supplies purchases and inventory, especially through reduced excess purchases, and implementation of an overall budgeting system has helped greatly in cost control. CCSS has shown a definite political will in support of the project and has invested considerable resources in reform, which suggest that changes will be internalized. However, it is unlikely that all objectives will be achieved by project end, due in large measure to the delayed arrival of computers, impeding progress in: applying computers to collections in field offices; integrating the budget and accounting systems; automating budget revisions; and improving inventory control on medical and other supplies. Computer training has likewise been postponed. Also, in certain areas, CCSS has chosen to work within the existing systems to gain immediate short-term results. Two external factors have adversely affected the ability of CCSS to improve its support systems: Costa Rica"s economic crisis in the early 1980"s, and the transfer of hospitals - almost all in run down condition - to CCSS from the Ministry of Public Health. Lessons learned are that: the configuration/negotiation/approval stage in computerization is difficult; computer use and training must be well planned to fully exploit computer capacity; the beneficiary institution must provide adequate counterpart personnel (in this project, there was a notable difference among departments in the presence and calibre of personnel); and because it was difficult during project design to assess accurately CCSS"s absorptive capacity, additional activities were added at mid-point. Action decisions are to formalize funding and specific budget/accounting and supply management objectives for a 6-12 month project extension, and to analyze additional areas for feasibility of USAID assistance.