Project assistance completion report : health services support, implementing agency -- Costa Rican Social Security Institute (CCSS)

The project has had a positive impact. Shortfalls in pharmaceuticals have dropped from 30% to a more manageable 3-5% as a direct result of project TA to improve the CCSS procurement system and rationalize the prescribing habits of physicians. Management Sciences for Health provided TA leading to installation of a computer package that will allow CCSS to monitor pharmaceutical use and predict need. The Academy for Educational Development held a workshop for pharmacists regarding the development of educational materials for improving pharmaceutical usage. In addition, a scientific journal, "Farmacos," was launched by the project. Its purpose is to provide technical updates on topics in drug therapy to CCSS doctors and pharmacists; 14 volumes were published and CCSS is committed to continuing biannual publication with its own resources. The project demonstrated that the CCSS procurement system was effective and very accountable, although purchases were at times delayed by bureaucratic red tape. It was necessary, however, to have a project advisor on site to monitor the procurement process and answer questions regarding A.I.D. financing and eligibility. CCSS was strengthened financially as well. The Government of Costa Rica (GOCR) has used project loan funds to pay off its accumulated quota-generated debt. The GOCR also paid the 1984, 1985, and 1986 employer's quota to the CCSS and continues to pay the budgeted amount of the employers's quota on a quarterly basis. This is a significant achievement and provides financial stability to the CCSS.