By Katie Hawks

Here is my completed Global Scholars Capstone paper!

Abstract

There are many healthcare disparities among women in Costa Rica, such as significant gaps in access, quality, and outcomes within the country’s healthcare system, which is often praised for its universal coverage. Despite the country’s reputation, many women, particularly those from marginalized and excluded communities, face many barriers that limit their access to essential healthcare. This paper explores these inequalities by examining the roles of social and economic status, geographic location, ethnicity, and migration status. It also highlights the need for changes to ensure that all women in Costa Rica receive the fair and equitable care they deserve.

Introduction

During my one-and-a-half weeks participating in a community service project in Costa Rica, I saw disparities in the Costa Rican healthcare and education systems up close while working alongside local community members. I spent time doing irrigation and environmental work, painting a local school, and engaging with the children in the community, which allowed me to interact directly with the locals and gain a deeper understanding of their daily challenges. Through these interactions, I learned about the cultural richness and resilience of the people, but I also heard firsthand about the struggles many women face in accessing primary healthcare services. The experience was eye-opening, as I realized how these inequalities extend beyond healthcare and into education, affecting the community’s overall well-being. It made me appreciate the importance of advocating for more inclusive and accessible resources for everyone, regardless of their background or social standing.
Costa Rica has universal healthcare designed to provide comprehensive coverage for its entire population. However, despite this, women from Indigenous and migrant communities continue to face barriers to accessing high-quality healthcare. Addressing these gaps is crucial to ensuring that every woman in Costa Rica, regardless of her background or social status, can access the care she deserves.

Discussion

Women from Indigenous and Afro-descendant communities in Costa Rica face numerous challenges in accessing proper healthcare. An issue in healthcare is that there is a lack of care for specific groups of people, which limits their access to essential services. Also, there’s limited availability of healthcare facilities in remote areas. For example, many Indigenous women can encounter healthcare providers who neither speak their language and do not understand their cultural practices, resulting in frequent miscommunications. This disconnect can discourage women from seeking care or following medical advice, making the health disparities in these communities worse. This situation is worsened more by economic obstacles, like poverty and limited transportation, making it difficult for women to reach urban areas where healthcare services are more accessible. To fix these challenges, Costa Rica should expand its healthcare infrastructure in rural areas and make sure that healthcare providers receive proper training.

Breast Cancer Treatment Disparities

Breast cancer is one of the leading causes of death among women in Costa Rica, and there is unequal access between groups of people for early detection and treatment services. Women from lower-income backgrounds and those living in rural areas face delays in getting mammograms and other necessary tests, mostly because of limited healthcare resources and financial challenges. These delays usually lead to late diagnoses when treatment is less effective and more expensive.
In addition to the delayed access to mammograms and diagnosis services, breast cancer patients in Costa Rica also face disparities in the availability of treatment. For example, chemotherapy, radiation therapy, and surgery are mostly accessible in city hospitals, making it more difficult for women in rural areas to receive care in time. Also, the public healthcare system, which many low-income women rely on, experiences frequent backups, causing further delays in treatment initiation.
The lack of awareness and education about breast cancer also makes the problem worse. This lack of knowledge can make diagnoses happen in later stages that become more challenging and expensive to treat.  By improving the access to services for people living in all locations, Costa Rica can help increase breast cancer survival rates and reduce the overall financial strain on patients. 

Maternal Cervical Cancer Care

The access to maternal and child healthcare services in Costa Rica can differ depending on a woman’s economic status and where she lives. Women in rural areas have less access to medical care because there is a shortage of healthcare facilities and providers in those remote areas compared to cities. This is made worse by things like poverty and the lack of reliable transportation, which make it even harder for these women to get the healthcare they need. This leads to higher rates of maternal and infant deaths because it’s harder to get care. It would be helpful for Costa Rica to focus on expanding its healthcare network in these underserved areas and consider using mobile health units to ensure that all women can access essential maternal health services, no matter where they live.
Cervical cancer rates among women in Costa Rica are another significant area of disparity in the system. Women from low income backgrounds and rural areas are less likely to receive regular screenings and care, leading to higher rates of cervical cancer in these communities. Something that worsens these women’s access is not just financial but also is the lack of awareness and education about cervical health. This often prevents women from seeking care. Additionally, cultural stigmas around gynecological exams discourage many women from getting regular screenings. To help this, Costa Rica should strengthen its public health education campaigns and try to have accessible screenings to all women, regardless of their economic status.

Migrant Exclusion

Migrant women, specifically Nicaraguan women who are undocumented, can face challenges in accessing healthcare in Costa Rica. Many are excluded from public health insurance programs because of their undocumented status and experience discrimination within the system. This leads to more deaths and illnesses spreading because they are not being properly treated. This is a human rights concern because it denies these women their right to health and care because of their lack of citizenship, and also affects other citizens.

Abortion Service Gap

The access to abortion services in Costa Rica is minimal and is even worse for women from marginalized communities. Restrictions in laws and social stigma in healthcare providers make it hard for women to obtain safe and legal abortion services. Also, the illegality of abortion, combined with this stigma, makes these challenges worse, limiting access to safe and legal reproductive healthcare. Women from low income backgrounds, refugees, and migrants, have a harder time overcoming these barriers because they lack the money, information, and support needed to navigate the system. Costa Rica needs legal reforms and public strategies that work to reduce stigma and ensure all women have safe access to reproductive healthcare.

Conclusion

Costa Rica’s healthcare system, even with its “universal coverage,” still has deep inequality that impacts women from these migrant and excluded communities. These women often face disadvantage due to their language barriers and a lack of cultural understanding. Also, they can face discrimination and economic issues. The small availability of healthcare facilities in remote areas where they live exacerbates these issues. Additionally, policies around reproductive health services affect women from low-income backgrounds, who may already lack the knowledge to understand the system. Reforms to help these disparities should have infrastructure improvements and ways of tackling the cultural biases that fill the healthcare system.

Criticism/Advice

There are many actions that should be taken to address these harmful healthcare disparities among women in Costa Rica. First, the government must expand healthcare infrastructure in rural and Indigenous communities. This could involve making mobile health units, increasing access to telemedicine, and building more healthcare facilities in underserved regions. Furthermore, doctors should be trained in many languages to understand patients better and aid the needs of diverse patients. Also, new policies are needed to improve access for migrants and undocumented women to make sure they are included in health facilities. Lastly, expanding access to reproductive health services, like safe and legal abortion, is crucial for protecting women’s autonomy over their bodies.
Costa Rica’s universal healthcare system has made some progress in extending coverage to its citizens, but these disparities among women, especially those from these excluded groups, continue to be a concern. Through these government changes, Costa Rica can allow diverse women to have the best health outcomes.

Bibliography

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