'Migrants and access to health care in Costa Rica'

Do Nicaraguan migrants in Costa Rica make disproportionate use of the available healthcare services or is it the case, as argued by pro-migrant rights groups, that access to health services for Nicaraguan immigrants is limited, and they are discriminated based on nationality?

In this article published in World Development, Koen Voorend, Arjun Bedi and Rebeca Sura-Fonseca assess two opposing views about migrant access to social rights and the effect of migrants on the sustainability of the welfare state.

Their investigation focuses on Costa Rica which has one of the strongest social policy regimes in the South and the highest (Nicaraguan) immigrant stock in Latin America. They assess two views which seem hard to reconcile, and are common in the country.

First, it is claimed that Nicaraguan migrants use public health services disproportionately, thereby threatening the country’s welfare system. Second, pro-migrant rights non-governmental organizations and academics are concerned, primarily based on qualitative studies, that access to health services for Nicaraguan immigrants is limited, and that they are discriminated based on nationality.

They find no support for either view. The incidence of migrant health care use is lower than their share in the population and at the same time there is no evidence of discrimination in health care access for migrants based on their nationality. The paper underlines the need for more informed migration debates.

Read the paper online: 'Migrants and Access to Health Care in Costa Rica'


Dr Koen Voorend
Rebeca Sura-Fonseca