Migrants and access to health care in Costa Rica

Koen Voorend, Arjun S. Bedi*, Rebeca Sura-Fonseca

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Scopus)
43 Downloads (Pure)


As in most immigrant-receiving countries in the global North, countries in the South face challenges regarding migrant access to social rights and the effect of migrants on the sustainability of the welfare state. In the Latin American context, this holds especially for countries such as Costa Rica, which has one of the strongest social policy regimes in the South and the highest (Nicaraguan) immigrant stock in Latin America. Set in the context of Costa Rica, this paper assesses 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. This paper relies on administrative data and a unique data set representative of Nicaraguan born individuals residing in Costa Rica to examine the validity of both these claims. We do not find support for either. 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.

Original languageEnglish
Article number105481
JournalWorld Development
Publication statusPublished - 13 Apr 2021

Bibliographical note

Funding Information: The authors acknowledge financial support from the Political Ecology and the Development Economics Research Group of the International Institute of Social Studies, Erasmus University Rotterdam.

Publisher Copyright: © 2021 The Author(s)

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