Abstract
Health status indicators for Costa Rica compare favorably to those in more developed countries. This impressive achievement and the narrowing of health status differentials between population sub-groups have been attributed to a strategy for delivering primary care. This commentary examines the primary health care program and the role of the Health Assistant in its implementation. Also considered are contemporary challenges presented by the transition to a disease profile more typical of a developed country, a health care system still favoring care in an urban, hospital setting, and economic stagnation. It is concluded that these challenges threaten to erode the health gains made. Achieving "Health For All 2000" will require an enduring commitment, dedication, and will to live within current economic constraints without sacrificing the primary care program.
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