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Costa Rica

Costa Rica is the only nation in Latin America without an army, and one of the most stable and robust democracies in the region. Costa Rica had a population of about 3.2 million in 1993 and is growing at the rate of 2.5% per annum. Its extensive social programs have placed the country's indicators among the best in Latin America. Nutrition trends in Costa Rica were previously reported in the SCN's 1989 Update on the Nutrition Situation (ACC/SCN, 1989, p.146-149).

Recent Trends in Nutrition

The most recent anthropometric data from the Nutritional Surveillance System of the Ministry of Health indicates continuing trends towards improvements in underweight prevalence. The data for the early 1990s indicates that, for the first time, the underweight prevalence was equivalent to the NCHS standards, i.e. 2.5%.

The prevalence of underweight preschool children (<-2 s.d. weight-for-age) in 1992 was placed at 2.3%. This prevalence had declined steadily since regular measurements started - e.g. from 14% in 1966, 12% in 1975, 6% in 1982, to the recent figure of 2%. Costa Rica is only the second country in Latin America to have achieved this level of nutrition, next to Chile, which reached this rate in late 1970s. From the surveillance data, most regions in the country showed improvements from 1989 to 1992 (see Figure 1). There was evidence, however, that the prevalence in rural areas was higher than in urban centers in the country.

The recent data also gives trends in the prevalence of overweight preschool children. Results indicate that, on average, the proportions of obese preschoolers have been low at 3.3%, which was maintained over the period 1989 to 1992. Previous data reported in Update 1989 gave a prevalence of overweight of about 6.9% of all preschoolers. The IMR of 14 per 1000 live births in 1993 is one of the best in Latin America.

Figure 1. Costa Rica: Prevalence of Underweight Children, (0-59 months) by Region, 1989-1992

Source: Ministerio de Salud (1992).
Factors Affecting Trends in Nutrition

Economic Growth. In 1993 Costa Rica's GNP per capita was estimated at U.S.$2,160. GDP per capita grew by 1.9% per annum between 1986 and 1993. Following two years of slow growth, the Costa Rican economy expanded by 7.3% in 1992, as the manufacturing and services sectors responded to growing demand for domestic investment and nontraditional exports. Despite the strong export growth, imports grew more rapidly, stimulated by large private external capital inflows that more than financed the rapidly deteriorating current account deficit. The capital inflows responded to high interest rates and improved investor confidence in economic management.

Food Security. Agriculture forms the backbone of the Costa Rican economy, and its national strategy has recently focussed on the production of export crops that, in recent years, meant large permanent shifts of some land from food crops such as rice, maize, and beans. The country now relies for a good portion of its cereal requirements on imports. The performance of the export crop sector has been good (particularly banana and coffee), and in non-traditional crops such as cut flowers, vegetables, coconut, tropical fruits, and macadamia nuts. The focus of the food security strategy has been household food access and individual utilization, especially for the poor. Calorie supply per capita has been kept high at around 2900 in 1992, increasing from the 1982 levels of 2509 kcals per capita. Although general inflation has been quite high recently (22% in 1992 and 17% in 1989), the food price index has not increased any faster. The purchasing power of the minimum wages had been rising despite the high inflation rates in recent years. This rose by 20% from 1980 to 1990.

Social Security, Health, Education. Costa Rica's extensive social security system, which encompasses unemployment benefits, health care, pensions, and housing was established in the 1940s. This system has, to a considerable degree, been responsible for the overall improvement in the nutrition and health well being of the average citizen. The government's commitment to this social security system has been maintained even at the height of the adverse shocks of the early 1980s, and received even more attention in recent years (see Public Expenditures).

The absolute per capita expenditures on health care by the government reached $140 per capita, among the highest in developing countries, and $80 for education. Health care budgets had been rising and nearly doubled in the last decade or so. The budget for education, although high, has not been increasing on a per capita basis since 1987.

Access to health care of the population is nearly universal. In 1988, the population considered to have access to basic health services was registered at 97%, one of the highest in the world, including those in the developed countries. Pregnant mothers generally had access to antenatal care (91% in 1988). Immunization coverage of all infants was placed at 95% against DPT in 1991, and 90% against measles.

COSTA RICA

(Estimates in 1993)

Population

: 3.21 million

Population Density

: 61 per sq. km.

Population Growth Rate

: 2.5% per annum

Urban Population

: 48%

IMR

: 14

GNP US$ (Per Capita)
(WB Atlas Methodology)

: 2,160

PPP estimates of GDP
($ Per Capita, in 1991)

: 5110


CHILD GROWTH AND SURVIVAL

Underweight preschool children (Percent below -2 s.d. weight for age)

Infant mortality rate (Per 1,000 live births)

ECONOMICS

GDP per capita (1987 Mkt. prices, Colones / capita)

Debt service ratio (Debt service/exports)

FOOD

Food production index (Per caput, 1979-81=100)

Dietary energy supply (Kcals/caput/day)

Consumer price index (1980=100)

FPI/CPI ratio (1980=100)

HEALTH

Immunization coverage (Percent)

Access to local health care (Percent)

PUBLIC EXPENDITURES

Education and health expenditures (US $ per capita)

Education and health expenditures (Percent of government expenditures)


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