Red de Cuido is a Costa Rican program that subsidizes care for older adults in poverty or at high social risk through locally established and managed care networks, hence improving health equity.
The focus: Costa Rica’s demographic transition is accelerating, with life expectancy and the number of older adults both increasing rapidly. As a result, care needs for older adults have grown, particularly for the most at-risk populations.
How it works: In Costa Rica’s Red de Cuido, the government subsidizes and oversees locally implemented and co-ordinated care networks (52 as of March 2021) for older adults in poverty or at other high social risk. These networks provide the services desired by the community and emphasize aging in place through a wide range of interventions including feeding, hygiene, equipment, social care, housing and municipal services, assistants, community homes, transport, health prevention and promotion, housing improvements, and long-term care. Networks can also allocate up to 10% of the government’s subsidy to hire professional carers.
Enabling environment: Red de Cuido is a product of Costa Rica's legal and policy environment, which emphasizes universal rights, including the care and protection of older adults. The Comprehensive Law for the Elderly, for instance, promotes the permanence of the elderly in their family and community nucleus, as well as comprehensive inter-institutional care for the elderly provided by public and private entities. The law also promotes older adults’ organization and participation in a manner that allows the country to take advantage of their experience and knowledge. Costa Rica’s legal and policy approach—which the Red de Cuido program follows—prioritizes community-centered and community-driven care, with input from older adults themselves, delivered through a variety of public, private and non-profit entities. The government increased the program's funding in 2015—augmented with social development funds and taxes on liquor, beer and cigarettes—to expand access to care.
Impact: The Care Network is the government’s main method of supporting older adults’ care needs. Nearly 80% of older adults receiving subsidized care obtain it through the Red de Cuido, or roughly 15,000 older adults (out of an estimated 105,000 older adults living in poverty or extreme poverty). While there is room to expand services beyond those older adults facing poverty to others who have care needs, the program has successfully created a safety net of care for the neediest and has helped to promote the rights and fair treatment of older adults.