Explaining the Adoption of Care Policies in Costa Rica and Uruguay: A Multiple Streams Approach

Abstract:This article aims to reveal how Costa Rica and Uruguay succeeded in adopting integrated care policies. By adapting the classic “multiple streams approach,” I analyze the processes leading to the adoption of two care policies in Costa Rica and Uruguay. The findings suggest that the key to understanding the adoption of care policies lies within the interplay between agents and contexts in different streams. Problems can be constructed as a top-down process by a women’s agency or as a bottom-up process from a feminist organization. Solutions can be designed in close-knit policy networks of technocrats/bureaucrats or in open policy networks of bureaucrats and civil society organizations. Care policies become prominent items on government agendas in the presence of programmatic political parties and high electoral competition settings that prioritize the issue to attract voters or consolidate support. The alignment of problems, solutions, and politics identify different pathways that lead to the adoption of care policies.