A Blueprint for Health and Happiness: Lessons from Cambodia and Costa Rica

January 2025

In the West, we hope for health, but our systems are designed to incentivise sickness—profit lies in waiting for us to get sick or fall into crisis and then getting paid to heal us. This approach is both incredibly expensive and ineffective.

 

A Case for Upstream Systems

In Cambodia, we are trialling a different approach by building low-cost, community-driven public systems that act as a safety net to prevent crises before they occur. Rather than providing ambulances at the bottom of the cliff, our Village Hives focus upstream to ensure communities are robust and resilient, preventing people from going over the edge in the first place.

In 2025, we will launch the fourth Village Hive in Battambang, Cambodia, while the National Ministry of Social Affairs (MoSVY) prepares to adopt the Village Hive Guidebook as the official framework for social protection across the country.

However, Cambodia is not the only country that is finding success with upstream initiatives that organise public systems around human well-being.

Lessons from Costa Rica

Costa Rica is one of the world’s five blue zones—regions known for a high concentration of people who live long, healthy lives, often surpassing 100 years of age.

Costa Rica is still technically classified as a developing country. Yet, Costa Ricans enjoy a longer life expectancy than the US and much lower rates of middle-age mortality while spending just one-fifteenth of what Western countries allocate to healthcare. They also consistently rank among the happiest nations on indexes like the World Happiness Report and the Happy Planet Index.

How does a nation with fewer resources achieve such remarkable outcomes? What can we learn from their approach?

Costa Rica’s secret lies in a brilliant strategy that focuses on preventing crises and illness before they occur.

At the heart of their success is a robust public health model. In Costa Rica, public policy is more than a framework; it’s a way of life and a source of national pride. Central to their approach is an extensive network of puestos de salud—small public clinics strategically placed to deliver healthcare directly to communities.

Since the mid-1990s, every Costa Rican has had the right to a home visit from a healthcare ambassador. These ambassadors go door-to-door throughout the year, connecting families with essential healthcare services and collecting vital data to continuously refine and improve public health systems.

How our Village Hive builds on this model

Our Village Hives share much in common with Costa Rica’s approach. They are both decentralised, community-driven models centred on home visits, satellite health centres, and preventative measures to strengthen public systems. However, the Village Hive takes this concept a step further.

By expanding beyond public health, the Village Hive integrates education and social welfare, creating a holistic public social protection system designed to support communities in every facet of their well-being.

A Real-Life Example: Sreypov’s Story

A recent case study showcases the transformative power of an upstream social protection system.

Sreypov, a mother of two young children, had a stable job and was able to support her family. However, a serious road accident left her injured and unable to work. Without the support of a Village Hive community, she likely would have fallen into poverty and the debt cycles that often entrap families for generations.

Instead, the Village Hive stepped in, providing Sreypov with the medical and social support she needed to recover and rebuild her life.

“When I was drowning, the Village Hive caught me,” she said. “The support has given me hope and allowed me to focus on healing without fear of losing everything. I am so incredibly happy and grateful to be part of a community where this kind of support exists.”

Sreypov’s story is just one example of how upstream initiatives can change lives. Listen to her share her story in her own words and hear firsthand the life-changing impact of the Village Hive.

Sreypov's Story

Redefining the Status Quo for Global Well-Being

The success of Costa Rica and the transformative stories from Cambodia’s Village Hives shows us that investing in upstream social protection systems isn’t just a bold idea; it’s a practical, proven path to fostering healthier, happier, and more resilient communities. By shifting our focus from reacting to crises to preventing them, we can build a future where no one falls through the cracks. The question isn’t whether this approach works, it’s how soon we can make it the status quo.

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