Maternal health:

• Maternal mortality is above the average for Latin America and the Caribbean, particularly in rural areas and areas with scattered populations.

• There is a high maternal mortality rate, with more than 100 deaths each year. 70% of these deaths occur in rural areas.

• Maternal-related health issues are the most common reason for hospital admission.

• One of the most vulnerable regions for maternal mortality is Mataglpa, one of the regions where we work.

• The leading causes of maternal death are directly related to lack of access to health services in poor and rural regions.

• Some 55% of women in rural regions give birth at home, without medical assistance.

• There is an absolute ban on abortion in Nicaragua, regardless of whether or not the mother’s life is at risk.

• Worldwide, 13% of all maternal deaths and an estimated 5 million cases of permanent or temporary disability occur due to unsafe abortions.

• Access to safe abortions results in dramatically reduced illness and death in women.

• The laws criminalizing abortion in Nicaragua punish health care professionals who perform abortion services or unintentionally cause abortion when treating serious pregnancy complications. Fear of imprisonment means that medical providers delay or deny treatment of serious pregnancy complications, which risks the lives and health of women and girls seeking medical care.

 

Leading causes of illness and death:

• The rate of chronic child malnutrition in Nicaragua is 22.6% in rural areas compared to 12.3% in urban areas.

• Acute respiratory infections, diarrhea and vector-borne diseases are the chief communicable diseases. Tuberculosis is prevalent in the poorest, most inaccessible areas.

• Cervical cancer (a largely preventable disease) is one of the main causes of death from tumors, due to a lack of screening, delayed reporting of test results and social barriers to accessing reproductive health services.

 

Health care infrastructure and spending:

• There is a significant lack of basic infrastructure and investment in health care facilities.

• The lowest levels of health care coverage are found in rural areas, where the population is scattered and the availability and/or use of services is low.

• More than one third of the population lacks access to health services and only 6.3% of the population is insured.

• Since the early 1990s, the provision of free medicine in public health care facilities has dramatically decreased. The high cost of prescription medicine results in patients either buying only part of what is prescribed or nothing at all.

• Nicaragua spends on average US $144 on health care per person each year, the lowest per capita health investment of any country in Latin America and the Caribbean. By comparison, Canada spends an average of US $5741 on health care per person each year.

 

Health care professionals:

• The Nicaraguan Ministry of Health provides no financial incentives for health care staff to work in remote and difficult-to-access areas.

• There is less than 1 physician per 1,000 inhabitants, with the lowest levels of health care coverage found in rural areas.

• Nicaragua does not train personnel to carry out any health promotion activities.

 

Doctors for Doctors in conjunction with our local partners, are working to increase rural people’s access to health care and improve the quality of the care they receive.

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Sources:

Canadian Institute for Health Information: http://www.cihi.ca/;

Document on Nicaragua, PATH: The Nicaraguan Health System: An overview of critical challenges and opportunities (2011);

Foundation for Sustainable Development: http://www.fsdinternational.org/; Health Expenditure per capita: www.data.worldbank.org;

Health Plan for Central America and the Dominican Republic 2010 – 2015, Councils of Ministers of Health of the System for Central American Integration (2009);

Inter-American Development Bank Country Strategy (2012 – 2017);

Rural Poverty Portal: www.ruralpovertyportal.org;

Safe Abortion: Technical and Policy Guidance for Health Systems, WHO (2012);

The Total Abortion Ban in Nicaragua: Women’s Lives and Health Endangered, Medical Professionals Criminalized, Amnesty International (2009).