Health Care
Like education, health care was among the top priorities of the Sandinista government. At the end of the Somoza era, most Nicaraguans had no access or only limited access to modern health care. Widespread malnutrition, inadequate water and sewerage systems, and sporadic application of basic public health measures produced a national health profile typical of impoverished populations. Enteritis and other diarrheal diseases were among the leading causes of death. Pneumonia, tetanus, and measles, largely among children less than five years old, accounted for more than 10 percent of all deaths. Malaria and tuberculosis were endemic.
Nicaraguans depend on a three-tier health system that reflects the fundamental inequalities in Nicaraguan society. The upper class uses private health care, often going abroad for specialized treatment. A relatively privileged minority of salaried workers in government and industry are served by the Nicaraguan Social Security Institute. These workers and their families compose about 8 percent of the population, but the institute devoured 40 to 50 percent of the national health care budget. The remainder of the population, approaching 90 percent, is poorly served at public facilities that are typically mismanaged, inadequately staffed, and underequipped. Health care services are concentrated in the larger cities, and rural areas are largely unserved. The Ministry of Health, which has sole responsibility for rural health care, preventive health care, and small clinics, received only 16 percent of the health budget, most of which it spent in Managua.
With help from the United Nations Children's Fund (UNICEF), 250 oral rehydration centers were established to treat severe childhood diarrhea, the leading cause of infant deaths, with a simple but effective solution of sugar and salts. The Ministry of Health trained thousands of community health volunteers (health brigadistas) and mobilized broad community participation in periodic vaccination and sanitation campaigns.
Nicaraguans depend on a three-tier health system that reflects the fundamental inequalities in Nicaraguan society. The upper class uses private health care, often going abroad for specialized treatment. A relatively privileged minority of salaried workers in government and industry are served by the Nicaraguan Social Security Institute. These workers and their families compose about 8 percent of the population, but the institute devoured 40 to 50 percent of the national health care budget. The remainder of the population, approaching 90 percent, is poorly served at public facilities that are typically mismanaged, inadequately staffed, and underequipped. Health care services are concentrated in the larger cities, and rural areas are largely unserved. The Ministry of Health, which has sole responsibility for rural health care, preventive health care, and small clinics, received only 16 percent of the health budget, most of which it spent in Managua.
With help from the United Nations Children's Fund (UNICEF), 250 oral rehydration centers were established to treat severe childhood diarrhea, the leading cause of infant deaths, with a simple but effective solution of sugar and salts. The Ministry of Health trained thousands of community health volunteers (health brigadistas) and mobilized broad community participation in periodic vaccination and sanitation campaigns.