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MOSAFC

Since 2007, the Nicaraguan government has implemented a health care strategy called MOSAFC, Modelo de Salud Familiar y Comunitario (Family and Community Health Care Model). This provides the population with free health cover and access. The emphasis is on health promotion and preventing ill health.

• health expenditure has increased and new infrastructure has been built including 19 specialist hospitals and 16 health centres
• primary health care consultations have more than doubled since the programme started
• the number of doctors has increased to 1 per 1,000 population
• the number of nurses and midwives has increased to 1.5 per 1,000 population

Progress of the MOSAFC health programme:

• under-five mortality has fallen from 59.8 per 1000 to 17 per 1000
• infant mortality has fallen from 46.2 per 1000 live births to 10 per 1000
• 98% of infants under two years old have been vaccinated against Diphtheria, Pertussis and Tetanus (DPT)

However other goals have seen less progress:

• maternal mortality has fallen from 196 per 100,000 live births to 130 per 100,000 (the country has a target of 42.5 per 100,000)

Nicaragua faces a triple burden of disease - infectious diseases, chronic diseases and external causes.

Current development objectives include strengthening quality and access to health services, adapting the public health system to deal with the country's changing healthcare needs and securing financial support to deal with public health alert and emergencies.