Overview
Health services in Nicaragua are mainly provided by the public sector and financed by general taxes. The primary health provider is the MINSA, officially covering about 70% of the population. The Nicaraguan Social Security Institute (INSS), which covers formal sector workers, finances health care for about 10% of the population. Only a small percentage of the population receives private health care services (either for-profit or nonprofit).
What happens if you need to see a doctor?
Health centers provide all primary health care services and are usually staffed with general practitioners or nurses. They provide pharmacy, basic laboratory, immunization, mental health, zoonosis, and environmental health services, and some offer dentistry.
Nicaragua’s Health Law states that at Health Centres, care for people with chronic diseases should be available. Article 5 of the General Law on Health states that healthcare for vulnerable sectors of the population will be free. This includes diabetes care.
Who decides what medicines a doctor can prescribe?
The Department of Regulation and Control of Pharmaceutical products (DRCPFA) controls and approves medicines and products.
Practically, what is it like to live with diabetes in Nicaragua?
Nicaragua faces many problems with lack of resources. There are financial constraints which lead to lack of tools for diagnosis and treatment as well as a lack of human resources. However, insulin and other medicines for diabetes are meant to be provided for free by Public and Social Security facilities.
The government provides 3 “puestas” of insulin (enough insulin for three shots) daily to children with type 1 diabetes, as well as 35% of syringes. The remaining cots of medical supplies for the treatment of diabetes are out of reach for the majority of people living with diabetes there. Insulin for children is only available in La Mascota, (the children’s hospital in the capital city of Managua) and many families lack transportation to get to the capital.
Out-of-pocket expenditure is already a heavy burden on individuals and their families, making Nicaragua the country with the third-highest private health expenditure in Latin America and the Caribbean.
What about getting admitted to hospital?
There are a total of 33 public hospitals in Nicaragua, with a total of 5,256 beds (102 beds per 100,000 population), and 2,001 of these beds are located in Managua. There are only three hospitals in the Caribbean region, an area covering 55% of the national territory. As mentioned, there are less resources and diagnostics tools outside of the capital city, where it is relatively easy to reach a hospital and receive free or low-cost treatment.
How does diabetes care vary throughout the country?
It can be deduced that the population of people with type 1 diabetes in the whole of Nicaragua is much larger than is documented because many people have not sought medical attention or aid due to an inability to access it.
Insulin is not always available at the location where someone has their consultation and, as noted above, children need to go to the National Paediatric Hospital in Managua to get their insulin. If someone lives outside of the city insulin and supplies are difficult to access. Access to specialists in rural areas is difficult and transportation costs are a barrier.
Last updated 2016