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Nicaragua
Nicaragua
occupies a landmass of 129,494 square km. Close to 20% of the country's
territory is protected as national parks or
biological reserves. The country is bordered by Costa Rica
on the south and Honduras on the north. Nicaragua's
economy has historically been based on the export of cash
crops such as bananas, coffee, sugar, beef and tobacco. At
present agriculture constitutes 60% of its total
exports which annually yield approximately US $300 million.
Nicaragua ranks among the poorest countries in the Western
Hemisphere. The reduction in inflation, economic growth and
privatization has not helped with Nicaragua's many social
issues. 48% of the population in Nicaragua live below
poverty, unemployment is 3.8%, and another 46.5% are
underemployed.
The
health sector encompasses both the public and private sectors. The public
health sector consists of the Ministry of Health; the Nicaraguan Social
Security Institute; and the health services operated by the Ministry of
Government and by the Ministry of Defense. The divisions of the
Comprehensive Local Health System (SILAIS) represent the Ministry of Health
in technical and administrative matters at the departmental level. The
private sector includes hospitals, clinics run by health insurance
management companies, and nongovernmental organizations.
The
general mortality rate was 26.5 per 100,000 population in 2000. Infectious
diseases fell from fourth to fifth place among the leading causes of death
in the last two years, with the number of deaths attributable to this cause
down by nearly 50% from 1996.
Acute respiratory infections were the most common noticeable disease with an
incidence rate for the 1997-2000 period of 2,658 per 10,000 population.
Children under 5 years of age were the hardest-hit, accounting for 57% of
all treated cases of the disease. The mortality rate was 6.47 per 100,000
population, with the hardest-hit group that of children under 1 year of
age, which accounted for 55% of all fatalities.
The
equipment is insufficient and its use is limited by lack of resources for
operation and maintenance. In 2000, of all available equipment, 73% was used
for diagnostic and treatment purposes and in direct support of medical care;
82 % was in hospitals but only 73% was in proper working order. The health
centers and health posts had 18% of equipment.
The
percentage of children in rural areas suffering from some degree of
malnutrition was 32%, compared with 19% in urban areas. The mortality rate
for all forms of malnutrition was 11 per 100,000 in 1998. Though iodine
deficiency is not a public health problem in Nicaragua there are still high-risk groups in the South
Pacific region where the prevalence of goiter in certain communities is over
20%.
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