Policy and Praxis: Planning for Health Care in Nicaragua
Contribution to Book
This chapter demonstrates how popular participation in the planning process has shaped the Nicaraguan health system since the Revolution of 1979. The Nicaraguan health sector prior to the Revolution of 1979 was characterized by fragmentation, poor distribution and duplication of services, and vertical political control by the dictator. Policy changes in that period are traced to the ascendancy of groups both within and without the Ministry of Health who successfully promoted a primary health care policy based upon popular or noninstitutional strategies over one that favored professional and institutional control. The creation of popular health councils as well as face-the-people meetings provided for direct input by the popular organizations and by the local communities into the health planning and evaluation process. The policy also reaffirms the medical model of healing and physician control over health care. As inpatient hospital bed capacity stabilized, there was an increase in hospital usage as measured by the number of discharges.
Document Object Identifier (DOI)
William Derman & Scott Whiteford
Donahue, J. M. (2019). Policy and praxis: Planning for health care in Nicaragua. In W. Derman & S. Whiteford (Eds.), Social impact analysis and development planning in the third world (pp. 240-261). Routledge.
Social Impact Analysis and Development Planning in the Third World