Health Care in Nicaragua : Primary Care Under Changing Regimes

This book describes the twists and turns of Nicaragua's health policy during the last two decades.

The authors, an epidemiologist and a health educator, have taken part in that system for a decade.

They bring a wealth of data and experience, along with analytical skills, to the task.The book examines efforts to promote community participation, harness international assistance, manage the private sector, and develop public health services under changing regimes and conditions.

Several policy issues serve as pervasive themes for the health system under the Somoza dictatorship, the Sandinista revolution, and the post-Sandinista centrist governments: to focus on primary care or hospitals; to limit or expand the roles for volunteers; to provide care for all or to prioritizegroups; to rely mainly on public or private services; to depend on central government or local control.No other book describes a developing country's health system with as much analytical detail or with as extensive documentation.

It is a thought-provoking case study of programs and policies in international health which draws on extensive comparison with other countries.