US Ambassador to Nicaragua Launches Banking on Health’s Work to Strengthen Contracting Out
On June 23rd, Paul Trivelli, US Ambassador to Nicaragua, formally presented three clinical guidelines for the prevention and treatment of breast cancer, cervical cancer, and for voluntary family planning services, developed by the USAID-funded Banking on Health Project for Nicaragua’s Social Security Institute (INSS) at an inaugural event in Managua. The guidelines mark a significant shift in the INSS’ approach towards health service coverage, which focuses on cost-effective and life saving preventive cancer screenings and high quality family planning services and counseling. Under the new guidelines, when a female client enters a health facility that contracts with the Social Security Institute, she will be automatically referred to a women’s clinic. Once there, she will be provided with voluntary cancer screening and information, as well as with access to voluntary family planning, counseling and services.
The inaugural event was held at Hospital Salud Integral, a “pioneer” provider whose experience setting up a family planning clinic inspired the design for the new guidelines. Paul Trivelli, US Ambassador to Nicaragua, Doña Edda Callejas, President of the INSS and Dra. Eréndira Rizo, Medical Director at Salud Integral presided over the event, highlighting that this program will save women’s lives in Nicaragua. Ambassador Trivelli also underscored the important role that the private sector has in providing care to the country’s low and middle income workers. Carol Horning, USAID’s Acting Mission Director, Connie Johnson, Chief of the Office of Social Investments, and Iván Tercero, Program Officer, also participated. The Ambassador’s official presentation can be found at (http://usembassy.state.gov/managua/wwwhemb.html). Local news media, including 100% Noticias television channel and La Prensa newspaper, covered the event.
Nicaragua's Social Security Institute contracts-out a basic package of health care services for formal sector workers and their dependents. This program shifts the provision of health care from the public sector to the private sector, improving efficiencies and access to quality services.
The Banking on Health Project began working in Nicaragua in November 2004. Its mission there is to increase access to finance for private providers and to strengthen the ability of the contracting-out system to contribute to quality reproductive health outcomes. Over the past two years, Banking on Health has facilitated more than $3.7 million in health sector loans from commercial banks under partial guarantee through the Development Credit Authority (DCA) program; delivered financial-management training to providers contracting with the INSS; worked with providers to understand the financial benefits of promoting RH/FP services within the capitated system; and worked with the INSS to promote RH/FP services. As part of this initiative, Banking on Health has developed clinical guidelines on breast cancer, cervical cancer and voluntary family planning services and provided hands-on, practical training to management and medical staff of 50 private health providers. It has trained the INSS and their supervisors in the monitoring and evaluation of the guidelines and certified 12 “replicators” within the INSS to provide ongoing training, support and assistance to providers in applying the new guidelines. The project has also worked with the providers association to gain support for the women’s clinic model, and it continues to work with the INSS to expand health care coverage to informal sector workers.
