Nicaragua

Dr. Ayanna Buckner traveled to Nicaragua to perform an evaluation of a health worker leadership training program.

Despite positive growth rates over the last eight years, half of the population of Nicaragua still lives in poverty. A slowing growth rate in recent years, coupled with the devastating economic and public health effects of Hurricane Mitch (1998) has left the Nicaraguan health system in disarray, and with few resources. With a population of 4.8 million people life expectancy remains low at 69 years, infant mortality is reported as 42 deaths per 1,000 live births, and only 81% of the population has access to safe drinking water.

Since 1999, the Nicaraguan PROSALUD Project has developed the concept and application of the Fully Functional Service Delivery Point (FFSDP). The FFSDP seeks to revolutionize health care in Nicaragua by making all basic health services available at any one services point. Part of the project includes the development of management and leadership skills of health care workers at all PROSALUD clinics. Dr. Ayanna Buckner chose to work on an independent evaluation of the impact of the projects. She developed patient, clinician, and administrator questionnaires as part of a 360-degree comprehensive look at self-perceived improvement in clinician and administrator leadership skills. She also collected government reports documenting changes in health outcomes over time in the areas where the leadership program was implemented.

PROSALUD is a non-profit organization that manages an innovative network of high-quality, low-cost, client-focused services. This public-private partnership model was developed in Bolivia in the mid-1980's and was then applied to Nicaragua to assist in reconstruction efforts after Hurricane Mitch. The project is managed by Management Sciences for Health, Inc. (MSH) and is financially supported by the United States Agency for International Development (USAID).

Learn more about the PROSALUD Project in Nicaragua