CARE is a leading humanitarian organization fighting

global poverty. We place special focus on working

alongside poor women because, equipped with the
proper resources, women have the power to help
whole families and entire communities escape
poverty. Women are at the heart of CARE's
community-based efforts to improve basic education,
prevent the spread of HIV, increase access to clean
water and sanitation, expand economic opportunity
and protect natural resources. CARE also delivers
emergency aid to survivors of war and natural
 Our Mission
Our mission is to serve individuals and families in the poorest
communities in the world. Drawing strength from our global
diversity, resources and experience, we promote innovative
solutions and are advocates for global responsibility. We
facilitate
 lasting change
Strengthening capacityby:
for self-help

 Providing economic opportunity

 Delivering relief in emergencies

 Influencing policy decisions at all levels

 Addressing discrimination in all its forms

Guided by the aspirations of local communities, we pursue our

mission with both excellence and compassion because the
people whom we serve deserve nothing less.
Care Central America,
Nicaragua
 Background
Nicaragua confronts the
hard realities of poverty
on a daily basis. Lack of
infrastructure and
resources as well as harsh
geography make access to
opportune and thorough
health care difficult,
especially for women who
are pregnant or have
small children.

The problem
The high maternal/infant mortality rates that
persist in rural zones of Nicaragua, and
especially in the departments of Matagalpa
and Jinotega (both of which will be targeted).
Health program in
Nicaragua
FamiSalud (3
project: Matagalpa,
Estelí and
Waspam)
Window of
opportunity
Healthy childhood
HIV/AIDS
prevention in
mobile population
Pro Adolescents
PROVIER (Project for
Improved Surveillance of
Respiratory Diseases )

 All Hazards:
 prevention and epidemic
control

Risk management in
Health
The Health Program goal
To reduce maternal/infant mortality by 12%
with respect to the baseline, from 2008 to
2015.
Respond to the underlying causes of
maternal/infant mortality
 Limited access to and coverage of maternal
health services
 Family planning
 Limited local response capacities
 Lack of healthy lifestyles among families and
communities)
The projects will pursue the following
objectives:

a) improve access to and

the coverage and
quality of public and
private maternal/infant
health services, in
accordance with the
Integral Healthcare
Model (Modelo de
Atención Integral en
Salud – MAIS);

c) increase local
capacities for effective
service delivery, in
accordance with needs
a) promote knowledge and healthful
attitudes and habits among individuals,
families and communities.

c) knowledge management (generation,

exchange and application of knowledge)
to improve maternal / infant health. The
projects will coordinate efforts with
NicaSalud (Network of NGO´s working
in health projects ) to create synergy.
Child Survival project
 Nicaragua Child Survival
Project (CSP) Since 1995 to
march 2008 in rural zone of
Matagalpa
 Cooperative Agreement
No: FAO-A-00-98-00076-00
 Project Duration: Phase
Two October 1, 2002 to
December 30, 2007

 Project Location:
Nicaragua, Matagalpa
Department, Municipalities of
Matagalpa, La Dalia, Waslala
Child Survival Project
 The CSP Phase II targeted 173 urban and rural
communities in the Municipalities of Matagalpa, La Dalia
and Waslala in the Matagalpa Department where the
incidence of maternal and perinatal mortality is
particularly high.
 Programmatic Results

 The project contributed to a paradigm shift at the Matagalpa

Hospital in a change in the attitudes of staff resulting in

 improved quality of care, a focus on client satisfaction, and

support for women during the birthing process (cultural
adaptation and psycho-social support)

 Improved quality and implementation of MINSA protocols and

policies at health facilities and hospital levels (IMCI, ANC,
AMAS, quality standards)

 Partnering with private sector Ixchen Clinic for the

incorporation and implementation of the MINSA quality of
care model and expansion of child health services
Figure 2: % of pregnant women who recieved at least 3 ANC
visits

 Strengthened links and community structures allowing civil 100%

88%

% of pregnant women who recieved at least 3

90%

society a greater role within the health system (legalization 80%

80%

of Community Health Associations, institutionalization of Birth 70%

60%

ANC visits
Plan) 50%

40%

30% 27%

20%

10%

0%
Base Line (La LQAS 2005 (No Data) Target Final Evaluation 2007
Dalia/Waslala) 2004
Durantion of Child Survival Project (CSP) XVIII: Phase Two
 Conclusions

The CSP met the project goal of

contributing to a decrease in maternal
and child morbidity and mortality. This is
evident in
The significant decrease in maternal and
infant mortality in the Matagalpa Hospital.
Although there was no formal
CARE/N is currently developing new
program designs to maintain the
momentum begun by the two phases of
the CSP and maintain a leadership role in
maternal child health activities in the
region.
Project
Window of Opportunity-
Maternal Nutrition

 Description:The Project will place the fight

against maternal and child malnutrition at the
center of the fight against poverty, using as a
conceptual model the analysis of the vicious
cycle of poverty and malnutrition, based on the
four intermediate causes of malnutrition (low
intake of foods, frequent infection, frequent
pregnancy and families with numerous children).
Partners
In association with MINSA (SILAIS
Matagalpa and Jinotega), target
communities, local partners (NGOs,
municipal governments) and national
partners, CARE will develop interventions
oriented toward two population
segments. Project interventions will
include: training, political advocacy,
information, education, communication,
knowledge management, organizational
learning and publicity activities
Project
Training Midwives to Save
Lives
DescriptionThe overall objective of this
project is to reduce maternal and infant
mortality in six municipalities with high
maternal mortality rates in Matagalpa.
The project will: improve the ability and
quality of services provided in deliveries;
change care-seeking behaviors by
strengthening the decision-making process
at the household level-in other words, to
increase mothers' willingness to give birth at
health centers with trained personnel as well
as midwives;
and organize an
emergency
transportation
network that can
transport women
suffering from
obstetric
emergencies to
health centers.

Sector: Reproductive
health
Project Name:United Families for
Health (FAMISALUD) Las Segovias
Project.

 Project Description:The project FAMISALUD is executed by

organizations that make up the sublink of The Segovia
federation of NICASALUD: action against hunger (AHC),
ALISTAR, ADRA, CARE, CEPS, INPRHU and IXCHEN, committed
in the effort to reduce poverty through the development of
multisector, integral activities based in the community; the
reinforcement of the link's work with the state's active
participation, the civil society and communities that are
subject and object of their own changes.

 As part of this effort, CARE executes the FAMISALUD project

in 90 communities in one of the zones of greatest poverty,
the department of Esteli en the Segovias region.
The general objective of the
intervention is
 To contribute to the health improvement of the Nicaraguan
population, through the development of the communitarian
integral health program (PSIC) in 90 communities of six
municipalities in the department of Esteli.

The specific objectives are:

 to prevent malnutrition and infectious diseases prevalent in
children under 5 years of age, emphasizing in children under
2 years, in the 315 beneficiary communities;
 to contribute to the improvement of environmental health
through the adoption of positive changes in the sanitary
hygiene habits, related to water management, solid and
liquid residue, with teachers, students and families of the 126
communities of the target department.
The global strategy of the
project
 Is the establishment of alliances among the
SILAIS, MECD (ministry of education, culture,
and sport), local governments and the sub link
"Las Segovias"; to increase the coverage of
health services in order to improve the health of
the most vulnerable population through the
implementation of joint interventions that
promote changes in the population behavior; the
reinforcement of the MINSA's (ministry of health)
ability to extend the coverage of the service
provision in the most vulnerable communities
and the reinforcement of the coordination
mechanisms, support and divulgation of
information for the NGOs collaborating with the
Health ministry (MINSA).