NI HEALTH SECTOR II

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The Health Sector Modernization Program (HSMP)--this project is the first phase--seeks to improve the efficiency, effectiveness, and equity of the Nicaraguan health system. The project has five components. Component 1 scales up the Integrated Model of Maternal and Child Care, centered around 8 priority interventions--acute respiratory infections, diarrheal diseases, maternal and perinatal mortality, family planning, nutrition, vaccines, tuberculosis, and malaria control. It targets nutrition with a food supplement and fortification program; information on breastfeeding; epidemiological surveillance of nutritional deficiencies; and technical support for food production. It extends Women's Centers according to nongovernmental models. It funds epidemiological surveillance, building local facilities to produce biological larvicides. Component 2, Hospital Modernization, finances training and consultant services to help implement management agreements; introduces a hospital management pilot project; and provides civil works and equipment. Component 3 improves the institutional capacity of the health ministry (MINSA) through budgets, inputs (pharmaceuticals and supplies), regulations, management information systems, strategic planning, and human resources as well as information, education, and communications. Component 4 modernizes the Nicaraguan Social Security Institute (INSS), expands health insurance, and scales up a workmen's compensation pilot.