Situated between the Atlantic and Pacific Oceans, with topography that includes lush tropical rainforests and active volcanoes, Nicaragua is home to an impressive biodiversity and rich fishing and forest reserves. Yet Nicaragua is also vulnerable to natural disasters such as earthquakes and hurricanes, which compound the poverty that is already widespread throughout the region.
In 1998, Hurricane Mitch left 400,000 homeless and displaced. Poverty in urban areas, where the majority of the population resides, has led to high levels of crime, while poverty in the Atlantic coastal region has increased in recent years and has led to an increase in drug trafficking and addiction. While the government tries to address these numerous social woes, Nicaragua's population remains one of the poorest in Latin America.
The volatile political environment in Nicaragua has hampered its stability and prosperity in the last few decades, with dictatorships, a war involving U.S.-backed contras, a polarized electorate, and several constitutional reformations. Corruption within the government and a general lack of governmental control persist, fueling civilian unrest and demonstrations. With a voting age of just 16, the majority of the population has the potential to affect real political change in this presidential democracy that continues to struggle to reduce rampant economic disparities.
The majority of Nicaragua's population is mestizo, of mixed European and Amerindian descent, and relies on agriculture industries like coffee farming and cattle ranching for their livelihood. The average Nicaraguan will only receive about five years of education due to a fragmented and inadequate educational system, and cannot expect much more from an equally deficient health care system.
With 40 percent of Nicaraguans excluded from the public health care system due to the uneven provision of services, it is no surprise that a wide array of health problems plague the population. Rural areas suffer in particular from a lack of facilities and services, and approximately one out of every four children in Nicaragua is stunted due to malnutrition.
In addition, acute respiratory ailments, diarrhea, malaria, and anemia are common among the population, and a lack of medicines at public hospitals means that many suffer needlessly from otherwise treatable ailments. For women in Nicaragua, the situation is far worse. A strong Roman Catholic and Evangelical presence in addition to pervasive violence and discrimination against women in society make access to sexual and reproductive health services a constant struggle.
In 2006, abortion in Nicaragua was banned under any circumstances, including in cases of rape, incest, or life-threatening pregnancy. The ban severely limits the rights and jeopardizes the safety of women in Nicaragua who already live in a region, Latin America, with one of the highest abortion rates and some of the strictest abortion laws in the world.
As a result of these restrictions, many women turn to illegal abortion in often unsafe and unhygienic conditions that leave them susceptible to fatal complications. Adolescents in Nicaragua are especially vulnerable to unsafe abortion, with the second-highest adolescent fertility rate in Latin America.
PPFA in Nicaragua
Poor health status and limited access to services in Nicaragua often correlate to poverty. Through the use of peer education programs and youth leadership trainings, as well as through the support of clinics providing quality sexual and reproductive health (SRH) services, Planned Parenthood Federation of America (PPFA) and its partner organizations reach out to marginalized populations in poor and rural areas throughout the country.
Currently, PPFA works with partners to increase the availability of preventive SRH services and information for adolescents, as well as raise awareness about the need for such services. PPFA's work in Nicaragua also focuses on decreasing the rate of maternal death and disability due to unsafe abortion by expanding access to affordable, quality sexual and reproductive health services for women.
PPFA's partner AMNLAE was originally founded to help provide medical care for Sandinista fighters during their struggle to establish democracy and a new national constitution in the late 1970's. Since 1977, however, AMNLAE has been working with young people to create programs for young people and for the past 12 years has worked with PPFA to promote healthy sexuality education and contraceptive services for young people countrywide.
AMNLAE implements our Adolescent and Youth Project, designed to reduce unintended pregnancy and sexually transmitted infections (STIs) among adolescents through peer education and the distribution of contraceptives. Peer educators work in 10 areas countrywide — some of which are extremely rural and remote — disseminating crucial SRH information to their friends, classmates, and neighbors on such topics as pregnancy, STIs including HIV/AIDS, and how to make safe and responsible choices that affect their sexual and reproductive health.
Peer educators also provide contraceptives to their peers, building a similar-aged client base. They are responsible for following up with their clients when they are in need of resupply or additional SRH information, and when needed, referrals to where to obtain more comprehensive SRH services.
In 2006 alone, educators reached nearly 12,000 young people in Nicaragua. The Adolescent and Youth Project model is self-sustaining on several levels, such as the continual outreach to potential new sites and the training of local technical-assistance experts to train new local program managers around the country.