What do Nica's that are poor with no health insurance do when they are sick or about to give birth do?

Howdy. I apologize for my ignorance, I know there are some good hospitals here for people with insurance and $$$, but what about for the Nicas that are poor,and don't have insurance.....More along the lines of a Mother expecting a child? Will she have to pay $$$ or is it funded by the Gov't. And if this child has any health issues, does the government pay for that? Or is it a sad case of sorry, not our problem. Thanks

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One thing I love about NicaLiving, you never have to apologize for it, gringo_canuck. :)

On the Contrary

My stepdaughter had Camila at Rivas Hospital. Maternity was quiet that day so she landed up in a private room with AC. Normal birth, a few stitches and a 24 hour stay...100% free

A friend of the family had hers last week, normal delivery here in SJdS at the clinic. In for 24 hours and again all 100% free.

Vivian Pellas is $1,200 to start.

Pre--and post baby!!

Does the govt provide any kind of $$$ towards mothe rcheck ups prior to birth---and post birth? Any $$ for foods for the baby?

Ours had some great care

In Managua while pregnant and at University. Some nice new 'First Lady' promoted single mother clinics. She was checked for fitness but as a soccer player and dancer and only 18 she was fit as a fiddle. After, and back in SJdS the baby has had the best care privately at about $10 a visit (worth it just to keep Mom happy) plus all the shots and regular check ups at the regular clinic.


So it is fair to say ALL Nicas have access to free health care-----And like most countries, more attainable in the big cities.

BUT how about the Gov't providing $$$ or food support for the mother/baby if they are poor? Ensuring they get the proper nutrition?

MINSA does a survey of babies born in Nicaragua

They test for iron deficiency and other things, from what I've heard. The other efforts seem to be more along the lines of give a woman a pregnant pig and she can have meat for the rest of her life if there's adequate forage around for the pig and her litter, and their litters, and if the family doesn't eat the sow before she gives birth. (And in the US, people can use the government subsidy for poor families to buy seeds, so lo mismo for agricultural families, bit tricker for urban Nicaraguan poor families though there may be other supports for them).

Nicaragua has an annual Gross Domestic Product per capita of $4,500 while Canada has a GDP of $43,100. Nicaragua seems to do a whole lot with that $4,500 GDP per capita, but it's a tenth of what Canada's GDP per capita is.

There's a certain amount of subsidized housing; there is a certain amount of subsidized electricity; free basic medical care; doctors who are not particularly greedy. At various times (don't know about now) basic foods have had either price supports or price freezes.

Rebecca Brown

Check your numbers

Ovidio Reyes - GM of the Central Bank of Nicaragua speaking on the 18th of October, said:

El producto interior bruto (PIB) per cápita de Nicaragua asciende en 2013 a 1.800 dólares anuales y, pese al dinamismo mostrado en su economía, continúa siendo el segundo más bajo del continente americano, dijo hoy el gerente general del Banco Central de este país centroamericano,

The gross domestic product (GDP) per capita in Nicaragua reached 1,800 dollars a year in 2013, and despite the dynamism shown by the economy, continues to be the second lowest in the American continent, said today the General Manager of the Central Bank of Nicaragua.

It was worse in a meeting last week here in Rivas, we reported that he said: "Nicaragua is advancing positively towards a solid economy and that the GDP Per Capita is one thousand seven hundred dollars annually.

The INE shows 77 percent of consumers on an electric supply subsidy.

Tell the CIA, too.

The figures are from the CIA World Fact Book. Interesting that they're optimistic about Nicaragua.

I'm on the electric supply subsidy -- that's more about not having an AC, microwave, or five bedrooms with private electrical shower heads that get used every day than it is about real poverty. I'll see what the TV and DVD players add to my bill next month.

The country is poorer than I thought, then, and is doing a whole lot with what it does have. When I was in the middle of that post, the MINSA woman came by with the anti-mosquito granules and I explained that I know to change the water in vases at least every other day, and the guppies take care of their tanks.

The other issue with agricultural countries is figuring out the cash value of subsistence living -- and there is a fair amount of that going on whether it's a group like the Miskitos doing subsistence farming and hunting, or the farm hands spending more time with their personal malaga and bean patches than with the owner's coffee plants. People who have very little cash but who don't die of starvation are doing something to survive that may not be considered in the GDP.

Rebecca Brown

OK, I spoke to the CIA

They said that they use the GDP - per capita (PPP) system which is GDP on a purchasing power parity basis divided by population as of 1 July for the same year.

Basically, the point still holds either way

A richer country can do things a poorer country can't do as easily, especially a country that has some extra special health problems that a colder country without the right kind of mosquitos doesn't have to deal with.

Rebecca Brown

The Young Doctor

who works at the rural clinic we help support makes a bit over $350 /mo. The two nurses make about $250.

Nurses get money for a Christmas dinner each year, the teachers (who make about $200) do not.


So you are saying ALL Nicas--even without insurance would receive good care...TY.........But what about if the child had health issues--still free? Reason I ask, partly because of schooling, and another part is that around our house I see a mother holding a child that appears to have a huge tumor in its head and she is always begging for $$$. Curious to what avenues she would have.

Our gardener which has INSS, came down ill suddenly last year, and after a week of sitting in the hospital by Huembas, finally got a cat scan, but nothing much else was done, he told us they found a tumor, but unable to operate.

TY for taking the time to respond.

the public hospitals

make a good-faith effort to give treatment with what they have to work with. Specialist rotate in from Leon or abroad for some things the local staff cannot handle. If one is sophisticated enough to sign up for a roving specialist and doesn`t die or lose interest before the date they will be treated to the best ability of the facility. 6 months sems to be the most common number we have been getting.

Cash is needed for medications and anything the hosptial can`t provide. If the facility cannot treat your problem, one of several posibilities is that you will be told stories so you can go home and die at no cost to the state.

Nicas with insurance go to private doctors but may have to go to the public hospital for anything that needs sophisticated ( or semi-sophisticated) equipment. People qualified for INSS go to the ``private side`` of the public hospital. Esteli, for example, has 2 small private hospitals that can do limited surgeries in a cleaner environment but if anything goes wrong they have to transport to the public hospital. If you get in a car wreck or something and can`t make it to Managua, you will end up in the local public hospital. There is no helicopter transport here that I know of.

Speaking of car wrecks, this last weekend was hard on my family-- they lost 3 firends to drunk drivers in 2 unrelated incidents. i went to the funeral of one of them at the private cementary just NW of town. It is quite attractive by northern Nic. standards.

Opinions are like belly buttons-- the best medical advise for ``poor`` people is to stop being poor and have few children.

``Socialism works fine until you run out of other peoples` money``

Margaret Thatcher

Good Informaton

Affordable access and quality of care are two key components.

Health care in Nicaragua has to be a balance for ex-pats. My Medicare advantage plan offers $25K for out of country emergency needs,, this is what I would use for an accident or a medical emergency ---(try to get to Pellas in MGA if I could, but not an option if I'm bleeding by the side of the road)-- and I were unable to travel out of the country.

Something simple, I would probably go to a local clinic initially.

Something potentially life threatening, even something like Dengue that should be treatable in Nicaragua,, I would jump on a plane for Miami, Houston, or LA, and grab a cab to a major hospital's emergency room. You SHOULDN'T die from Dengue, but several have over this last year. Why take the chance? Of course, you can't wait: the airlines don't like people dying on their planes, and they will restrict your boarding if they suspect you might fall into that category.

The good news is, health care in Nicaragua can only get better . . . .the opposite of what is currently happening in the US.

Condolences to your family. A shame to lose friends and family that way.

just remember..

there are a lot of good hospitals here beside pellis..they got there certifications..becuse they had the money to get them..im starting to think a lot of u guys like to here ureselfs talk..but know nothing about the country

Pellas got their acreditation because

They went through the steps to get it.

What do you mean by "Paid for It?", what are you suggesting?

(BTW, the fact that you have been here so long tells me nothing about what you know about the country. Your posts tell me all I need to know about that.)

Paid for it?...If you call this paying for it then I guess yes, it costs money to provide the level of service that they provide in order to qualify.

Pellas voluntarily submits to an intense evaluation process every three years. The inspection includes confirming 320 standards of quality and over 1,300 measurable elements of compliance in hospital processes.

Dr. Alejandro Ayón, HMVP Medical Director acknowledged that the process involves a consistent effort not just from doctors and nurses, but from the entire hospital staff.

The HMVP receives between 2,000 and 3,000 outpatients daily (of which about 10% are foreigners) for laboratory services, imaging and medical services. As well, one of the new services is their dental clinic. The HMVP has a US $12 million expansion plan to build an intermediate care unit and increase the number of beds.

Of the 323 hospitals accredited worldwide, 34 are in Latin America, including four in Central America, three in Costa Rica and one in Nicaragua - HMVP.

And so you don't think I am pro private or whatever else you may think and put two and two together to get 5, read my positive posts on this thread about giving birth at the local establishments?

what i meant..its..

expensive to get certified..and they have the money to do it..some of the other hospitols..dont have the money to spend to get certified..and some are pretty good..salud integral..batista for 2..and do some checking and see the dif in prices..What do you mean by "Paid for It?", what are you suggesting?..what are u on there pay roll..yeah they do a good job..butt..(BTW, the fact that you have been here so long tells me nothing about what you know about the country. Your posts tell me all I need to know about that.)..and thanks..that tells me alli need to know about u..have a merry christmas

You can give it out whenever you like

But you never like it coming back your way do you?

The certification is about proving you are a good hospital. If that means spending money on the things they are checking then it means that the accreditation process works.

I went through one in Calgary when they checked the security at the hospital I worked at. It had a secure 30 day psyche assessment unit and several psyche wards. It was very thorough. I don't think we could have smoked our way through.

good for pellis..

they are a good hospital..im not saying there not..what im saying u dont have to be certified to be a good hospital..there are other good ones here..and a lot of pellis's dr's also practice at other hospitals..but a lot of u guys just like everyone to know what u know..


Yes Hospitals pay big $$$$ to obtain certain status, Hospital I worked back in Virginia had Magnet status.....and there is a whole procedure the hospital and staff go to in achieving that status...it is all centered around the Nursing---just another item that tries and sways people to use that hospiatl

Isnt that the point of the site?

We all have the same knowledge level or access to it and then use it as and when we want.

You have asked for information before and we have been given it. Visa Versa too!

But you prefer to be that crusty old guy in the lunchroom with the "don't talk to me" attitude.

True, So True

"not know anything about the country" But, we're learning, thanks to the guys with time in country.

But, you do have the advantage of being in Managua, a big plus. Some of us are in the boonies, a serious consideration if the hammer falls.

One of my biggest medical fears is an auto accident, and the two-three hour drive to MGA. We have brought a lot of medical support stuff down, even bags of D5W,, thanks to my wife, but if I needed an operation to -for example- stem internal bleeding, then I couldn't wait 6 months for the specialist from Leon. The D5W MIGHT keep me alive on trip to Pellas, keep the BP up.

I'm otherwise healthy, and could probably see something coming (even something like Dengue). Those drunk drivers who took out Billy Bob's extended family, probably not so much . . .

and i also have a farm..

in waslala..and go up every month..the last 80km of road..is a easy 3hr 4x4 ride..and i have visited patients in the hospial there..in feb..i have a girl coming down to stay at my place..so she can have her baby here in mga..

It's not just "ALL Nicas"

If you are in Nicaragua you can go to a public clinic or hospital for free care, You don't have to prove you qualify in order to go there.

There certainly are limititions on what can be done but having a baby is something Nicaraguans do all the time so dealing with it iw well within the skill set of the clinics and hospitals.

My very limited experience:

Serivces are generally free, as long as a willing doctor is around. Be sure to thank them, too, because they're probably doing it for free.

There are, however, severe financial constraints. I can hardly give a single example of this, but my novia has a young, very sick cousin. They generally ask that she brings in consumable supplies; that is, while the hospital will supply the scissors, she's required to supply the feeding/draining tubes, etc. And if she doesn't? Well, they might have one or two... or half of one... for an adult.

Even with that general rule, though, sometimes they say that the only help available is in Managua, or that the only free help is a visiting Cubano doctor in Managua.

At least, that's the experience of one very sick kid in Esteli.

Clinic doctors are paid, not much, but they do get something

Many doctors have clinic hours and then private hours. Same doctor, different payer.

Rebecca Brown


Thanks for responding

My step daughter

had her baby at the local public hospital with no problems and goes to public clinics for routine care for her and the baby. For any emergency, they go to a private doctor or clinic. Another friend left the country to avoid having to go to the public hospital to have her baby.

I don`t like to use the term ``poor`` because I consider it an insult, but most low on cash Nicas do the same-- they go to the public sector when they have to but if time is critical or they are running scared of the public hospital they go private. Among the many things I find irritating is getting phone calls to take fly spray, etc. to relatives in the hospital.

I also note, that because there is no out-of-pocket cost for an exam, many people here abuse the public emergency room with things that are not emergencies. but not to worry, it`s all free thanks to foreign aid.

``Socialism works fine until you run out of other peoples` money``

Margaret Thatcher


Was incorrect of me to use the word "poor" My mistake. And sorry to hear about your family and friends recent loss to drunk drivers!

Abuse of Emergency Rooms happens everywhere, can't get in to see your family doctor---head to the ER.

Many Thanks for the information.

from what i understand..

everyone has free health care..maybe not the best..but most people i know having babies..its free..