USAID/Nicaragua health program performance : contributing to improved maternal, reproductive and child health in Nicaragua

public and private sectors, NGOs, universities and communities) by providing technical and financial assistance. The purpose of this evaluation was to: (1) determine the extent to which the objectives of the program were met and their contribution to the gender approach; (2) to evaluate the implementation of the mid-term (2007) evaluation recommendations; and (3) to identify the key factors that contributed to or prevented achieving the proposed results. In general, during the period studied, Nicaragua has made significant progress in family planning and maternal and child health. The Government of Nicaragua-led implementation of health policies, plans and strategies, coupled with the harmonization and coordination of international health cooperation (including USAID cooperation), has contributed to progress in the main demographic and maternal and child health indicators: (1) total fertility rate (TFR); (2) maternal mortality rate (MMR); (3) mortality rate (MR) in children under 5 years of age; (4) infant mortality rate (IMR); (5) neonatal mortality rate (NMR); and (6) chronic malnutrition (CM) in children under 5 years of age. In the case of HIV/AIDS, as expected, increasing the coverage of counseling and voluntary testing in key populations has increased the disease's prevalence and incidence, but has reduced its lethality and mortality. As this report shows, implementing the Family and Community Health Model (MOSAFC) has been fundamental to the country's health achievements, especially the role of the Family, Community and Life Committee (GFCV), which is the cornerstone of Ministry of Heath (MINSA) health promotion and prevention work. (Excerpt, modified)