Nicaragua builds a national policy on safe hospitals

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In the last year, Nicaragua has worked hard to implement the safe hospital strategy in its health facilities. Projects supported by the European Commission’s Disaster Preparedness Program (DIPECHO) to promote safe hospitals have been instrumental in the progress made thus far. These projects have contributed to training multidisciplinary teams that can apply the Hospital Safety Index (HSI), a tool developed by PAHO/WHO for primary and secondary health facilities.

The scope of the DIPECHO Action Plan VII (“Safe Hospitals and Urban Risk: Safe Cities in Central America”) has benefited the work of Dr. Francisco Reyes Morales, director of the local integrated health systems (known by the Spanish acronym, SILAIS), and Dr. Paul Borgen, head of the Ministry of Health’s Technical Liaison Unit for Disasters. They have led in developing training for use of the HSI to assess health facilities, together with the Nicaraguan University of Engineering. Other sectors and actors have joined in the process, including engineering staff of different municipal authorities.

After training was completed, the assessment process began in primary and secondary level health care facilities as well as less complex facilities in the SILAIS of the Departments of Nueva Segovia, Estelí, Madriz, Managua, and Masaya.

Plans prepared for Ocotal Hospital and the Jalapa Health Center focused on improving access for disabled persons, pregnant women, and older adults; upgrading signage for evacuation routes; and improving fire safety measures. Assessments and mitigation measures have been applied at the Alemán Nicaragüense Hospital and the Francisco Buitrago Health Center in Managua, at the San Juan del Río Coco Hospital in Madriz, and at the Humberto Alvarado Hospital in Masaya, as well as two other health centers.

The safe hospitals strategy is involving health workers in a new and more comprehensive way of managing disaster risk in the sector. It has attracted interest from organizations like the Association for Cooperation with the South (Spain), which supports implementation of the Hospital Safety Index and the development of mitigation activities. CARE, the international NGO, is supporting similar work in the Department of Masaya, and the Nicaraguan Red Cross is working in Managua on urban risk issues.

The Ministry of Health has established guidelines to strengthen the process and has created a high-level technical team to develop the nation’s policy on safe health facilities. Currently, the country’s National Disaster Prevention Agency is working with other institutions to create a National Policy on Integrated Risk Management. The Ministry of Health’s promotion of the safe hospital strategy will serve to support the 2010 National Risk Management Plan. For more information on these initiatives, contact This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Emergency Preparedness and Disaster Relief

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