In the late 1990s, infant mortality in Nicaragua stood as 53 out of every 1,000 live births - the highest in Central America and among the five highest in the hemisphere. Nicaragua also ranked first in adolescent pregnancies. Jinotega women and families faced exceptionally high reproductive risk as a consequence of high fertility and minimal birth spacing amongst women under nineteen. The fertility rate of 7.8 was nearly double the national rate of 4.5. The excessive rate of maternal and perinatal deaths became the top priority when looking at the major health concerns in Jinotega.
Diarrhea was the leading cause of mortality and morbidity amongst children under five years of age in the department of Jinotega, making up 85% of all cases. Acute Respiratory Infection represented 22% of all deaths amongst those less than five years of age in the department of Jinotega. Twenty-three percent of child mortality in Nicaragua was attributable to the associated effects of mild to moderate malnutrition, contrary to the common misconception that only severe malnutrition can cause death.
JinoHealth
W/NP excitedly received notification on September 18, 1998 that USAID had given an award for a program in reproductive health and child survival. The program, known as the JinoHealth Maternal & Child Survival Project, would work with 156 communities surrounding the city of Jinotega to reduce mortality and morbidity in women and children by working at the grass-roots level.
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Over a period of three years, participants in the project saw an increased awareness of the signs and causes of Acute Diarrheal Disorder, Acute Respiratory Disorder, and malnutrition. Increases were also seen in the practices of child immunization, breastfeeding, which typically improved nutrition and hydration in infants, and prenatal and postnatal health care. Additionally, word was received from USAID prior to Christmas of 2001 that there had been fewer maternal and infant deaths recorded in the department of Jinotega. Although most goals were well on their way to being met, improvements still needed to be made in some areas. These improvements served as the impetus behind JinoHealth II, which was implemented in the fall of 1999.
An important concept in W/NP's philosophy of project planning involves satellite projects that support a larger project. This is known as the "multiplier effect." Spawned from JinoHealth I and II were a whole series of projects involving gardening, composting, sewing centers, potable water, Vitamin A supplementation, child feeding centers, family planning, ambulances, fire trucks, and eyeglasses missions.
