Health financing for universal coverage

Health financing challenges and the role of institutional design and organizational practice for health financing performance in Nicaragua

Discussion paper 2/2010

World Health Organization

Publication details

Number of pages: 22
Publication date: 2010
Languages: English
WHO reference number: HSS/HSF/DP.E.10.2



The Nicaraguan government is committed to moving to universal coverage in order to provide adequate quality health care for all. Yet, there are challenges to achieving this with the existing health financing system. The purpose of the paper is to assess its performance and to analyse the existing institutional design and organizational practice in health financing with the objective of revealing its effect on the level of health financing performance.

The paper proposes several policy options for the health financing system to improve. Foremost, substantial improvements could be achieved, if existing legal provisions were implemented and enforced properly. Progress towards universal coverage is dependent upon Nicaragua's ability to introduce appropriate institutional and organizational changes, on political commitment and on gaining public support for boosting national solidarity.