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Case Study: Banking on Health in Nicaragua

Banking on Health, a project funded by USAID, works to increase access to financing for the private health sector in developing and emerging economies. In 1998, Nicaragua began a broad based health reform process that has enabled the contracting out of health services, including reproductive health and family planning. Contracted providers, known as Empressas Médicas Previsionales (EMPs) suffered when the National Social Security Institute (INSS) modified its certification process, adding rigourous standards for infrastructure, finance and administration, and service delivery. Many EMPs lacked access to financing to make the required physical infrastructure improvements and invest in quality of care. As a result, Banking on Health has provided training to banks, EMPs, and the INSS, to promote family planning services as a cost containment strategy.