In June 1990, when the territorial Delegation of INPRU was created, legally calling it INPRHU-MADRIZ, began its operations by initially promoting projects to address the problem of street children, secondly community prevention health projects, sexual reproductive health, training for health brigades and midwives; and promoters in Natural Medicine,  initiating the program of attention to children, then social actions centered on the family are incorporated through promotions and community references for attention to children and adolescents (promotion of Human Rights). Currently based on the experiences of development cooperation focused on children and adolescents and the health care of women, family and community, the childhood and community health program (PRONISAC) is formed in 2019.

The program directly serves 75 communities and 19 urban sectors in 5 municipalities of Madriz (San Juan del Rio Coco, Telpaneca, San Lucas, Totogalpa and Somoto).

Strategic Objectives of the Program:

  1. Contribute to the improvement of the quality of life of girls, boys, adolescents, youth and women of the communities through the prevention of gender-based violence.
  2. Contribute to strengthening the capacities of families and communities for the protection of children and adolescents and the promotion of children’s rights.

3.Contribute to the eradication of child labor in the Department of Madriz.

  1. Contribute to the improvement of the health status of the population of Madriz through positive changes in the health of families and communities.

The thematic axes of the the the childhood and community health program (PRONISAC)

  1. Child participation
  2. Attention and prevention of violence and human trafficking
  3. Insertion and Promotion of primary education in the education system
  4. Child economic exploitation
  5. Sexual and Reproductive Health
  6. Promotion of women’s health.
  7. Child, adolescent and youth psychosocial care
  8. Maternal infant
  9. Chronic and communicable diseases
  10. Promotion of Natural Medicine
  11. Promotion of good eating habits in childhood
  12. Health and sports

Child participation

Children are socially vulnerable to be directed in actions and decision making by adults, INPRHU Somoto since its creation has promoted the strengthening of capacities in childhood so that they have the opportunity to develop as active citizens, present their demands, in conditions to act and assume responsibilities in their schools, family and community; that they participate constantly. Participation develops social skills: ability to share, respect for the opinions of others, the value of the community, this participation is done in school, in the community and with municipal authorities; On the other hand, in addition to participating in spaces where they make their proposals, a methodology promoted by INPRHU is the interest groups, where the children meet 2-3 times a week and participate in creative and recreational activities such as Sports, music , traditional dance, theater, plastic arts and crafts. Here boys and girls experience confidence and build their self-esteem. Also included in the participation are the conversation and reflection groups, where adults talk with the children about the problems and topics of interest to the child’s life (School to Parents).

Attention and prevention of violence and trafficking in persons

Violence against women and girls in all its forms is a public health problem that has to be addressed from many sectors, such as INPRHU, our focus is on Primary prevention using as a reference the “ecological model” where it guides interventions Consider and discuss the conditions that exist throughout all the different levels for prevention and care (individual, family, community and society level), analyzing the risks that women and girls have of experiencing violence. As such, from the family and community we address biological, social, cultural and economic factors, as well as norms or patterns that can increase the risk that men commit acts of violence, so from the organizational base we incorporate young men and adults so that they are part of preventive actions, in focus of changes of behavior from the family, including education in values, and intersectoral actions at municipal and departmental level.

  1. Insertion and Promotion of primary education in the education system

In Nicaragua, 35% of the population are boys and girls under 15 years old, they are part of the family nucleus that on average are 6 members in each family and live in high poverty, or in extreme poverty. That is why INPRHU, within its priorities, has to be an active promoter of Primary Education, that children remain, learn with quality and are protagonists of their own development, thus contributing to the education policy in Nicaragua, and to SOP (Strategic Objectives of the program)) 4. As a strategy for the promotion of quality primary education, it implements the CRE methodology ” school reinforcement club”, a Ludo pedagogical methodology where inter-learning processes between girls, boys and adolescents are promoted through open, experiential educational spaces, Reflective, dynamic generators of the joy of personal growth and social participation. This methodology contributes to the inclusion and educational permanence of girls, boys and adolescents, promoting gender and generational equity. In addition, we contribute to the construction of individual and collective identities, based on values ​​of sociability and coexistence with equity between girls, boys and adolescents and social actors in their environment.

4, Child economic exploitation

The participation of children in economic activities continues to be one of the main activities implemented by some parents to ensure family support. Activities classified as worse forms of child labor have been reduced; However, the participation of girls working in domestic activities, children as a child labor force in the agricultural sector is still being presented, putting their development at risk, some children and adolescents are obliged to contribute and guarantee the own and family subsistence. INPRHU, within its priorities, continues to contribute to the reduction of child labor, incorporating in its actions to achieve this purpose the municipal and community social actors, the parents and therefore children and adolescents, raising awareness in family and the community on the Right to Education and not to child labor, promoting “Child Labor Free Zones”

  1. Sexual and Reproductive Health

In addition to the INPRHU Somoto Education, within the Development strategy since its inception in Madriz, it has strengthened the capacities in Families, through the support of the work of Health Brigades, an approach that it maintains in the promotion community-based Family planning (PPFC) and support to the Ministry of Health in the Promotion of the “Community Delivery of Contraceptive Methods from the Community (ECMAC) Strategy, these two family planning strategies  is aimed at increasing access to planning services family of women and men living in communities of difficult access, improve the availability of information and services to plan the time, number and distance between pregnancies. On the other hand, it focuses on the prevention of adolescent pregnancy through the realization of educational activities with methodologies focused on the self-reflection of goals and life plans, as well as the promotion of healthy behaviors and sexual and reproductive rights.

6.Promotion of women’s health.

With the purpose of contributing to improve the health status of women in urban and rural areas of Las Segovias, INPRHU Somoto promotes Behavior Change strategies in women, couples and families focused on the prevention of STIs, HIV / AIDS, Sensitization for the detection of Cervical Uterine Cancer and Breast Cancer. On the other hand, provide the information service for the health care of women in aspects related to nutrition and hygienic practices.

  1. Psychosocial care childhood, adolescence and youth

Within the interventions focused on children and adolescents, the Psychosocial care component is parallel to community actions with children and adolescents, the approach is personalized, in some cases group reflective sessions, integration of children / as in recreational activities for the improvement of their self-esteem, and promotion of individual development for their empowerment, and therefore; the approach with fathers and mothers through the schools for Fathers.

  1. Maternal Infant

INPRHU Somoto since 2007 has been contributing to the Family and Community Health Model (MOSAFC), with two community strategies for the improvement of Maternal Health and three Community strategies for the improvement of Child Health. In Maternal Health with the Implementation of a Safe Motherhood Delivery Plan (PPMS) and Community Essential and Neonatal Obstetric Care (CONE-C) for the prevention of maternal and neonatal mortality. In Child Health, it has implemented PROCOSAN (Community Health and Nutrition Program), AIEPI Community (Integrated care for prevalent childhood diseases), Community Case Management (MCC). The purpose is to contribute to the reduction of childhood diseases, improve nutrition, reduce infant mortality, all with the strengthening of the capacities and participation of the community network in the management and implementation of strategies; articulation with the Ministry of Health and the direct promotion of better health practices in the families of rural communities.

  1. Chronic and communicable diseases

The Department of Madriz has 5 municipalities in extreme poverty, so there is child malnutrition, children are short for age when they are of school age, when they become adults, the problem of Overweight / Obesity occurs ( 65% of the population) which is a risk factor for Cardiovascular diseases and Diabetes. INPRHU Somoto therefore promotes actions to promote healthy lifestyles, adequate and balanced eating habits, detection, care and referral to the health units of people with hypertension and diabetes to reduce complications, and if there have been any complications, the implementation of community-based rehabilitation (RBC). On the other hand, Madriz affects vector-borne diseases such as Chagas and Dengue; INPRHU contributes with community actions for the prevention and control of these diseases always with the action of the community network of health brigades, in coordination with the Ministry of Health.

10.Promotion of Natural Medicine

Since 1990 the promotion of the benefits and uses of medicinal plants has been a priority in INPRHU Somoto, has trained community personnel in the identification, classification and use of different medicinal plants in the area, promotes the cultivation of plants in medicinal gardens family and community where they have been supported on some occasions by cooperators with experience in the production and processing of them, and about 10 years ago the incorporation of sea water for the attention to child malnutrition and improve conditions of dermal, respiratory and digestive

11.Promotion of good eating habits in childhood                                                                                   

In the 5 municipalities in extreme poverty of MADRIZ, manifestations of chronic malnutrition in children under 5 have been reduced, however, there is still child malnutrition in acute condition, so INPRHU Somoto within its priorities has parallel to food production, the promotion of nutritional practices in families for nutritional improvement in childhood. Through PROCOSAN, adequate food is promoted and as the mother should feed the child, strategies such as “Families cooking and eating better”, “Home Workshops / Positive Deviation” have been implemented, in both strategies the positive practice of Some families promote the use of products that are harvested in the area and incorporate what they had not used and exist in the area.

12.Health and sports

In projects for the care of the elderly, and specifically in those with chronic noncommunicable diseases, physical exercise such as walking, cycling, is promoted. In Projects with Youth, Children and Youth, INPRHU promotes Sports such as Soccer and Chess to maintain Healthy body and mind.