“Never again will there be in it an infant who lives but a few days:” Faith based action for social justice through community based primary health care (CBPHC) in rural Nicaragua

ISSUES: Rural Nicaragua is characterized by extreme poverty, difficult geographic access to health care services, lack of potable water and sanitation services, and few economic opportunities. Resultant health inequities –- higher rates of morbidity and mortality for vulnerable women and children –- are daily injustices suffered by the majority of the rural poor. In this setting, the above bible passage from Isaiah 65:20 is a promise that many rural communities can only hope for. DESCRIPTION: We describe a forty year commitment to decreasing health inequities in a non profit faith based CBPHC program in rural Nicaragua. Motivated by the biblical call to serve the poor and work towards social justice and health for all, this faith based community organization brought together churches in the U.S. and Nicaragua to develop the first rural CBPHC program in Nicaragua. From the start, the program sought to partner with communities in health and development to reverse the injustices of health care access and outcomes that resulted in high child and maternal mortality. LESSONS LEARNED: 1. Over a forty year period of time, this CBPHC program has resulted in significant decreases in child under five mortality in the rural areas of intervention. RECOMMENDATIONS: The commitment of individuals, churches and foundations in the U.S. in collaboration with local Nicaraguan individuals, churches and communities despite a long history of both man made and natural disasters in Nicaragua is an example of how faith based program can continue to work towards decreasing health inequities despite great obstacles.