Committee on the Rights of Persons with Disabilities

Initial report submitted by Nicaragua under article 35 of the Convention, due in 2009 * , **

[Date received: 8 May 2019]

I.Introduction

1.Nicaragua has a land area of 130,373.5 square kilometres (km2), which has now been extended by 90,000 km2 of the Caribbean Sea, an area it obtained the rights to through the International Court of Justice. Serving a population of 5,954,900 inhabitants, the Government of Reconciliation and National Unity takes seriously its commitment to provide comprehensive support to persons with disabilities through social, economic and political programmes. Persons with disabilities themselves drive progress in the attainment of their rights through the direct participation of their representatives in federations and associations.

2.The State and Government have led a determined fight to restore the rights of the Nicaraguan population through State institutions, trade organizations and social movements, thus fully re-establishing lost rights that were denied for 16 years by the neoliberal leaders who reversed the progress that had been achieved during the first phase of the Sandinista Popular Revolution in the 1980s.

3.The 2012–2016 National Human Development Plan sets out lines of action for building an egalitarian, fair and compassionate society that is committed to the fundamental values of Nicaraguans from all of the country’s communities, and especially from historically excluded groups, such as persons with disabilities, that are now being prioritized and actively integrated.

4.The return to power of President Daniel Ortega in January 2007 has helped to secure absolute stability and the recognition of the rights of persons with disabilities, thereby improving the standard of living of a segment of the population who have seen their rights restored in the areas of equality, fairness, respect for their ideas, health, rehabilitation, education, employment and self-employment. In addition, there is now greater awareness; infrastructural work has been carried out to ensure the accessibility of public, private and community spaces; laws have been adopted; and international treaties and protocols have been recognized.

5.By ratifying the Convention on the Rights of Persons with Disabilities, Nicaragua acknowledged on the world stage that it must work to secure rights, with all public servants sharing a duty to implement the law. Nicaragua has also now recognized the Optional Protocol before the United Nations, and this has allowed for significant progress to be made on the basis of social justice, Christianity, socialism and solidarity.

6.As a State, Nicaragua sees as a benefit and an opportunity its duty to submit this report, which reflects the progress achieved since it ratified the Convention on the Rights of Persons with Disabilities. This instrument is leading the country to achieve extraordinary goals in terms of the enjoyment of rights, driven mainly by the social and economic policy adopted by the Government of Reconciliation and National Unity.

II.Background

7.The executive branch of the State of Nicaragua has been the main promoter of rights restitution, especially for persons who are vulnerable to danger, natural disasters, poverty, social exclusion and discrimination on account of politics, religion or sexual orientation.

8.The rights of campesinos and workers were realized during the government of the Sandinista Popular Revolution, paving the way for agricultural reform with a leading role for young people. Through social security, the reform benefited thousands of Nicaraguans who had suffered the adverse effects of the violent assault of the 1980s and had been left with a disability, irrespective of their allegiance. In addressing this situation, the Government paid particular attention to the health and rehabilitation, both in Nicaragua and abroad, of those persons who had acquired a disability, thus recognizing their rights.

9.All the rights realized during the revolution in the 1990s and the early 2000s were revoked by the successive neoliberal Governments that claimed the executive and legislative power to reform laws, decrees and protocols, thereby condemning persons with disabilities to social, economic, political and cultural exclusion.

10.On 19 September 2006, during his election campaign, presidential candidate Daniel Ortega signed a memorandum with the Nicaraguan Federation of Associations of Persons with Disabilities that clearly set out the steps he would take to recognize and realize the rights of this segment of the population during his term of office.

11.As a result of this memorandum, Nicaragua signed and ratified the Convention on the Rights of Persons with Disabilities and its Optional Protocol. Demonstrating its commitment to the Convention, it then embarked on a process of discussion and analysis of in-force disability laws that led to the adoption of the new Persons with Disabilities Act, which is in line with the Convention and supports the comprehensive enjoyment of the rights of persons with disabilities through the efforts of public and private institutions and society as a whole.

12.Efforts are under way to recognize and restore the rights of persons with disabilities by coordinating the work of Government institutions, the private sector, the National Council for the Promotion and Application of the Rights of Persons with Disabilities and the parliamentary committees on accessibility, inclusive education, sports and legal affairs.

13.Furthermore, since persons with disabilities are represented in the Office of the Civil Branch of Government for Organizations of Persons with Disabilities, they are able to engage in horizontal communication with the executive branch and government institutions.

14.Work has also been done in the legal sphere to recognize the rights of persons with disabilities.

15.Below is a list of the treaties, laws and protocols that Nicaragua has revised, established, recognized and implemented.

National level
1	Constitution and reforms thereof
2	Act No. 94 on benefits for Nicaraguan combatants and civilians injured in war
3	Act No. 98 establishing safeguards for the rights and benefits of persons with war disabilities who are veterans of the People’s Sandinista Army and the forces of security and order of the State
4	Act No. 119 on benefits for war victims
5	Act No. 160 on additional benefits for retirees
6	Act No. 175 establishing a reserve fund for the payment of ex gratia pensions
7	Act No. 185 on the Labour Code
8	Act No. 238 on the promotion, protection and defence of human rights in the context of AIDS
9	Act No. 545 on debt forgiveness for persons with war disabilities who are veterans of the Nicaraguan army, officials of the Ministry of the Interior or former Nicaraguan resistance fighters, and who bank with the Housing Bank of Nicaragua under liquidation
10	Act No. 613 on the protection and safety of persons engaged in diving activities
11	Act No. 650 on the protection of the human rights of persons with mental illnesses
12	Nicaraguan Mandatory Technical Regulation No. 12006-04 on accessibility
13	Act No. 582 on education
15	Act No. 675 on Nicaraguan Sign Language
14	Act No. 763 on the rights of persons with disabilities, adopted on 13 April 2011; repeal of Act No. 202 on prevention, rehabilitation and equal opportunities for persons with disabilities
15	Act No. 779 on violence against women
	International level
	United Nations
1	Universal Declaration of Human Rights
2	International Covenant on Civil and Political Rights
3	International Covenant on Economic, Social and Cultural Rights
4	International Convention on the Elimination of All Forms of Racial Discrimination
5	Convention on the Elimination of All Forms of Discrimination against Women
6	Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment
7	Convention on the Rights of the Child
8	International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families
9	Standard Rules on the Equalization of Opportunities for Persons with Disabilities
10	Convention on the Rights of Persons with Disabilities and its Optional Protocol
11	Geneva Conventions relating to the protection of victims of international armed conflicts
12	Declaration on the Rights of Deaf-Blind Persons
13	Declaration on the Rights of Disabled Persons
14	Declaration on the Rights of Mentally Retarded Persons
15	Resolution of the Permanent Council on persons with disabilities in the American Hemisphere of 3 June 1996
16	International policies on the health of persons with disabilities
17	World Programme of Action concerning Disabled Persons
	Organization of American States
1	American Declaration of the Rights and Duties of Man
2	American Convention on Human Rights
3	Inter-American Convention on the Elimination of All Forms of Discrimination against Persons with Disabilities
	International Labour Organization
1	Vocational Rehabilitation and Employment (Disabled Persons) Convention, 1983 (No. 159)
	Other
1	Managua Declaration on children and young persons with disabilities and their families, 3 December 1993
2	Beijing Declaration on the Rights of People with Disabilities in the New Century, adopted on 12 March 2000 at the Global Disability Summit

III.National context

16.Disability in Nicaragua has multiple causes. Important factors in the increase in the number of persons with disabilities are old age, chronic degenerative diseases, communicable diseases, congenital defects, accidents, medical negligence, malnutrition, public disorder, anti-personnel mines, war and natural disasters. In addition to these issues, the problem of population growth, spread and migration makes addressing the matter of disability more complex. Machismo has a negative impact on the quality of life of women in general and women with disabilities in particular, who are exploited, abused and isolated.

17.Inclusive education, which is intended to open up possibilities and opportunities for persons with disabilities, is a major challenge in terms of ensuring that teachers in the education system are properly trained and that the entire educational community provides high quality and compassionate support for persons in this population group.

18.High unemployment rates are due to various factors, including a lack of training, the inaccessibility of workplaces, the lack of accessible transportation and the constant economic problems plaguing the country. Many of those who are “occupied” (i.e. employed) earn very little or receive no other form of remuneration.

19.High rates of open unemployment and illiteracy, globalization and the attitudes of certain businesspersons have become a serious obstacle to the enjoyment of the right to work. The situation is made worse by the discretion allowed in the discharge of obligations established under the Labour Code and other relevant laws.

20.Regarding health and social security, the State has been making considerable efforts to ensure rehabilitation services. However, interventions have centred on the biological-psychosocial model, which consists of professionals in the various fields assessing and defining the therapeutic steps to be taken.

21.Mobility is a two-pronged issue, determined by the physical limitations of the individual on the one hand and infrastructural limitations in the environment on the other. The fact is that most urban infrastructure in Nicaragua is not accessible, and is therefore a serious impediment to the full enjoyment of freedom of movement and access and the conduct of activities enabling persons with disabilities to lead a life of equal opportunity. Nicaraguan Mandatory Technical Regulation No. 12006-04, on accessibility, which is currently in force and is overseen by the Ministry of Transport and Infrastructure, provides for the creation of an implementation committee comprising government institutions and independent bodies.

22.Public transportation and the national road network do not meet accessibility conditions for wheelchair users and persons with other disabilities or reduced mobility, nor is adapted or special transport available for these users, who are therefore forced to travel by other also inadequate means.

23.Concerning information and communication, the National Library does not have texts in Braille, and public documents are not transcribed into Braille. A small library affiliated with the Culture Institute has some materials in Braille, but its collection does not include official documents. No other types of text are published in alternative formats for blind persons.

24.The media are not available in accessible formats, and accommodations are not made for persons with disabilities, including persons with hearing and visual impairments. For example, there are no texts published in simplified language for persons with intellectual disabilities, and nationally televised news bulletins have not incorporated simultaneous sign language interpretation or close-up shots for persons with low vision into their regular programming.

25.A mechanism is in place that will enable persons with hearing or language impairments to communicate in the event of a natural disaster or other emergency. However, there is no similar mechanism that persons with disabilities might use should they fall victim to crime or abuse or find themselves in a situation where their safety is seriously at risk.

26.The justice system has put in place a sign language interpretation service and other means of communicating with victims of abuse or other violations, in coordination with the departmental level courts. However, these professionals are scarce and their availability thus limited, so organizations are having to train up staff of the Ministry of Education, the Ministry of Health and the National Technological Institute with a view to providing better support and interpretation services for deaf persons.

The “A Voice for All” Programme

27.In 2009–2010, the Government of Nicaragua, with support from the Government of Cuba, ran the “A Voice for All” (Todos con Voz) Programme, consisting of a psychosocial, pedagogical, clinical and genetic study of persons with disabilities at the national level.

28.The programme set out to:

Study the world of persons with disabilities and their biological and psychosocial specificities;

Determine possible causes;

Identify main needs and promote strategies for ensuring that critical problems are addressed.

Scope

29.The study entailed observing in their daily activities, for at least a year, any person affected by a permanent limitation of one or more of the following forms:

Motor

Hearing

Visual

Mental

Organ or intestinal (chronic kidney failure)

Multiple

Intellectual

IV.Progress on compliance with the Convention on the Rights of Persons with Disabilities

Equality and non-discrimination

30.The State’s public institutions have espoused equality and non-discrimination as a fundamental principle.

Equality: Equal footing in the effective enjoyment of human, civil, political, economic, social, cultural rights by women and men without discrimination.

Equity: Fair treatment aimed at achieving effective equality through affirmative actions that recognize the specific conditions of each person or group derived from rights related to race, sex, religion, ethnic origin or any other factor that produces discriminatory effects on rights, benefits, obligations and opportunities for women and men.

Non-discrimination: Any distinction, exclusion or restriction made on the basis of sex which has the effect or purpose of impairing or nullifying the recognition, enjoyment or exercise by women, irrespective of their marital status, on a basis of equality of men and women, of human rights and fundamental freedoms in the political sphere.

Progress over the period 2007–2013

31.In an effort to implement the provisions of the Convention on the Rights of Persons with Disabilities, Nicaragua has been taking action to benefit this group, one of the principles of the revolutionary Government of President Daniel Ortega being to restore and realize the human rights of the population, especially its most vulnerable groups.

32.To this end, the State has established a legal framework recognizing these rights that consists of:

(a)The Convention on the Rights of Persons with Disabilities and its Optional Protocol, signed and ratified without reservations;

(b)Act No. 675 on Nicaraguan Sign Language;

(c)The Divers Support Act;

(d)Act No. 522, the General Act on Sports, as amended to assign 3 per cent of the total earmarked budget to persons with disabilities, this benefit having now been available for two years;

(e)Act No. 650 on the protection of the rights of persons with mental illness, adopted by the National Assembly in 2008 with the aim of applying this vision of rights to persons with psychiatric disorders;

(f)Act No. 763 on the rights of persons with disabilities, which entered into force on 5 November 2011, repealing Act No. 202;

(g)Act No. 820 on the promotion, protection and defence of human rights in the context of AIDS, adopted in December 2012;

(h)Special Act No. 830 on support for former combatants to strengthen peace, unity and national reconciliation, adopted on 13 February 2013, which includes a complete chapter on the rights of persons with disabilities resulting from the war;

(i)Act No. 842 on the protection of the rights of consumers and service users, adopted in September 2013;

(j)Nicaraguan Mandatory Technical Regulation No. 12006-04 on accessibility, and reforms thereof (see annex 1: electronic folder of laws).

33.The member organizations of the Office of the Civil Branch of Government for Organizations of Persons with Disabilities were given the opportunity to state their requirements in relation to the following laws:

(a)The Family Code, section on the legal capacity of persons with disabilities;

(b)The Code of Civil Procedure;

(c)The Traffic Act.

Women with disabilities

34.It is a State policy of the Government of Reconciliation and National Unity to empower women through the introduction of social, economic, cultural and political programmes and projects in which they play a leading role. Mechanisms have been established to ensure respect for the role of women, including a 50 per cent quota in public sector jobs and employment, as well as in community organizations, trade unions and political parties. Efforts have been made to introduce the same quotas for persons with disabilities.

35.The Ministry of Women’s Affairs is promoting among government institutions and autonomous entities participatory lines of action on gender and a participatory gender policy that are to be taken into account in all programmes and projects being rolled out at the State level. These lines of action include:

Raising awareness among Nicaraguan women of civic duty, rights, participation and power in all areas of life;

Ensuring that women are aware of the Constitution and laws so that direct democracy and civil rights are fully exercised;

Promoting among women, in coordination with the relevant institutions and organizations, instruction in sexual and reproductive health, in political, economic, social and labour rights and in any technical, scientific, cultural and spiritual knowledge that contributes to their comprehensive education as human beings;

Fostering and raising the profile of women’s leadership in all areas of life;

Helping women leaders to achieve at least 50 per cent representation in State institutions and on the lists of political parties and social movements at the local and national levels;

Promoting and raising the profile of women’s active participation in elections, both as candidates and voters;

Supporting women candidates in their electoral campaigns through training and the design of women-oriented campaign, communication and outreach strategies;

Nurturing in women human values that encourage family and community reunification and coexistence in line with the principles of national reconciliation and unity;

Fostering among women a feeling of national identity and belonging to a diverse, multi-ethnic, plurilingual, unique, national, Latin American and Caribbean culture that must be revitalized and defended as the heritage of future generations;

Encouraging women to defend, preserve and restore the country’s natural resources, the environment and all its life forms;

Encouraging women to take ownership of a rights and human development model of cultural, social, political and economic affairs and world relations, in keeping with the principles and values of justice, sustainability, solidarity, peace and well-being for all persons without discrimination on account of age, race, religious belief, political affiliation or other characteristic;

Fostering in women a spirit of solidarity and engagement in efforts to eradicate poverty and all its appalling consequences from the society Nicaragua is seeking to transform.

36.To integrate persons with disabilities into the labour market, the Ministry of Labour has held career counselling workshops for 26 women with disabilities in order to teach them about basic job search techniques and labour rights and help them to find employment.

Children with disabilities

37.The comprehensive family and community support model used by the Ministry for the Family, Adolescents and Children extends beyond the individual to the family, fosters family and community coexistence based on love and the revival of humanistic values and promotes new child-rearing and family relations paradigms.

38.The goal is to help at-risk children and adolescents and/or those whose rights have been violated, pregnant adolescents, persons with disabilities, older persons and families in situations of social risk and vulnerability to achieve the 25 basic conditions for well-being through family support strategies, values education and the provision of integrated government services, in coordination with the institutions of the National Social Welfare System, namely the Alliance Office of the Civil Branch of Government, under the shared responsibility model, the Offices of the Civil Branch of Government for Family, Community and Life, and the “Promotoría Solidaria” programme at the community level.

“Promotoría Solidaria” programme

39.Under the umbrella of the “Promotoría Solidaria” programme, the Nicaraguan authorities has been training young people to become outreach workers who provide support for State institutions, especially the Ministry for Family, in their various activities for the benefit of children with disabilities.

40.The outreach workers also work in coordination with technical staff to provide families with training in the values of respect, solidarity and equality of all persons. Their goal is to nurture the right to recreation of children with disabilities by providing spaces where they can get together and play, thereby countering preconceived notions and stereotypes and showing that they can live happily in their families and communities.

Implementation of the community-based rehabilitation strategy

41.Nicaragua is implementing a community-based rehabilitation strategy, this being a methodology well suited for approaching disability in a holistic manner. Since 2008, it has been taking action to benefit children with disabilities or developmental delays, in terms of both detection and community-based assistance, such as training their mothers in how to guide their children’s education, within the framework of an inclusive development approach, using the Portage Guide to Early Education as the key tool. The Portage Guide is used to assess a child’s behaviour and to design a curriculum with realistic goals that leads to the acquisition of additional skills. The Guide also helps assess the behaviour a child is learning and suggests techniques for teaching different behaviour. The test measures five areas of child development, namely, socialization, language, self-help skills, cognition and motor skills (see annex 2: basic guide to the Portage methodology).

42.Efforts to provide systematic support are being made in 14 municipalities in central Nicaragua where a community-based rehabilitation network has been set up to provide assistance to children with disabilities and thus improve their social and educational inclusion.

43.These community-based networks have led to the identification of children with developmental delays or disabilities who were not registered under the national “A Voice for All” programme.

44.Another measure that has been very important in guiding parents is a simple booklet designed by the Ministries of Family, Health and Education called “Love for tiny tots” (Amor para los más chiquitos). It is used to prevent and detect certain disabilities and developmental delays at the community level through a holistic approach.

45.Various social service providers, such as health-care practitioners, education professionals, officials of the Ministry for Family, community educators and health outreach volunteers, have been trained to use the “Love for tiny tots” booklet.

46.This early education booklet has been rolled out in various departments across the country, the aim being to reinforce the role of families in child-rearing models by providing them with information on how to care and educate a child at home.

47.Each booklet explains the child development process, from birth to preschool age, and recommends age-appropriate activities with a view to stimulating development.

48.There is also an “A Voice for All” booklet, which provides all outreach workers with basic knowledge of disability types.

Right of children with disabilities to a name, a nationality and recreation

49.Another very important step in the restoration of children’s rights in Nicaragua was the recognition of the right of children with disabilities to a name and a nationality. Municipal administrative fees have been waived so that children with disabilities can be duly registered in the civil registry by a notary public and be issued with a birth certificate. This programme was launched in 2008 for an indefinite period to benefit Nicaraguan children.

50.The restitution of the right to recreation is evident in the design and implementation of initiatives contributing to coexistence and socialization that are run at the Happy Childhood fair, which takes place from November to January each year. In addition, long-term actions and activities are being undertaken with professional associations and organizations that serve children with disabilities.

51.It is worth noting that, for more than seven years, Nicaragua has kept a register of congenital malformations at the La Mascota hospital as part of the State’s ongoing efforts to prevent disabilities among children.

Awareness-raising

52.Nicaragua has made extraordinary strides in raising awareness among public servants and society as a whole. As a result, it has been able to adopt key measures, including budgetary measures, to implement the Convention on the Rights of Persons with Disabilities at the national level. For example:

(a)The Government is sensitive to the issues and the need to recognize rights and, accordingly, has ratified the Convention on the Rights of Persons with Disabilities and its Optional Protocol without reservations;

(b)Significant progress has been made in amending the legal framework to bring it into line with the provisions of the Convention on the Rights of Persons with Disabilities;

(c)The State has held awareness-raising sessions for the teachers and administrative staff of independent institutions and for ministry officials at which information was provided on the principles of promoting the full exercise of the rights of persons with disabilities recognized under the Convention. It has also been running a sustained enrolment campaign entitled “Enrol Now” (Matricula Ya) so that persons with disabilities can access inclusive education in schools, institutions and universities.

Accessibility

53.Under the legislation currently in force, the Government of Nicaragua has set up an inter-agency commission of experts to coordinate actions on behalf of persons with disabilities, as required to comply with the Nicaraguan Mandatory Technical Regulation on accessibility. The commission is coordinated by the Ministry of Transport and Infrastructure and provides expert support for its secretariat. It has powers to invite member agencies to explain agreements and commitments.

54.Training sessions have been held to raise awareness of the national implementation of Nicaraguan Mandatory Technical Regulation No. 12006-04 on accessibility and the amendments thereto. The Regulation was drafted by the Ministry of Transport and Infrastructure and approved in Official Gazette No. 253 of 29 December 2004.

55.Training sessions in the departments of Granada, Masaya, Matagalpa, Chinandega and Estelí were attended by 408 technical and professional staff members from municipal urban planning and land registry offices, as well as technical staff from the Nicaraguan Institute for Municipal Development and the Association of Municipalities of Nicaragua.

56.In coordination with organizations of persons with disabilities, the Nicaraguan Mandatory Technical Regulation on accessibility has been disseminated to technical staff and officials working in infrastructure-related areas of the following ministries: the Ministry of Education, the National Institute of Technology, the Ministry of Health, the Nicaraguan Sports Institute and the Nicaraguan Institute for Municipal Development. The ministries are now implementing the Regulation and a total of 140 technicians have received related training.

57.Through the National Council of Universities, a series of talks has been organized for 90 engineering and architecture students to ensure that during their studies they are made aware of the Technical Regulation on accessibility and can implement it once they begin working, whether for a public body or a private entity.

58.Another important initiative of the Nicaraguan authorities is the performance of technical inspections to assess compliance with and implementation of the Technical Regulation on accessibility in public and private buildings. The Accessibility Committee was set up to carry out this task. The Committee, which is coordinated by the Ministry for Transport and Infrastructure and includes representatives of organizations of persons with disabilities, selects existing and new buildings to inspect, analyses the findings and submits observations to a representative of the institution concerned so that corrective action can be taken.

59.The following buildings have been inspected:

Ministry of Transport and Infrastructure

Supreme Electoral Council: Central Office for Civil Registration and Identity Cards

Ministry of Labour

Central offices of the National Institute of Technology

Supreme Court of Justice: Property Registry

Government Services Office, Nicaraguan Social Security Institute, José Benito Escobar branch

Ministry of Education

Ministry of Health, Concepción Palacio site

Banco de América Central, head office

Banco de la Producción, head office

CITIBANK Nicaragua, head office

Casimiro Sotelo Transport Terminal, Roberto Huembés Market

Israel Lewites Transport Terminal, Israel Lewites Market

Rigoberto Cabezas Transport Terminal, Wholesale Market

Hispamer Cultural and Tourist Centre, new building

New National Judicial Centre

60.Schools, Secondary Schools and Vocational Training Centres:

National Academy of Languages, National Institute of Technology

Carlos Manuel Vanegas Olivas Agriculture and Livestock Technical College, Department of Chinandega

José Dolores Estrada Agriculture and Livestock Technical Institute, department of Granada, municipality of Nandaime

Santiago Baldovino Agriculture and Livestock Technical College, department of Matagalpa, municipality of Muy

Atlántico Sur Autonomous Region Agriculture and Livestock Technical College, municipality of Nueva Guinea

Agriculture and Livestock Technical Institute, department of Chontales, municipality of Juigalpa

National Administration and Economics Institute, department of Chinandega, municipality of Chichigalpa

National Forestry Institute, department of Estelí, municipality of Estelí

National Administration and Economics Institute, department of Estelí, municipality of Estelí

German-Nicaraguan Vocational Training Centre, department of Managua, municipality of Managua

Simón Bolívar Vocational Training Centre, department of Managua, municipality of Managua

National Administration and Economics Institute, department of Magua, municipality of Managua

Polytechnic Institute, department of Boaco, Boaco municipality

José Martí Techer Training College, municipality of Matagalpa, department of Matagalpa

Augusto C. Sandino Public School, municipality of Ciudad Sandino, department of Managua

Ernesto Che Guevara Public School, municipality of Villa El Carmen, department of Managua

Divino Niño School, municipality of La Libertad, department of Chontales

El Tuma School, municipality of La Dalia, department of Matagalpa

Hugo Chávez School, Clementina Cabezas School, Hispanidad School and Cristo Rey School, municipality of Managua, department of Managua

14 de Septiembre School, municipality of San Carlos, department of Río San Juan

Solomon de la Selva Institute, municipality of León, department of León

Josefa Toledo National Institute, municipality of Juigalpa, department of Chontales

Eliseo Picado National Institute, municipality of Matagalpa, department of Matagalpa

Héroes y Mártires de La Reforma National Institute, municipality of Masaya, department of Masaya

Maestro Gabriel Institute and Ramírez Goyena Institute, municipality of Managua, department of Managua.

Hospitals and Health Centres

No.	2007– 2 012: Sandinista National Liberation Front – Government of Reconciliation and National Unity	Type of facility	Department	Type of work undertaken
Public Investment Programme 2007–2012
1	Expansion and repair of the Muelle de los Bueyes Health Centre	Health centre	Chontales	Renovation
2	Construction of a children’s unit at the German-Nicaraguan Hospital, Managua	Hospital	Managua	Renovation
3	Renovation of the Julio Duran Health Centre, Chichigalpa, Chinandega	Health centre	Chinandega	Renovation
4	Construction of the La Primavera Health Post, Managua	Health post	Managua	New construction
5	Construction of the José Niebrowsky Hospital, Boaco	Hospital	Boaco	Replacement building
6	Construction of the Camilo Ortega Health Post, Managua	Health post	Managua	New construction
7	Construction of the Laureles Sur Health Post, Managua	Health post	Managua	New construction
8	Construction of the San Rafael del Norte Health Centre, Jinotega	Health Centre	Jinotega	New construction
9	Construction of the Muelle de los Bueyes Primary Hospital, Chontales	Primary hospital	Chontales	New construction
10	Construction of the head office of the comprehensive local health-care system, Atlántico Norte Autonomous Region	Other	Atlántico Norte Autonomous Region	New construction
11	Las Breñas Health Post, Rosita, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	New construction
12	Construction of the Fruta de Pan Health Post, Rosita, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	New construction
13	Replacement of the Klisnak Health Post, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Replacement building
14	Replacement of the Wisconsin Health Post, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Replacement building
15	Construction of Kukra Hill Maternity Centre, Atlántico Sur Autonomous Region	Maternity centre	Atlántico Sur Autonomous Region	New construction
16	Construction of a gynaecology and obstetrics unit at the German-Nicaraguan Hospital, Managua	Hospital	Managua	Renovation
17	Construction of an intensive care unit at the German-Nicaraguan Hospital, Managua	Hospital	Managua	Renovation
18	Construction of the Tipitapa Primary Hospital, Managua	Primary hospital	Managua	Replacement building
19	Construction of the San Rafael del Sur Health Centre, Managua	Health centre	Managua	New construction
20	Construction of the Jorge Dimitrov Health Post, Managua	Health post	Managua	New construction
21	Construction of the Santa María de los Ángeles Health Post, Managua	Health post	Managua	New construction
22	Construction of the El Sauce Primary Hospital	Primary hospital	León	New construction
23	Construction of the San Juan de Río Coco Primary Hospital, Madriz	Primary hospital	Madriz	New construction
24	Renovation and expansion of the La Cruz de Río Grande Health Centre, Atlántico Sur Autonomous Region	Health centre	Atlántico Sur Autonomous Region	Renovation
25	Construction of the El Triunfo Health Post, El Almendro	Health post	Rio San Juan	New construction
26	Physiotherapy unit at the Juan Antonio Brenes Hospital, Somoto, Madriz	Hospital	Madriz	Renovation
27	Héroes y Mártires de San José de la Mulas Primary Hospital, La Dalia, Matagalpa	Primary hospital	Matagalpa	New construction
28	Construction of the Prinzu Pawanka Primary Hospital, Prinzapolka, Atlántico Norte Autonomous Region	Primary hospital	Atlántico Norte Autonomous Region	New construction
29	Carlos Fonseca Primary Hospital, Mulukuku, Atlántico Norte Autonomous Region	Primary hospital	Atlántico Norte Autonomous Region	New construction
30	Hospital wards, España Hospital, Chinandega	Hospital	Chinandega	Renovation
31	Renovation of the Somotillo Primary Hospital, Chinandega	Primary hospital	Chinandega	Renovation
32	Renovation of the Murra Health Centre, Nueva Segovia	Health Centre	Nueva Segovia	Renovation
33	La Esperanza Health Centre, El Rama, Atlántico Sur Autonomous Region	Health centre	Atlántico Sur Autonomous Region	Renovation
34	Renovation of the José Dolores Estrada Health Centre, Managua	Health centre	Managua	Renovation
35	Renovation of the Amak Bocay Health Centre, Jinotega	Health centre	Jinotega	Renovation
36	Expansion of the Corn Island Health Centre, Atlántico Sur Autonomous Region	Health centre	Atlántico Sur Autonomous Region	Renovation
37	Remodelling of the operating theatres at the Luís Felipe Moncada Hospital, Río San Juan	Hospital	Río San Juan	Renovation
38	Renovation and expansion of the Sabana Grande Health Post, Managua	Health post	Managua	Renovation
39	Renovation of the Chichigalpa Health Centre, Chinandega	Health centre	Chinandega	Renovation
40	Renovation of the Hermanos Martínez Health Post, Somoto, Madriz	Health post	Madriz	Renovation
41	Renovation of the Terrabona Health Centre, Matagalpa	Health centre	Matagalpa	Renovation
42	Renovation of the San Francisco de Asís de Camoapa Primary Hospital, Boaco	Primary hospital	Boaco	Renovation
43	Renovation of the critical care facilities at the Asunción Hospital in Juigalpa, Chontales	Hospital	Chontales	Renovation
44	Expansion and remodelling of the Puerto Cabezas Polyclinic, Atlántico Norte Autonomous Region	Health centre	Atlántico Norte Autonomous Region	Renovation
45	Renovation of the Rosita Primary Hospital, Atlántico Norte Autonomous Region	Primary hospital	Atlántico Norte Autonomous Region	Renovation
46	Rehabilitation of the emergency unit of the Ernesto Sequeira Bluefields Hospital, Atlántico Sur Autonomous Region	Hospital	Atlántico Sur Autonomous Region	Renovation
47	Renovation of the National Diagnostics and Referral Centre, Managua	Other	Managua	Renovation
48	Renovation and expansion of the Carlos Rugama Health Centre, Managua	Health centre	Managua	Renovation
49	Renovation of seven operating theatres at the Oscar Danilo Rosales Hospital, León	Hospital	León	Renovation
50	Renovation of the emergency unit at the La Trinidad Hospital, Estelí	Hospital	Estelí	Renovation
51	Renovation of the critical care facilities (three operating theatres, emergency unit and intensive care unit) at the San Juan de Dios Hospital, Estelí	Hospital	Estelí	Renovation
52	Renovation of the Condega Health Centre, Estelí	Health centre	Estelí	Renovation
53	Renovation of the San Andrés Health Post, Wiwili, Jinotega	Health centre	Jinotega	Renovation
54	Renovation and expansion of the Raití Health Post, Waspan, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
55	Construction of the Laguna de Perlas Maternity Centre, Atlántico Sur Autonomous Region	Maternity centre	Atlántico Sur Autonomous Region	New construction
56	Renovation of the emergency unit at the Santiago de Jinotepe Hospital	Hospital	Carazo	Renovation
57	Renovation of the intensive care unit at the Bertha Calderón Hospital, Managua	Hospital	Managua	Renovation
58	Renovation of infrastructure at the National Ophthalmology Centre, Managua	Hospital	Managua	Renovation
59	Renovations to ceilings in the operating block at the Luis Felipe Moncada Hospital, San Carlos	Hospital	Rio San Juan	Renovation
60	Remodelling and refitting of the women’s wards and operating theatres at the Asunción Regional Hospital, Juigalpa, Chontales	Hospital	Chontales	Renovation
61	Renovation of the Raiti Maternity Centre	Maternity centre	Atlántico Norte Autonomous Region	Renovation
62	Replacement of the Lapan Health Post	Health post	Atlántico Norte Autonomous Region	Replacement building
63	Expansion of the El Sauce Primary Hospital	Primary hospital	León	Renovation
64	Replacement of the Leonel Rugama Family Health Centre in Estelí (Stages I and II)	Health centre	Estelí	Replacement building
65	Renovation of three operating theatres at the Manuel de Jesús Rivera Hospital, La Mascota	Hospital	Managua	Renovation
66	Construction of the Nejapa Health Post	Health post	Managua	New construction
67	Construction of a perimeter wall at the Humberto Alvarado Hospital, Masaya	Hospital	Masaya	Renovation
68	Construction of the Cárdenas Maternity Centre, Rivas	Maternity centre	Rivas	New construction
69	Renovation of the emergency unit and clinical laboratory and construction of an outpatient unit of the Luis Felipe Moncada Hospital in San Carlos	Hospital	Rio San Juan	Renovation
70	Construction of a maternity centre in the Community of El Naranjo, Waslala	Maternity centre	Matagalpa	New construction
71	Replacement of the maternity centre in Puerto Cabezas, Atlántico Norte Autonomous Region	Maternity centre	Atlántico Norte Autonomous Region	Replacement building
72	Construction of the maternity centre in Yalí, Jinotega	Maternity centre	Jinotega	New construction
73	Construction of the Santa Teresa Health Centre, Carazo	Health centre	Carazo	Replacement building
74	Construction of the health centre in the municipality of La Libertad, Chontales	Health centre	Chontales	Replacement building
75	Replacement of the health centre in the municipality of San Carlos, Rio San Juan	Health centre	Rio San Juan	Replacement building
76	Construction of the Chichigalpa Primary Hospital	Primary hospital	Chinandega	New construction
77	Replacement of Biltignia Community Health Post No. 1, Bonanza, Atlántico Norte Autonomous Region (Emergency Social Investment Fund)	Health post	Atlántico Norte Autonomous Region	Replacement building
78	Ciudad Sandino Ophthalmology Centre, Managua	Health centre	Managua	New construction
79	Villa Soberana Health Post, Ciudad Sandino, Managua	Health post	Managua	New construction
80	Antenor Sandino Health Post, León, Perla María, 2007	Health post	León	New construction
81	San Miguelito Health Post, Larreynaga-Mina Limón, 2008	Health post	León	New construction
82	La Concha Health Post, Villanueva, Chinandega	Health post	Chinandega	New construction
83	Centre for Adolescent Health, Sto Tomás del Norte, Chinandega	Other	Chinandega	New construction
84	Jinotepe Health Centre, Carazo	Health centre	Carazo	New construction
85	Buena Vista Health Post, La Conquista, Carazo	Health post	Carazo	New construction
86	Muy Muy Maternity Centre, Matagalpa	Maternity centre	Matagalpa	New construction
87	Bluefields Ophthalmology Centre, Atlántico Sur Autonomous Region	Health centre	Atlántico Sur Autonomous Region	New construction
88	Walpa Karawala Health Post, Atlántico Sur Autonomous Region	Health post	Atlántico Sur Autonomous Region	New construction
89	La Barra Karawala Health Post, Atlántico Sur Autonomous Region	Health post	Atlántico Sur Autonomous Region	New construction
90	Guadalupe Karawala Health Post, Atlántico Sur Autonomous Region, 2007	Health post	Atlántico Sur Autonomous Region	New construction
91	Kara Karawala Health Post, Atlántico Sur Autonomous Region, 2007	Health post	Atlántico Sur Autonomous Region	New construction
92	Hugo Chávez Health Post, Managua	Health post	Managua	New construction
93	Agua Fria el Pilon-El Sauce Health Post, 2008	Health post	León	New construction
94	Clinic for patients with chronic kidney failure, El Viejo Sur, Chinandega	Other	Chinandega	New construction
95	Yalagûina Health Centre, Madriz	Health centre	Madriz	New construction
96	San José de Cusmapa Maternity Centre, Madriz	Maternity centre	Madriz	New construction
97	Construction of the San Juan de Awaswa Health Post (2008)	Health post	Jinotega	New construction
98	Bilwi Ophthalmology Centre, Atlántico Norte Autonomous Region	Health centre	Atlántico Norte Autonomous Region	New construction
99	Replacement of the Klingna Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Replacement building
100	Replacement of the Awas Yari Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Replacement building
101	Replacement of the Rahwawatla Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Replacement building
102	Replacement of the Regional Nursing School, Puerto Cabezas, Atlántico Norte Autonomous Region	Other	Atlántico Norte Autonomous Region	New construction
103	Replacement of the Dakra Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Replacement building
104	Replacement of the Kambla Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Replacement building
105	Replacement of the San Pablo Health Post, Puerto Cabezas Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Replacement building
106	Replacement of the Sangnilaya Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Replacement building
107	Replacement of the Sukatpin Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Replacement building
108	Replacement of the Betania Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Replacement building
109	Replacement of the Sumubila Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Replacement building
110	Construction of an outpatient clinic and medical supplies warehouse in Waspam, Atlántico Norte Autonomous Region	Health centre	Atlántico Norte Autonomous Region	Renovation
111	Replacement of the Kuahkwil Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Replacement building
112	Labour and delivery units, Bertha Calderón Hospital, Managua	Hospital	Managua	Renovation
113	La Chureca Health Post, Managua	Health post	Managua	New construction
114	Pagronica Health Post, El Jicaral, 2009	Health post	León	New construction
115	Adolescent Health Unit, Corinto Hospital, Chinandega	Hospital	Chinandega	Renovation
116	La Grecia Health Post, Chinandega	Health post	Chinandega	New construction
117	Belén Health Post, Chinandega	Health post	Chinandega	New construction
118	Los Laureles Health Posts, El Viejo Norte, Chinandega	Health post	Chinandega	New construction
119	Auditorium and three cubicles, El Viejo Sur, Chinandega	Health centre	Chinandega	Renovation
120	Auditorium at the Monimbó Health Centre, Masaya	Health centre	Masaya	Renovation
121	Enrique Cisne Health Centre, Nindirí, Masaya	Health centre	Masaya	New construction
122	La Montañita Health Post, Tisma, Masaya	Health post	Masaya	New construction
123	Mother and baby unit, Jinotepe Maternity Hospital, Carazo (2009)	Hospital	Carazo	Renovation
124	Construction of the San Jorge Health Centre, Rivas	Health centre	Rivas	New construction
125	Construction of the Pica Pica Health Post, Potosí, Rivas	Health post	Rivas	New construction
126	Construction of the Physiotherapy Unit at the Dr. Alfonso Moncada Guillén Hospital	Hospital	Nueva Segovia	Renovation
127	Sébaco Maternity Centre, Matagalpa	Maternity centre	Matagalpa	New construction
128	Construction of the Plan de Grama Maternity Centre, Wiwilí	Maternity centre	Jinotega	New construction
129	Construction of patient accommodation, El Cuá, Jinotega	Accommodation	Jinotega	New construction
130	Construction of patient accommodation, Bocay, Jinotega	Accommodation	Jinotega	New construction
131	Construction of labour and delivery unit, Neonatal Hospital, Nuevo Amanecer, Atlántico Norte Autonomous Region	Hospital	Atlántico Norte Autonomous Region	Renovation
132	Replacement of the Nueva Jerusalén Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Replacement building
133	Construction of maternity centre, Rosita, Atlántico Norte Autonomous Region	Maternity centre	Atlántico Norte Autonomous Region	New construction
134	La Cruz de Río Grande Maternity Centre, Atlántico Sur Autonomous Region	Maternity centre	Atlántico Sur Autonomous Region	New construction
135	Solidaridad Hospital, Managua	Hospital	Managua	New construction
136	Las Torres Health Post, Managua	Health post	Managua	New construction
137	Somotillo Maternity Centre, Chinandega	Maternity centre	Chinandega	New construction
138	San Remigio Health Post, El Viejo Norte, Chinandega	Health post	Chinandega	New construction
139	Alejandro Calero Health Centre, Masaya	Health centre	Masaya	New construction
140	Silvio González Health Post, Diriamba, Carazo	Health post	Carazo	New construction
141	Diriamba Health Centre, Carazo	Health centre	Carazo	New construction
142	Belén Health Centre, Rivas (2010)	Health centre	Rivas	New construction
143	Expansion of wards for patients with health insurance, Ocotal branch, Nueva Segovia	Hospital	Nueva Segovia	Renovation
144	Construction of the El Jícarito Health Post, Macuelizo, Nueva Segovia	Health post	Nueva Segovia	New construction
145	Matagalpa Ophthalmology Centre	Health centre	Matagalpa	New construction
146	Villa Sikia Health Post, Paiwas, Matagalpa (2010)	Health post	Matagalpa	New construction
147	Kuwali Maternity Centre, Matagalpa	Maternity centre	Matagalpa	New construction
148	San Isidro Maternity Centre, Matagalpa	Maternity centre	Matagalpa	New construction
149	Cocal Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	New construction
150	Barrio Los Angeles Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	New construction
151	El Corozo Health Post	Health post	Atlántico Norte Autonomous Region	New construction
152	Silibila Health Post, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	New construction
153	Annex to the Women’s Unit, Ernesto Sequeira Hospital, Atlántico Sur Autonomous Region	Hospital	Atlántico Sur Autonomous Region	Renovation
154	Annex to the Neonatology Unit, Ernesto Sequeira Hospital, Atlántico Sur Autonomous Region, 2010	Hospital	Atlántico Sur Autonomous Region	Renovation
155	Detoxification Unit, Hospital Atlántico Sur Autonomous Region, 2010	Hospital	Atlántico Sur Autonomous Region	Renovation
156	Annex to the Kukra River Health Centre, Atlántico Sur Autonomous Region, 2010	Health centre	Atlántico Sur Autonomous Region	Renovation
157	Accommodation for relatives of patients, Roberto Calderón Hospital	Accommodation	Managua	New construction
158	Construction of the Haematology-Oncology Unit, Phase II, Roberto Calderón Hospital	Hospital	Managua	Renovation
159	Iraní Polyclinic, Managua District VII, Managua	Health centre	Managua	New construction
160	Lidia Saavedra Polyclinic for Older Persons, Managua	Health centre	Managua	New construction
161	Las Pozas Health Post, Cinco Pinos, Chinandega	Health post	Chinandega	New construction
162	Cinco Pinos Maternity Centre, Chinandega	Maternity centre	Chinandega	New construction
163	Health Documentation Centre, Corinto Hospital, Chinandega	Hospital	Chinandega	Renovation
164	Sto. Tomas del Norte Maternity Centre, Chinandega	Maternity Centre	Chinandega	New construction
165	Consultation and waiting rooms, Masatepe Health Centre, Masaya	Health centre	Masaya	Renovation
166	Telpaneca Maternity Centre, Madriz	Maternity centre	Madriz	New construction
167	Construction and fitting out of premises of the National Endoscopy Service, Managua	Health centre	Managua	Renovation
168	Carlos Fonseca Rehabilitation Centre for the Blind, Managua	Other	Managua	New construction
169	Construction of the El Castillo Health Post, Río San Juan	Health post	Rio San Juan	New construction
170	Construction of the Dipilto Maternity Centre, Nueva Segovia	Maternity centre	Nueva Segovia	New construction
171	Construction of a health post in the community of Mezas de Alcayan, Nueva Segovia	Health post	Nueva Segovia	New construction
172	Construction of a mother and child ward at the Victoria Motta Hospital, Jinotega	Hospital	Jinotega	Renovation
173	Construction of the Ayapal Maternity Centre	Maternity centre	Jinotega	New construction
174	High-Risk Pregnancy Unit, César Amador Molina Hospital, Matagalpa	Hospital	Matagalpa	Renovation
175	Héroes y Mártires Maternity Centre, Matagalpa	Other	Matagalpa	New construction
176	Remodelling of the Outpatient Clinic at the German-Nicaraguan Hospital, Managua	Hospital	Managua	Renovation
177	Remodelling of the Emergency Unit at the German-Nicaraguan Hospital, Managua	Hospital	Managua	Renovation
178	Construction of accommodation, Bertha Calderón Hospital	Accommodation	Managua	Renovation
179	La Providencia Health Post, León, Sutiaba, (2007)	Health post	León	Renovation
180	Sabana Grande Health Post, El Sauce, (2007)	Health post	León	Renovation
181	Licoroy Health Post	Health post	Estelí	Renovation
182	Construction of the Dialysis Unit, Estelí Hospital	Hospital	Estelí	Renovation
183	Trinidad Guevara Polyclinic, Matagalpa	Health centre	Matagalpa	Renovation
184	Lacayo Farfán Health Post, Matagalpa	Health post	Matagalpa	Renovation
185	Salinas Grandes Health Post, León, Perla María, 2008	Health post	León	Renovation
186	Remodelling of the operating theatre, España Hospital, Chinandega, Ministry of Health	Hospital	Chinandega	Renovation
187	Expansion of the Birth Unit, Moyogalpa Hospital, Rivas	Hospital	Rivas	Renovation
188	Remodelling of the Maternity Centre, Altagracia, Rivas	Maternity centre	Rivas	Renovation
189	El Palmar Health Post, Estelí	Health post	Estelí	Renovation
190	Guanacastón Health Post, Estelí	Health post	Estelí	Renovation
191	Renovation of the Llano Largo Health Post, Estelí	Health post	Estelí	Renovation
192	Opening of an orthotics and prosthetics workshop at the La Trinidad Hospital, Estelí	Hospital	Estelí	Renovation
193	Construction of maternity accommodation, Estelí Hospital	Accommodation	Estelí	Renovation
194	Expansion of the laboratory at the La Trinidad Health Centre, Estelí	Health centre	Estelí	Renovation
195	Solingalpa Health Post, Matagalpa	Health post	Matagalpa	Renovation
196	Quebrada Honda Health Post, Matagalpa	Health post	Matagalpa	Renovation
197	Renovation of the Cuá Health Centre, Jinotega	Health centre	Jinotega	Renovation
198	Muelle de los Bueyes Health Centre, Chontales	Health centre	Chontales	Renovation
199	Repairs to the health post in Lapan, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
200	Repairs to the health post in Sahsa, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
201	Repairs to the Yulu Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
202	Repairs to the Sisin Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
203	Repairs to the Ninayari Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
204	Repairs to the Francia Sirpi Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
205	Repairs to the Tuara Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
206	Repairs to the Auyaphini Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
207	Repairs to the Krukira Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
208	Repairs to the Tuapi Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
209	Repairs to the Lidaukra Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
210	Repairs to the Maniwatla Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
211	Repairs to the Kahka Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
212	Replacement of the Pahara Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
213	Repairs to the Awas Tara Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
214	Repairs to the Dakban Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
215	Renovation of physicians’ accommodation, Waspam, Atlántico Norte Autonomous Region	Staff accommodation	Atlántico Norte Autonomous Region	Renovation
216	Remodelling of critical care facilities, Waspam Hospital, Atlántico Norte Autonomous Region	Hospital	Atlántico Norte Autonomous Region	Renovation
217	Installation of an incinerator at the Luis Felipe Moncada Hospital, Río San Juan	Hospital	Rio San Juan	Renovation
218	Renovation of the Yalagûina Maternity Centre, Madriz	Maternity centre	Madriz	Renovation
219	Rest areas for physicians, German-Nicaraguan Hospital, Managua	Hospital	Managua	Renovation
220	Jicarito Health Post, Telica, 2009	Health post	León	Renovation
221	Unión España Health Post, 2009	Health post	León	Renovation
222	Federico Hosanam Health Post, Larreynaga, 2009	Health post	León	Renovation
223	Santa Pancha Health Post, Larreynaga, Mina Limón, 2009	Health post	León	Renovation
224	MINVAH Health Post, Larreynaga, Mina Limón, 2009	Health post	León	Renovation
225	Sector 4 Isla del Amor Health Post, Corinto, Chinandega	Health post	Chinandega	Renovation
226	Sector 1B Health Post, Corinto, Chinandega	Health post	Chinandega	Renovation
227	Sector 6 Health Post, Corinto, Chinandega	Health post	Chinandega	Renovation
228	Augusto Cesar Sandino Health Post, Chinandega	Health post	Chinandega	Renovation
229	Roberto Cortez Health Centre, Chinandega	Health centre	Chinandega	Renovation
230	Remodelling of the emergency and mother and baby units, El Viejo Sur, Chinandega	Hospital	Chinandega	Renovation
231	Ramón Antonio López Health Post, El Realejo, Chinandega	Health post	Chinandega	Renovation
232	Edwin Chamorro Health Centre, Buenos Aires, Rivas	Health post	Rivas	Renovation
233	Tomabú Health Post (renovation), Estelí	Health post	Estelí	Renovation
234	Las Gavetas Health Post (renovation), Estelí	Health post	Estelí	Renovation
235	Installation of air conditioning in the pharmacy, X-ray suite and laboratory, Gynaecology Hospital, Estelí, 2009	Hospital	Estelí	Renovation
236	Renovation of the San Nicolás Maternity Centre, Estelí	Maternity centre	Estelí	Renovation
237	Renovation of the Camoapa Maternity Centre, Boaco	Maternity centre	Boaco	Renovation
238	Repairs to the Puerto Cabezas Maternity Centre, Atlántico Norte Autonomous Region	Maternity centre	Atlántico Norte Autonomous Region	Renovation
239	Renovation of the San Carlos Health Post, Waspam, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
240	Renovation of the Asang Health Post, Waspam, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
241	Renovation of the Krin Krin Health Post, Waspam, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
242	Renovation of the Andris Health Post, Waspam, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
243	Renovation of the Andris Tara Health Post, Waspam, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
244	Renovation of the Koom Health Post, Waspam, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
245	Renovation of the Bismona Health Post, Waspam, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
246	Renovation of the Bilwaskarma Health Post, Waspam, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
247	Renovation of the Lajon Health Post, Bonanza, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
248	Renovation of the Kukalaya Health Post, Bonanza, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
249	Renovation of the Aguas Claras Health Post, Bonanza, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
250	Remodelling of the Beholdeen Health Post, Bluefields, Atlántico Sur Autonomous Region	Health post	Atlántico Sur Autonomous Region	Renovation
251	Remodelling of the Pathology Department, German-Nicaraguan Hospital, Managua	Hospital	Managua	Renovation
252	Quezalguaque Health Centre (2010)	Health centre	León	Renovation
253	Pancasan Health Post, La Paz Centro (2010)	Health post	León	Renovation
254	Remodelling of the Emergency Unit, España Hospital, Chinandega, Ministry of Health	Hospital	Chinandega	Renovation
255	Respiratory Unit, Paediatrics, Children’s Hospital, Chinandega	Hospital	Chinandega	Renovation
256	Remodelling of the Gastroenterology Unit, Paediatrics, Children’s Hospital, Chinandega	Hospital	Chinandega	Renovation
257	Installation of washrooms and air conditioning, surgical unit, Paediatrics, Chinandega	Hospital	Chinandega	Renovation
258	Remodelling of the Diagnostic Ultrasound Unit, Children’s Hospital, Chinandega	Hospital	Chinandega	Renovation
259	Adolescent Health Unit, Children’s Hospital, Chinandega	Hospital	Chinandega	Renovation
260	Renovation of the Special Care Unit, Children’s Hospital, Chinandega	Hospital	Chinandega	Renovation
261	Renovation of the X-ray Unit, Children’s Hospital, Chinandega	Hospital	Chinandega	Renovation
262	Renovation of the Epidemiological Monitoring Office on the premises of the comprehensive local health-care system, Chinandega	Other	Chinandega	Renovation
263	Renovation of the surgical and emergency units, Somotillo Primary Hospital, Chinandega	Hospital	Chinandega	Renovation
264	El Guasaule Health Post, Somotillo, Chinandega	Health post	Chinandega	Renovation
265	Renovation of the kitchens	Hospital	Chinandega	Renovation
266	Remodelling of the mother and child unit, Corinto Hospital, Chinandega	Hospital	Chinandega	Renovation
267	Renovation of three consulting rooms, El Viejo Sur, Chinandega	Health centre	Chinandega	Renovation
268	Renovation of consulting and storage rooms, unit for vector-borne and rodent-borne diseases, El Viejo Sur, Chinandega	Health centre	Chinandega	Renovation
269	Renovation of the Héroes y Mártires Maternity Clinic, Masaya	Other	Masaya	Renovation
270	Remodelling of the HIV testing unit, research and study centre, Granada	Hospital	Granada	Renovation
271	Renovation of the Delivery Unit, Postnatal Unit, San Nicolás Health Centre, Estelí, 2010 R	Health centre	Estelí	Renovation
272	Roof of the Leónidas García Health Centre, Ciudad Antigua, Nueva Segovia	Health centre	Nueva Segovia	Renovation
273	Repairs to the Las Brisas Health Post, Santa María, Nueva Segovia	Health post	Nueva Segovia	Renovation
274	Muelle Health Post, Puerto Cabezas, Atlántico Norte Autonomous Region, 2010	Health post	Atlántico Norte Autonomous Region	Renovation
275	Expansion of the Laguna de Perlas Health Centre, Atlántico Sur Autonomous Region	Health centre	Atlántico Sur Autonomous Region	Renovation
276	Miguel Bikan Health Centre, Waspam, Atlántico Norte Autonomous Region	Health post	Atlántico Norte Autonomous Region	Renovation
277	Gynaecology and Oncology Centre, Bertha Calderón Hospital, Managua	Hospital	Managua	Renovation
278	Remodelling of the Haematology-Oncology Unit, first stage, Roberto Calderón Hospital	Hospital	Managua	Renovation
279	Remodelling of the dining room, Roberto Calderón Hospital, Managua	Hospital	Managua	Renovation
280	Infrastructure and electrical system, National Radiotherapy Centre, Managua	Hospital	Managua	Renovation
281	Remodelling of the Emergency Unit, Maternity Hospital, África 70	Hospital	Chinandega	Renovation
282	Remodelling of the postnatal unit, Maternity Hospital, África 70	Hospital	Chinandega	Renovation
283	Lighting in green areas and the emergency unit, Corinto Hospital, Chinandega	Hospital	Chinandega	Renovation
284	Renovation of the HIV clinic, Humberto Alvarado Hospital, Masaya	Hospital	Masaya	Renovation
285	Remodelling of the external consulting area of the HIV clinic, Granada	Hospital	Granada	Renovation
286	Remodelling of the Pedro Narváez Cisneros Health Post, Jinotepe	Health post	Carazo	Renovation
287	Remodelling of the Pedro Narváez C. Jinotepe Health Post, area for patients with health insurance, Maestro Hospital	Health post	Carazo	Renovation
288	Palacagüina physiotherapy room, Madriz	Health centre	Madriz	Renovation
289	Renovation of the Situation Room and Emergency Operations Centre on the premises of the comprehensive local health-care system, Nueva Segovia	Other	Nueva Segovia	Renovation
290	Replacement of the offices of the Tropical Diseases Programme, Ocotal	Other	Nueva Segovia	Renovation
291	Renovation of the labour and delivery units, Enoc Ortez Health Centre, San Fernando	Health centre	Nueva Segovia	Renovation
292	Construction of maternity centre, Macuelizo, Nueva Segovia	Maternity centre	Nueva Segovia	Renovation
293	Construction of the Los Chiles Maternity Centre	Maternity centre	Rio San Juan	New construction
294	San Juan de Nicaragua Health Post, Río San Juan	Health post	Rio San Juan	Renovation
295	Expansion of the El Cuá Maternity Centre	Maternity centre	Jinotega	Renovation
296	Expansion of the San José de Bocay Maternity Centre	Maternity centre	Jinotega	Renovation
297	Construction of a septic tank at the San Rafael del Sur Health Centre	Health centre	Managua	Renovation
298	Construction of the Pantasma Maternity Centre	Maternity centre	Jinotega	New construction
299	Construction of the Wiwilí Maternity Centre	Maternity centre	Jinotega	New construction
300	Improvement of the wastewater system at the El Sauce Primary Hospital	Hospital	León	Renovation
301	Remodelling of the nuclear medicine building at the National Radiotherapy Centre	Hospital	Managua	Renovation
302	Renovation of facilities for patients with health insurance, Masaya	Other	Masaya	Renovation
303	Renovation of facilities for patients with health insurance, Matagalpa	Other	Matagalpa	Renovation
304	Renovation of facilities for patients with health insurance, Solidaridad	Other	Managua	Renovation
305	Renovation of facilities for patients with health insurance, Boaco	Other	Boaco	Renovation
306	Renovation of facilities for patients with health insurance, El Maestro, Diriamba	Other	Carazo	Renovation
307	Expansion and renovation of facilities for patients with health insurance, Granada	Other	Granada	Renovation

61.Demonstrating its commitment to compliance with the Regulation on accessibility, the Government of Nicaragua, through the Ministry of Transport and Infrastructure, has taken measures to ensure respect for and the restitution of the rights of persons with disabilities in the context of transportation, including by:

Designing technical specifications for the purchase of new transportation vehicles that establish requirements for space and lifting equipment (ramps)

Including improvements to accessibility in the requirements for new intercity transport terminal buildings

Providing support to mayors’ offices in the fitting out of new public transportation vehicles and adaptation of existing intercity transport terminals

Working in coordination with the Managua Municipal Council for Markets to install accessibility signs in land transport terminals (the Municipal Council being responsible for the administration of such terminals)

Disseminating the Regulation on accessibility via departmental transport offices, thereby ensuring that it is taken into account and applied in the field of transport

Beginning the process of acquiring 35 urban public transportation vehicles equipped with ramps and spaces for persons with disabilities in the municipality of Managua

62.With regard to support for older persons, particularly those with disabilities, and in compliance with the Nicaraguan Mandatory Technical Regulation on accessibility, buildings that house offices and support centres for older persons in 14 departmental facilities and payment centres have been equipped with access ramps, handrails, accessible bathrooms and wide doors to facilitate mobility and accessibility. Two pharmacies, two eye clinics, an occupational health clinic, a clinic for older persons and the Solidarity Hospital of the Nicaraguan Social Security Institute have also been made accessible.

63.Through local governments, the State has guaranteed accessibility in 14 municipalities, namely, Estelí, Matagalpa, Jinotega, Ocotal, Bluefields, Bilwi, Managua, Nagarote, Juigalpa, El Jícaro, La Paz Centro, Masaya, Nindirí and Niquinómo, by installing paths, platforms, parks, sports facilities, ramps and signs for persons with disabilities. Six municipalities, namely, Estelí, Managua, Masaya, Jinotega, Ocotal and Puerto Cabezas, have approved accessibility ordinances (see annex No. 3: Accessibility works).

Accessibility of information

64.Through its ministries and autonomous institutions, the Government of Nicaragua is making efforts to uphold the right of access to information. To this end, a number of national professional training courses have been made accessible to persons with disabilities, including a computing course using the JAWS application designed for persons with visual impairments, a basic sign language course, orientation and mobility courses and Braille courses.

65.Act No. 621 on Access to Public Information is thus adhered to both in law and in practice. An Access to Public Information Office has been set up in each ministry to provide the public with access to ministerial decisions and agreements.

66.The Government of Reconciliation and National Unity is also endeavouring to ensure that all messages broadcast by the President and the National Assembly are accompanied by interpretation into Nicaraguan Sign Language.

Right to life

67.The State of Nicaragua protects and preserves life from the moment of conception, a stance that it considers law under the following terms:

(a)The law is a legal system rooted in a society;

(b)The law arises and exists to serve people and is a means whose end is the people;

(c)Hominun causa omne ius constitutum est (“every law is created for the benefit of man”) (Hermogenian, Roman jurist).

68.Life is therefore a legal right that is the root of all other legal rights. Without life, no rights can be exercised.

69.The Constitution recognizes the right to life, which is defined in the following articles:

(a)Article 23. The right to life is inviolable and is inherent to every human being. There shall be no death penalty in Nicaragua.

(b)Article 74. The State grants special protection to the process of human reproduction.

70.Women enjoy special protection during pregnancy and are granted maternity leave with pay and all appropriate social security benefits.

71.No one may deny employment to women on grounds of pregnancy or dismiss them during pregnancy or the postnatal period, in conformity with the law.

72.These are legal arguments that allow the State to protect the lives of both the woman and the child in the womb. One of the institutions that ensures that life is protected is the Ministry of Health. Its protocols describe how cases should be handled if complications arise.

Social security

73.Through the Nicaraguan Social Security Institute, the State guarantees the economic and health benefits described in the Social Security Act and its Regulations for all insured persons, retirees and war victims, with or without disabilities (see annex No. 4: Act No. 175, Pension Reserve Act, electronic folder of laws).

74.Persons with a permanent partial or total disability are compensated with economic benefits intended to repair the harm caused by loss of earnings capacity, as determined by the Disability Commission.

75.Health service providers also grant health benefits to all insured and retired persons, with or without disabilities. They provide comprehensive surgical and medical care based on the principles of bioethics, namely, justice, charity and autonomy accompanied by quality, efficiency, effectiveness, safety and compassion. Health service providers are also involved in work to promote, prevent and monitor communicable and non-communicable diseases, and in their diagnosis, treatment and rehabilitation, in accordance with the rules of the Ministry of Health and the Nicaraguan Institute of Social Security.

76.The State has a Directorate of Direct Medical Services which provides a number of supplementary medical services to insured persons, retirees and war victims, including:

Glasses, contact lenses and ocular prostheses

Hearing aids and prostheses for deafness

External prostheses and orthoses

77.The State ensures compliance with article 86 of the Social Security Act, which stipulates that persons in receipt of an old-age, invalidity or permanent total disability pension whose physical condition is such that they require the assistance of another person on a permanent basis and who have been assessed by the Disability Commission, are granted an assistance allowance equal to 20 per cent of the basic pension, which may not under any circumstances be less than 50 per cent of the general minimum wage in force.

78.On 19 July 2013, under Presidential Decree No. 28-2013, the rights of older persons and persons with disabilities were upheld through the granting of a reduced pension to those who do not make the contributions set out in the Social Security Act (see annex No. 5: Presidential Decree No. 28-2013).

Health

79.The legal and institutional framework for the restitution of the rights of persons with disabilities in Nicaragua includes the following instruments:

Act No. 423, the General Act on Health

Decree No. 001-2003, the Regulations implementing the General Act on Health

Regulation No. 045, on the protocol for bed sores and venous ulcers

Memorandum of cooperation between the Ministry of Health, the disability sector and the Office of the Human Rights Ombudsman

Agreement on health care with organizations of older persons

Act No. 70, establishing the Alcohol and Drug Addiction Institute

Protocols for the care of chronic patients, neonatal care and Operation Miracle, which have been reviewed and updated

80.These laws and agreements are legal instruments that are binding on health-care practitioners nationwide. Their purpose is to restore the rights of persons with disabilities by adapting offices and facilities so as to guarantee their accessibility for persons with disabilities, and ensuring the availability of specialized medical care, including assistive devices (wheelchairs, orthotics and prosthetics) and, where necessary, specialized testing, external consultations, internal medicine, psychological assistance, physical, speech, occupational and hydrotherapy, electromyography, the filling of prescriptions, wheelchairs, walkers, and prosthetics, orthotics and assistive device workshops.

81.The Aldo Chavarría hospital, the Trinidad hospital and the nursing school in Puerto Cabeza provide 300 prosthetic and 480 orthotic devices per year.

82.The Government has taken action to respond to the auxiliary needs identified in the “A Voice for All” biological and psychosocial survey, in particular by distributing 4,000 wheelchairs through the Ministry of Health, municipal authorities and the “Promotoría Solidaria” outreach programme as well as crutches, white canes and walkers to over 1,400 persons with disabilities.

Prevention of blindness

83.Operation Miracle is running in five locations:

the Carlos Fonseca centre in Matagalpa

the Sandino centre in Managua

one centre in Bluefields

two mobile centres currently located in Carazo and Chontales.

84.Since 2007, 122,545 people have undergone surgery.

85.The Comandante Carlos Fonseca Amador national centre for the rehabilitation of blind and visually impaired persons will provide assistance to persons with visual impairments by helping them to develop various skills, at a cost of 7,035,000 córdobas.

86.The centre measures 790 m2 and includes classrooms, an auditorium, living areas, equipment stores and sleeping quarters.

87.There are audiology centres in Managua, León, Matagalpa, Estelí and Jinotega. Over 300 hearings aids have been distributed and 700 hearing tests administered. There are 22 ear, nose and throat offices in 14 local comprehensive health-care systems and 22 trainee doctors in this specialty. Training in hearing loss care is provided.

88.In addition, through inter-institutional coordination the State ensures that health-care units carry out those special tests and procedures that they are able to provide themselves and provide procedural support for those special tests that are not available through medical services but are necessary for the care of persons with disabilities. It also provides persons with disabilities with all medication and diagnostic and laboratory tests prescribed by professionals affiliated with the Ministry of Health without charge.

89.As one of the Government’s goals is to reduce infant and neonatal mortality, it has rolled out the maternity houses (Casas Maternas) programme, whose primary function is to prevent pregnancy-related complications and problems in newborns, thus preventing disability in children from conception. To this end, 100 maternity houses, with a total capacity of 1,200 beds, have been equipped or built in rural areas and in ethnic and indigenous communities. In 2006, 9,200 births were overseen there, a figure that had tripled by 2012, reaching 25,160 births that year. As a result, the risk of maternal death and of disability has diminished, and birth registration is guaranteed (see annex 6: Casas Maternas network).

90.This State-run programme won the 2011 Americas Prize. The Government of Nicaragua was awarded the Americas Prize for its national Casas Maternas strategy by the United Nations International Training Centre for Local Actors in Atlanta since it met the following three criteria:

Achieving excellence in performance and improvement

Demonstrating excellence in innovation

Adhering to the highest ethical standards

Physical rehabilitation

91.One of the commitments assumed by Nicaragua is to prioritize rehabilitation. Accordingly, it has strengthened the network of rehabilitation services under the Ministry of Health. There are currently 38 level-1 physiotherapy units in health-care centres and 22 rehabilitation services located in departmental hospitals. There is also one teaching hospital specialized in rehabilitation (Aldo Chavarría hospital) and one national referral hospital (Antonio Lenin Fonseca hospital), as well as three centres for the production of prosthetic, orthotic and other assistive devices, located in Managua, Estelí and Puerto Cabezas.

92.In addition, a health centre with a physiotherapy service has been built in the Atlántica Norte autonomous region (Puerto Cabezas) and another is nearing completion at Ocotal hospital in the department of Nueva Segovia. These facilities enhance the comprehensive assistance being provided to persons with disabilities in the northern and Caribbean areas of the country.

93.The Aldo Chavarría hospital has broadened its scope, moving from being a centre for persons with motor disabilities to being a rehabilitation centre for blind persons and persons with motor disabilities and thus extending the coverage of its basic functional training services to 50 blind persons within a four-month period.

94.At the national level, the National Institute of Technology has established close coordination with the Ministry of Health at the Aldo Chavarría rehabilitation hospital, where periodic training is provided to trainee doctors in physiatry, enabling them to intervene early with persons with disabilities so that they receive the professional and employment habilitation needed for their new life circumstances.

Disability and the prevention of HIV/AIDS

95.In November 2007, at the Central American Congress on AIDS (CONCASIDA), Nicaragua initiated a drive to tackle the issue of HIV and persons with disabilities. Although there is no data on persons with disabilities living with the virus, Nicaragua understands that having the disease leads to limitations and restrictions. Accordingly, in 2008, it introduced training in aspects of prevention for leaders of the disability sector and encouraged exchanges between the National Council for Persons with Disabilities and the National AIDS Council. In addition, steps have been taken to encourage persons with disabilities to participate in events and activities organized by the National Council for Persons with Disabilities. In 2010, HIV prevention materials were developed in sign language and Braille. Furthermore, consultations have been undertaken with a view to launching or printing documents that can be read or studied by persons with disabilities.

96.In 2010, an HIV prevention campaign consisting of posters in sign language was launched, and was followed by forums and training sessions with an emphasis on HIV prevention for persons with motor disabilities, deaf persons and blind persons with the fundamental aim of recognizing them as sexual beings.

97.Representatives of the Office of the Civil Branch of Government for Organizations of Persons with Disabilities have been a part of the National AIDS Council since 2013.

98.When the relevant law was amended, measures relating to prevention and care were included for the benefit of persons with disabilities.

The “A Voice for All” (Todos Con Voz) programme

99.In recognition of the need to restore the rights of persons with disabilities, a biological, psychosocial, pedagogical, clinical and genetic study called “A Voice for All” was conducted.

100.The study was piloted in Masaya from 8 October 2009, as the first stage of work on the topic of disability, and was based on tangible facts that made it possible to identify all persons with disabilities, assess their biological and psychosocial condition and determine potential causal factors.

Objectives of the study

101.The first objective was to study the world and psychosocial specificities of persons with disabilities and develop a profile of the population of persons with disabilities.

102.The second objective was to ascertain the causes of disability or the events associated with them.

103.The third objective was to identify this population group’s main needs.

104.The final objective was to promote strategies to improve the support provided to this population group and respond as quickly as possible to critical cases.

Methodology

105.The research involved actions and descriptive elements combining clinical, epidemiological, pedagogical and social methodologies for the purpose of characterizing persons with disabilities who met the criteria for inclusion in the study.

Inclusion criteria

106.All persons with intellectual or other disabilities of the types listed below were included in the study.

Motor disabilities

107.Persons with motor disabilities, including:

(a)Paralysis of an upper or lower limb;

(b)Hemiplegia, hemiparesis, paraplegia, paraparesis, quadriplegia or quadriparesis;

(c)Amputation of upper or lower limbs;

(d)Coordination and muscle tone disorders;

(e)Serious disorders of the central nervous system (e.g. muscular dystrophy);

(f)Alterations of the musculoskeletal system, absence of limbs or other anatomical regions, severe spinal deformities.

Sensory disabilities

108.Persons with the following visual impairments:

(a)Complete blindness: inability to see light in either eye;

(b)Visual impairment: severe, inoperable visual impairment which, in order to be sufficiently corrected to see close up, requires glasses or contact lenses with a minimum strength of 4 diopters;

(c)Complete loss of an eye.

109.Persons with the following hearing impairments:

(a)Deafness: inability to perceive any sound;

(b)Hearing loss: various levels of hearing loss that requires the use of hearing aids.

Disorders of the organs or viscera

110.Persons with chronic kidney failure (only cases where the person required dialysis or haemodialysis).

Mental disabilities

111.Persons with chronic psychosis, namely, schizophrenia, paraphrenia and bipolar disorders.

112.Persons with dementia, in other words any type of Alzheimer’s disease, vascular dementia or mixed dementia.

Mixed or multiple disabilities

113.This term refers to persons with two or more disabilities.

Intellectual disability

114.Persons who have received a diagnosis of light, moderate, severe or profound intellectual disability or who are suspected of having such a disability and need to be examined in order to confirm the diagnosis.

Study population

115.On behalf of the Government of Reconciliation and National Unity, visits were made to 179,138 households, leading to the inclusion of 126,316 persons with disabilities in the study, equivalent to a disability ratio of 2.5 per 100 inhabitants. Of this number, 32,728 persons – 25.92 per cent of the persons with disabilities included in the study – had an intellectual disability (a disability rate of 0.63 per 100 inhabitants) and 93,588 people – 74.08 per cent of the people studied – had other types of disability (a disability rate of 1.8 per 100 inhabitants). Of those with other disabilities:

46,619 had a motor disability (36.9 per cent);

16,045 had a visual impairment (17.15 per cent);

12,780 had a hearing impairment (10.12 per cent);

7,397 had a mental disability (5.86 per cent);

10,159 had multiple disabilities;

588 were patients with chronic kidney failure.

116.The departments with the highest disability rate are Boaco (3.68 per 100 inhabitants), Río San Juan (3.49 per 100 inhabitants), Madriz (3.36 per 100 inhabitants) and Zelaya Central (3.35 per 100 inhabitants). The lowest rate is in Masaya (1.47 per 100 inhabitants).

117.The following paragraphs provide an overview of the other disabilities by age group and sex:

The other disabilities covered in the study were found predominantly among persons over 60 years of age (41,691 people, or 44.55 per cent) and tended to be motor disabilities, visual and hearing impairments and multiple disabilities. Mental disabilities and visceral disorders were found primarily among 40- to 59-year-olds.

With regard to rates, other disabilities were most prevalent among persons over 60 (0.8 per 100 inhabitants), followed by 40- to 59-year-olds (0.44 per 100 inhabitants), 30- to 39-year-olds (0.18 per 100 inhabitants), 20- to 29-year-olds (0.15 per 100 inhabitants) and 5- to 14-year-olds (0.12 per 100 inhabitants). These disabilities were less frequent among 15- to 19-year-olds (0.08 per 100 inhabitants) and 0- to 4-year-olds (0.03 per 100 inhabitants).

Generally speaking, there was a greater number of other disabilities among males (41,182, or 51.49 per cent) than among females (45,393, or 48.51 per cent), representing a male to female ratio of 1.06.

The findings were similar in most of the departments, except in Managua, where more females had a disability, representing a male to female ratio of 0.89, and in León (0.95), Granada and Carazo (0.97 respectively) and Masaya (0.99).

Males were also found to have higher rates of visual and hearing impairments, mental and visceral disorders and multiple disabilities, but not of motor disabilities, which were slightly more common among females.

Disabilities were more common among males of all age groups, except in the over 60 group, where more women had a disability.

Transition from study to government programme

118.As a result of the study, the State established the national “A Voice for All” Programme, headed by the Ministry of Health and coordinated with the work of other entities, including the Ministry of Labour, the Ministry of Education, the Ministry for Family, the Office of the Human Rights Ombudsman, the “Promotoría Social Solidaria” outreach programme and the Office of the Civil Branch of Government for Organizations of Persons with Disabilities.

119.Concerning the training of human resources, 11 doctors were sent to the sister republic of Cuba to study clinical genetics and obtain a master’s degree in genetic counselling. Of them, nine are departmental coordinators for the “A Voice for All” programme.

120.The World Health Organization’s community-based rehabilitation guidelines were launched within the framework of the programme, with the participation of “A Voice for All” departmental coordinators, the Office of the Civil Branch of Government for Organizations of Persons with Disabilities, the Office of the Human Rights Ombudsman and other associations working on disability issues (see annex 7: community-based rehabilitation guidelines, Nicaragua launch booklet).

121.In addition, training in primary ear and hearing care in line with the basic, intermediate and advanced modules developed by the World Health Organization has been provided at the national level to improve ear health and reduce and prevent hearing impairment.

122.The “A Voice for All” Programme is supported by departmental coordinators at the national level and municipal coordinators across the country. A national plan on comprehensive support for persons with disabilities has been adopted with the general aim of providing comprehensive support to all persons with disabilities nationwide, using mechanisms that involve the individual, families, communities and society as a whole. The plan’s specific objectives are to:

(a)Carry out prevention, care and rehabilitation activities for persons with disabilities;

(b)Improve inter-institutional coordination to ensure the provision of comprehensive care to persons with disabilities;

(c)Ensure genetic assistance for persons with disabilities.

123.In 2011, house-to-house visits were made to 114,902 persons with disabilities, with medical consultations and specialized care organized in parallel. Cases that required surgery were attended to immediately, and certain technical needs, such as for wheelchairs, crutches, canes and walkers, were addressed. The “Promotoría Social Solidaria” programme provides monthly food packages to persons with disabilities whose cases are considered critical, who, in this year, numbered 4,000 nationwide.

124.In 2012, a total of 256,634 house-to-house visits were conducted, providing 33,409 medical consultations to critical cases and 223,225 to other persons with disabilities.

125.In the same period, 1,473 persons with disabilities were transferred to departmental hospitals or national referral hospitals, of whom 200 were hospitalized and 263 underwent specialized examinations.

126.As at July 2013, there had been 163,379 house-to-house visits and the same number of medical consultations, during which “A Voice for All” booklets designed especially for persons with disabilities were distributed (see annex 8: “A Voice for All” booklet).

127.In coordination with the Office of the Civil Branch of Government for Organizations of Persons with Disabilities, regulations for implementing Act No. 763 on the rights of persons with disabilities have been drafted and a document designed to serve as a certificate of disability and identification card for persons with disabilities has been approved, with the aim of:

(a)Providing persons with disabilities registered in the “A Voice for All” Programme, based on the requirements of the Ministry of Health, with a disability certificate and identification card (see annex 8);

(b)Guaranteeing access to the benefits deriving from having a disability certificate and identification card for persons with disabilities registered under the “A Voice for All” Programme;

(c)Establishing requirements and procedures for the issuance of disability certificates;

(d)Establishing which health entities are responsible for issuing disability certificates and identification cards;

(e)Defining the functions of the certification teams.

Education

128.On 11 January 2007, President Ortega decreed that education would be free of charge, thus restoring the right to education of all Nicaraguans. The roll-out of social programmes, such as the provision of school meals, textbooks and school kits for low-income students, and the refurbishment of schools have contributed to increased enrolment, retention and successful completion of nursery and primary education.

129.The education policy set out under the 2012–2016 National Human Development Plan establishes that the Government of Reconciliation and National Unity will continue to guarantee and strengthen the population’s right to free education. From this standpoint, a fundamental human rights-based approach to education has been taken, respecting the principle of universal education.

130.Under the new education model being built in Nicaragua, there is no discrimination of any kind. Nicaraguans receive an education under equal conditions and have equal opportunity to attend a school near their home.

131.The Government is making efforts in the area of teacher training to ensure that teachers have the pedagogical tools they need to provide good quality, equitable instruction that takes into account the learning needs of each student.

132.One of the lines of action adopted by the Ministry of Education to improve the quality of education is the professionalization of teaching. As teachers are the key actors in education, the quality of the education, skills updates and in-service training they receive continues to have a decisive impact on students’ academic outcomes, and the manner in which they teach sets an important standard for the development of the school community.

133.The main lines of action envisaged under the education policy of the Government of Reconciliation and National Unity include:

Continuing the battle for the sixth and ninth grades, in all educational modalities, in order to eliminate rural-urban inequalities, ensuring that all schools offer schooling up to the sixth grade and that more teachers are recruited to support the progressive expansion of schooling up to the ninth grade.

Broadening and strengthening nursery education, as part of comprehensive early childhood support efforts and an initial step in ensuring the integration, retention and success of pupils in primary education.

Boosting conditions for the continuous improvement of efforts to include persons with disabilities in the education system, thus guaranteeing the rights of children, adolescents, young people and adults with disabilities.

Organizing the basic and intermediate education subsystems into educational clusters to address the problem of school dispersion by building systemic synergistic relationships between schools within a given area and facilitating convergence in the organization of activities.

Developing a quality model centred on the school as a setting for human and community development that enables communities to play a role and makes for relevant and meaningful learning.

Moving forward on the professionalization, training and recognition of teachers.

Broadening and strengthening the system of continuous assessment that feeds into students’ progress, the incorporation of information and communications technologies into curricula and the implementation of supplementary programmes, such as tutoring and academic support.

Implementing a flexible curriculum that allows for curricular adjustments to meet the diverse educational needs of the student body.

134.The Ministry of Education’s Special Education Directorate consists of two departments, one for special education and another for inclusive education.

135.At the national level, there are:

26 State special education schools, with an average of 3,000 students enrolled each year, where instruction is provided, either temporarily or permanently, only to students with severe disabilities.

2,148 preschool, primary and secondary education centres attended by an average of 14,000 students with some form of disability each year.

The Academic Advisory Unit, composed of 130 teachers who travel to the mainstream education centres attended by students with special educational needs whether or not stemming from a disability. These teachers have experience in special education and a command of Braille and Nicaraguan sign language, and some hold a specialization in psychology. Their responsibilities are to:

Provide technical and methodological support to teachers in mainstream schools attended by students with special educational needs in accordance with the principle of inclusive education.

Conduct psychopedagogical tests in order to place children, adolescents and young people in the school nearest to their home.

Support the design of an individualized adapted curriculum.

Train teachers in topics related to pedagogical support strategies for students with educational needs whether or not stemming from a disability and to inclusive education.

Facilitate assessment, planning and training workshops.

Interpret for students with visual impairments at the secondary level with a view to facilitating the education process.

Provide training to parents in methodological strategies and therapies aimed at giving their children timely and adapted support.

The Early Education Programme, the objective of which is to identify and provide timely care to children aged between 0-3 years old who are at high risk of or already have developmental issues, with a view to strengthening and developing as far as possible their physical, intellectual, sensory and affective potential through home visits. The Programme is designed not only to develop skills and functional abilities in children but also to enable changes in the family and the environment in which they live that improve their living conditions and ensure that they are respected and included in their family unit and community. Activities are informal and community-based, which facilitates children’s access to preschool education, whether in special education schools or in formal or community preschools. An average of 800 children with developmental issues receive support each year.

Eight Educational Resource Centres for Respect of Diversity, located in the country’s mainstream schools and staffed by teachers who have graduated from teacher training colleges and have experience in special and inclusive education. They are involved in the following activities:

Information-sharing

Counselling and intervention

Research

Training

Formulation of educational materials

Eight schoolrooms, located in hospitals in León (1), Matagalpa (1), Managua (2), Río San Juan (1), Juigalpa (1), Jinotepe (1) and Estelí (1) and used to provide instruction to school-age children who, for health reasons, are hospitalized for long periods of time. Their main purpose is to ensure educational continuity for patients.

An educational resource centre for the blind, which has a team trained to adapt and produce educational materials in Braille, tactile and audio formats.

136.The Special Education Directorate has a team of 11 national pedagogical advisors who have vast experience in special and inclusive education and university-level professional training. The team’s functions include: carrying out support visits to teachers in special educational schools and schools implementing inclusive education programmes, school principals and the technical teams of departmental and municipal authorities; designing curricular support documents; providing training to the staff of departmental and municipal authorities, teachers at special education and mainstream schools and teachers of the Academic Advisory Unit; and adapting and producing educational materials in Braille, tactile and audio formats.

137.Noteworthy actions undertaken by the Special Education Directorate include:

The annual school enrolment campaign

Seminars on inclusive education

Contests on good practices in inclusive education

Fairs to mark the International Day of Persons with Disabilities

An art festival involving children, adolescents and young people with disabilities

The establishment of the National Counsel of Nicaraguan Sign Language pursuant to Act No. 675 on Nicaraguan Sign Language, published in the country’s Official Gazette No. 75 of 24 April 2009

The design, in coordination with the National Institute of Technology and the National Association of the Deaf, of a basic course in Nicaraguan Sign Language

The publication of a document setting out the regulations on assistance for students with special educational needs as part of efforts to promote respect for Nicaraguan diversity

The development, in coordination with the Teacher Training Directorate, of a programme on inclusive education and respect for diversity and the revision of the module on the same topic to be taught to students at Teacher Training Colleges

Work in conjunction with the Ministry of Education’s statistics office to develop a means of compiling information on students with some form of disability who attend mainstream schools at the preschool, primary and secondary levels, and its roll-out as of 2012.

138.The Ministry of Education’s Special Education Directorate has also rolled out an in-service training plan for teachers and support teams in the field that includes diplomas, courses and training on the following topics:

Inclusive education and respect for diversity

Capacity-building for developers and facilitators of inclusive education

Pedagogical strategies

Curricular accommodations

Early education

Respect for diversity

Multiple disabilities and deaf-blindness

Braille

Use of the abacus

Orientation and mobility

Basic course in Nicaraguan Sign Language

139.The following numbers of teachers have received training:

An annual average of 280 teachers receive training in orientation and mobility, use of the abacus and the Braille system (specifically for teachers who work with blind students). In the workshops, teachers learn techniques to help their blind students to develop the ability to recognize and be aware of their surroundings, to organize and familiarize themselves with their world through physical contact and to move from one place to another efficiently.

Since 2010, an annual average of 150 teachers working with children with hearing impairments have received training in Nicaraguan Sign Language.

140.Sign language interpreters have begun to be assigned to secondary school students with hearing impairments to enhance the education process.

141.Regarding the inclusion of persons with disabilities in educational teams, it should be noted that there are workers with disabilities at the Ministry of Education headquarters, in the Ministry’s departmental and municipal branches and in both special and mainstream schools.

Challenges

142.One challenge is to strengthen support teams at the departmental level by establishing multidisciplinary teams who guide teachers and parents in providing effective support to children, adolescents and young people with some form of disability in order to foster and develop to the greatest extent possible their physical, intellectual, sensory and affective potential.

143.Another challenge is to work in coordination with universities and teacher training colleges to provide specialization courses for teachers who work with students with some form of disability.

144.Working in coordination with the National Institute of Technology to provide courses in Nicaraguan Sign Language interpretation is another challenge outstanding.

145.A further challenge is to strengthen technical education by setting up and properly equipping the classrooms where baking and beauty workshops are held in 25 special education schools.

146.One further challenge is the need to carry out research projects through the Educational Resource Centres for Respect of Diversity that improve educational practices in mainstream schools.

Technical and vocational training

147.Pursuant to Executive Decree No. 3-91 of 10 January 1991, the lead agency for technical and vocational training in Nicaragua is the National Institute of Technology. Its remit includes:

(a)Implementing vocational training programmes designed to enable persons over the age of 14 years and specific population groups to obtain a technical job, adapt to a new job and improve their technical skills;

(b)Design and implement special programmes for women, unemployed persons and handicapped persons, as well as training programmes to support cooperatives and microenterprises.

148.The main objective is to provide comprehensive, good quality training to those requesting it in various sectors of society, with clear policies and strategies that meet the expectations of the country’s social and productive sectors, based on the National Human Development Plan.

149.The topics of entrepreneurship, business management, self-esteem, attitude, responsibility, hygiene and health have been introduced into the institutional study curriculum as a cross-cutting focus in all training courses with the aim of contributing to the social and professional development of persons with disabilities and their greater interaction with the community.

150.The Professional Rehabilitation Department offers various training options to improve the socioeconomic conditions of persons with disabilities through self-employment or starting a microenterprise. The goal is to professionally rehabilitate target groups by preparing them for jobs that meet the needs of the labour market with a view to their integration into the social, professional and productive life of the country.

151.The following activities were conducted in the period 2011–2013:

Training for 1,211 persons with visual impairments (646 men and 565 women) in the following areas: working as a telephone receptionist, motivation and self-esteem, small business management, computing, textiles (hammocks, macramé, bags, baskets, among others), massage, English, packaging (shrimps, baked goods and cigars), box sanding and, with particular success, the preparation of cigars, including training for 106 persons in how to adapt workstations for persons with visual impairments.

Training for 3,142 persons with disabilities (1,060 men and 2,082 women) in the following specializations: bread making, carpentry, foam crafts, floral arrangements, computer repair and maintenance, piñata construction, cutting and sewing, baking and cake decorating, basic gas motors, general beauty services, home-made sorbet, cellular phone repair, hammock-making, self-esteem, decoration and design techniques, collar, sleeve and skirt adjustments, basic plumbing, residential electricity, preserve and nectar-making, general costume jewelry making, Nicaraguan cooking, flower-making and floral arrangements, introduction to professional rehabilitation, business management, accounting and business profile writing, winemaking, horticulture, computing using Job Access With Speech (JAWS), acrylic nail application, vegetable gardening, artisanal breadmaking, basic English, motorcycle repair, handicrafts, hammock weaving, dairy product making, barbershop skills, plant nursery set-up and management, and cosmetology, among others.

Technical assistance and guidance for associations of persons with disabilities.

Awareness-raising on Act No. 763 on the rights of persons with disabilities.

Assistance to persons with disabilities through case studies.

Occupational assessments for applicants for training courses.

Coordination with associations of persons with disabilities to conduct situational evaluations and training needs assessments.

152.Since 2013, accessible technical training modules for persons with disabilities have been designed, accredited and implemented, including in support technologies such as computing with JAWS, basic sign language, orientation and mobility, and the Braille system. Forty-three heads of training at National Institute of Technology training centres have been trained to teach these modules.

153.To ensure that the training is appropriate, psychological, pedagogical and occupational assessments are conducted so that persons with disabilities are placed on a course suited to their abilities.

154.In order to direct the teaching and learning process in a most efficient and useful manner, talks on pedagogical guidelines are held with instructors who provide training to persons with disabilities at the national level.

155.Every two years, the National Institute of Technology teaches an introduction to professional rehabilitation course to residents in physiatry at the Aldo Chavarría rehabilitation hospital in Managua, including information on Act No. 763 on the rights of persons with disabilities.

Employment

156.The Government of Reconciliation and National Unity has persistently demonstrated the political will to protect and restore the labour rights of persons with disabilities with a view to achieving their labour market integration. This determination is directly reflected in the legal framework, and in the following laws in particular:

Act No. 648 on equal rights and opportunities and the related regulations.

Act No. 641 (the Criminal Code). Title X, on violations of labour rights, Sole Chapter, Articles 315–317.

Act No. 815 (the Labour Code).

157.The Government of Nicaragua has also been working to raise awareness among private sector employers, encouraging them to hire persons with disabilities and adapt workspaces and job descriptions to accommodate them. The Ministry of Labour has organized seminars for persons with disabilities and employers with a view to finding common ground in support of their needs.

158.The Ministry of Labour has trained 121 persons with disabilities in occupational health and safety with a view to sensitizing both businesses that employ persons with disabilities and those that do not and showing them how to comply with legislation pertaining to rights of persons with disabilities.

159.In 2010, an inter-agency network for equality and non-discrimination in employment was established. The network is composed of 30 institutions, organizations of persons with disabilities and family, community and life councils, and has been successful in raising awareness of and enhancing compliance with labour legislation. The ultimate aim is to foster a new work culture that is based on respect and de facto compliance with the principles of equal rights and equal opportunities.

160.The Public Employment Service of the Ministry of Labour has prioritized the labour market integration of persons with disabilities as part of its efforts to promote and enforce compliance with fundamental labour rules, principles and rights and strengthen tripartism and dialogue. As a result of its efforts, in the period 2010–2013 365 persons with disabilities were able to find work.

161.Another task of the State of Nicaragua is to carry out labour inspections, focusing on education and monitoring compliance with the labour rights of workers with disabilities. For this purpose, the inspection service uses a methodological and technical guide for labour inspections that has recently been updated to include a section on equality and non-discrimination in employment, mainly with a view to protecting the rights of women and persons with disabilities. The section of the technical guide for inspections that deals with equality and non-discrimination covers the following issues:

Section 5: Equality and non-discrimination
	Violation subject to revision	Legal provision
7.1.1	There is discrimination on grounds of sex and the wages of women workers are not equal to those of their male counterparts.	Arts. 27 and 82, Constitution; Art. 138 Labour Code; Art. 2, Act No. 648; Art. 1, 2 and 8, Act. No. 799; Basic principle XIII; ILO Convention No. 100
7.1.2	In selection, administration and internal promotion processes not all persons are assessed according to their ability, irrespective of their sex, age, race, disability or political, religious or other beliefs.	Arts. 27 and 28, Constitution; Basic principle VIII; Art. 34, Act No. 763; ILO Convention No. 111
7.1.3	Employers do not guarantee employment for all their workers but discriminate against them on grounds of pregnancy, race, religion, age, disability, sexual orientation or family situation.	Arts. 74 and 82, Constitution; Basic principle III; Art. 34, Act No. 763
7.1.4	Employers subject workers to discriminatory medical examinations (pregnancy tests, HIV-AIDS tests, fingerprint tests, comprehensive medical examinations, polygraph examinations and others). After statutory medical examinations, the results are not disclosed firstly to the employees themselves.	Art. 15, Act. No. 779; Ministerial Agreement 005-09-05; Basic principle XI
7.1.5	Employers do not show due consideration and respect for workers, refraining from ill-treatment by word, act or omission and any act that might undermine their dignity.	Arts. 26 and 36, Constitution; Art. 17, Labour Code; Act. No. 202; Art. 13, Act. No. 238
7.1.6	A company with 50 or more employees does not meet the minimum 2 per cent quota for persons with disabilities on its payroll. Companies with more than 10 workers and less than 50 workers that do not employ at least one worker who has a disability.	Arts. 56, 57 and 62, Constitution; Arts. 198, 199, 200 and 201, Labour Code; Act No 763 on the Rights of Persons with Disabilities
7.1.7	Persons living with HIV/AIDS have the right to work and are able to carry out their duties according to their ability. HIV infection is considered an obstacle to recruitment, a reason for sanctions or a grounds for dismissal.	Art. 36 on the promotion, protection and defence of human rights in the context of HIV/AIDS, Act No. 779
7.1.8	Employers do not grant all pregnant women workers 4 weeks of paid rest before delivery and 8 weeks after delivery, or 10 weeks in the case of multiple births, with the amount paid being based on the last or highest wage.	Art. 74, Constitution; Art. 138, Labour Code; Art. 4, Act. No. 718
7.1.9	Employers ask women who they plan to recruit to take a pregnancy test.	Art. 74, Constitution; Basic principle XII; Ministerial Agreement No. 005-05-07
7.1.10	The workplace does not have an adequate facility for breastfeeding or, in the absence of such a facility, workers are not allowed to arrive one hour late or leave one hour early, for a period of six months after delivery.	Art. 143, Labour Code
7.1.11	Employers deny employment to women on the grounds of pregnancy, or dismiss them without just cause during pregnancy or in the postnatal period.	Art. 74, Constitution; Art. 144, Labour Code
7.1.12	Employers are violating women workers’ psychological rights, or are sexually harassing or blackmailing them.	Arts. 26 and 36, Constitution; Art. 17, Labour Code
7.1.13	Employers fail to respect the dignity and privacy of both women and men, who have an equal right not to be subjected to any kind of violence, be it verbal, physical, sociological or of a sexual nature.	Arts. 26 and 36, Constitution
7.1.14	Detention facilities do not keep special records showing the income of persons deprived of their liberty that is to be given to the person in question or to a family member specified by him or her, which records may be inspected at any time by the labour inspectorate.	Art. 197, Labour Code
7.1.15	The employer does not keep discriminatory lists, and does not disclose information on its workers or former workers to other employers, for the purpose of discrimination.	Art. 17 (b), Labour Code

162.Recent inspection-related actions include a talk given by the Special Prosecutor for Persons with Disabilities on 7 and 8 March 2011, which was attended by public servants from the Ministry of Labour.

163.In 2012, corrective action to remedy violations under section 7 of the technical guide on inspections on equality and non-discrimination was ordered following a total of 1,535 labour inspections nationwide with the aim of educating employers about non-discrimination in employment and ensuring the correct application of Act No. 763 on the labour inclusion of persons with disabilities. The inspectors also drew attention to the requirement for workplaces with more than fifty workers to meet a minimum 2 per cent quota for persons with disabilities on their payroll and for those with less than fifty workers to have at least one person with a disability on their payroll. When seeking to recruit person with disabilities, employers are encouraged to consult the database maintained by the Ministry of Labour’s Public Employment Service. Also in 2012, a total of 78,354 workers benefited from protection in application of section 7 of the inspection guide.

164.With regard to occupational health and safety with an emphasis on persons with disabilities, to mark the National Day of Occupational Health and Safety, celebrated on August 18, the National Council on Health and Safety, chaired by the Ministry of Labour, organized a workshop for the exchange of good practices and experience in the field of disability under the slogan “Workers with disabilities working in safe and healthy conditions”. The focus was on preventing occupational risks in places where persons with disabilities work, ensuring full enjoyment of all their labour rights and promoting business opportunities that facilitate labour integration.

165.As a guarantor of rights, Nicaragua has made enormous efforts to guarantee employment and self-employment for its people in general, and for persons with disabilities in particular, and its institutions have responded as described below.

166.In the quest to respond to the social and labour needs of persons with disabilities, the State of Nicaragua, through the National Institute of Technology, conducted two diagnostic tests to identify workers with some form of disability. The results showed that 54 per cent of workers or 172 persons working at the National Institute’s central offices had a disability.

167.Various State institutions also employ persons with disabilities. There are 8 persons with disabilities working in the central offices of the Ministry of Transport and 476 persons with disabilities working at the Ministry of Health.

168.The National Institute of Technology has also carried out two projects for mine victims, one focused on training strategies for the socioeconomic and vocational reintegration of persons with disabilities who are victims of landmines, the other focused on the reintegration of persons with disabilities who are victims of anti-personnel mines in the municipality of Condega, in Estelí Department. Under the projects, men and women have received training and help to set up productive projects, which help to improve the living conditions and quality of life of the mine victims and members of their families, through the work undertaken in each family.

Participation in political and public life

169.The State of Nicaragua has been making progress in terms of access to the various forms of participation and inclusion in political and public life for persons with disabilities. As a result of these efforts, the Supreme Electoral Council has:

(a)undertaken a census to map out where persons with disabilities are living and begun the process of relocating polling stations in order to improve access to the hugely important political right that is the right to vote;

(b)undertaken a survey to identify persons with disabilities who for various reasons have not been issued with an identity card;

(c)worked to actively integrate persons with disabilities in Nicaraguan electoral processes, giving them the training required for them to be aware of their political rights in electoral matters.

170.In 2008 the Supreme Electoral Council began its programme of work for polling officers. The process continued in the 2010 elections for the Regional Autonomous Governments of the Nicaraguan Caribbean Coast, the 2011 national presidential legislative elections and the 2012 municipal elections.

171.Braille tablets were provided to enable blind people to exercise their right to vote in person:

(a)Election publicity documents were published in Braille for the first time;

(b)The National Census was carried out in the 50 largest municipalities of the country, which are located mainly in urban areas – rural areas are pending – under the joint leadership of the Ministry of Education, the Ministry of Health, municipal councils and organizations of persons with disabilities in the respective municipalities. In 2007 and 2008, 40,000 persons with disabilities were registered during this exercise.

172.The nationwide process of changing identity cards began in 2010, working with national organizations of persons with disabilities.

173.Local governments in the municipalities of Estelí, Matagalpa, Jinotega, Puerto Cabezas, Chinandega, Rivas and Masaya have adopted municipal ordinances on accessibility as a result of the political engagement and advocacy of organizations of persons with disabilities and have established budgets for eliminating architectural barriers, supporting the operations of associations, auxiliary measures, the plan techo (roof plan) for at-risk families, improvements to homes and basic, technical, vocational and professional training.

174.The Nicaraguan Caribbean Coast is divided into two autonomous regions, each with its own government. The government of the Atlántico Sur Autonomous Region has created the position of regional secretary for the promotion of the rights of persons with disabilities and, in 10 of the region’s 12 municipalities, the municipal officer positions envisaged in in-force legislation for the promotion of the rights of persons with disabilities have already been filled.

175.Municipal officers have been appointed in 15 municipalities in the departments of the Pacific, north and central areas, as well as in 10 municipalities in the autonomous regions of the Caribbean Coast, as provided for in in-force legislation (Act No. 763) on the promotion of the rights of persons with disabilities. The 15 other municipalities are in the departments of Matagalpa, Rivas, Buenos Aires, Belén, Tola, Cárdenas, San Juan del Sur, Moyogalpa, Altagracia, Chinandega, Larreynaga, Masatepe, Esquipulas, Ocotal, El Sauce.

176.In the most recent municipal elections, held in 2012, a number of persons with disabilities stood for election and 11 were elected to serve as municipal councillors. Their success was a political accomplishment for this population group as it was the first time that members of organizations of people with disabilities had been nominated as candidates.

Participation in cultural life, recreation, leisure and sport

2008

177.A sports federation was established to meet the needs of athletes with disabilities in the course of 2008. The federation is named the Sports Federation of the Nicaraguan Paralympic Committee and is known by the acronym FEDCOPAN.

178.Following amendments to the General Act on Sports, since 2008, 3 per cent of the budget has been assigned to national and international sporting activities in the following disability categories: vision impairments, deafness, intellectual impairments, cerebral palsy, Down syndrome, and physical and motor disabilities. A total of 3,674 athletes over the age of 12 years old, of whom 70 per cent were men and 30 per cent women, have participated in international events in different disciplines, achieving excellent results at the Central American level.

2009

179.In 2009, sports received a larger budget, allowing the National Sports Institute to increase women’s participation in sports, supporting emerging athletes aged between 12 and 19 years old in the field of athletics, obtaining first place for the second time in succession at the student level in Central America, and expanding support for other disciplines such as swimming and powerlifting. The total number of participating athletes in 2009 was 4,250.

2010

180.In this year, the Government of Reconciliation and National Unity allocated 3 per cent of the national sports budget to support the development of sports and recreation for persons with disabilities, thereby increasing their participation in national and international events. The total number of participating athletes in this year was 4,880.

2011–2012

181.For the first time Nicaragua participated in the Pan American Games, in Mexico, sending a minimum delegation to compete in the goalball, powerlifting and athletics events, and also in the Paralympic Games in London, to which it was able to send two female athletes and one male athlete, with Gabriel Cuadra obtaining a para pan American record in the 800m in the T-36 (cerebral palsy) class.

182.Since 2012, the number of competing athletes has risen to 9,350, of whom 65 per cent are men and 35 per cent are women.

Physical education

183.There are plans to have physical education teachers in the special schools run by the Ministry of Education. Seven hard-of-hearing persons and one other have been trained as physical education experts.

Physical recreation

184.The participation of persons with disabilities in recreational activities such as hiking, children’s games and camping is beginning to rise.