Central American Health Institute
Country of Operation
SummaryCentral American Health Institute (ICAS) is a non-governmental organization based in Nicaragua and dedicated to improving the quality of life of the regional population and especially of the poorest and most vulnerable groups.
Key program components
ICAS has over 16 years of experience in support of the health and rights of Nicaragua’s most vulnerable groups, especially adolescents and young people, drug addicts, sex workers, their partners and clients, men who sex with men, prisoners, mobile populations, poor rural women and other groups with insufficient access to social and health services and information. ICAS has developed a highly successful approach using competitive vouchers to increase access to sexual and reproductive health services for adolescents from 2000 to 2005, to STI/HIV/AIDS services for population at high risk for HIV from 1995 to present (McKay et al 2006) and breast and cervical cancer screening for older poor rural women (1998-ongoing). Other programs focus on prevention and control of tobacco use.
The sex worker STI treatment vouchers were distributed in areas of Managua where sex workers were commonly found and were used in 22,082 visits between 1995 and mid 2008. Sandiford and colleagues noted that the introduction of the sex worker voucher was accompanied by annual declines in the prevalence of syphilis (8.6%) and gonorrhea (9.4%) among the poorest sex workers (see World Bank, 2005, A Guide to Competitive Vouchers in Health).
The adolescent vouchers were used 15,134 times in the project period. Utilization of adolescent reproductive health services and use of contraceptives were higher in the voucher group compared to a control group.