Addressing Adolescent Pregnancy and Maternal Mortality in Nicaragua

Extraordinarily high rates of adolescent pregnancy and intrafamilial sexual violence in Nicaragua, coupled with limited educational and occupational opportunities for girls from the most impoverished families, pose challenges for the future of child and family health in the country. This paper reports on the author’s recent trip to examine Nicaragua’s immunization programs in the context of support from Gavi, the Vaccine Alliance. Through clinics and community health programs managed by the Ministry of Health (MINSA), Nicaragua offers a range of routine vaccines to the public at no cost. Thanks to Gavi support since 2005, MINSA has been able to offer some of the newer and more expensive vaccines, such as the rotavirus and pneumococcal vaccines, free of charge, as well. But as she sought to situate what she learned about immunization programs within the broader context of maternal and child health in Nicaragua, the author was struck by the number of adolescent girls who become pregnant at a very young age and considered what implications this may have for the health outlook of Nicaragua’s newest families.


Katherine E. Bliss
Senior Fellow and Director, Immunizations and Health Systems Resilience, Global Health Policy Center