Atencion Primaria En Salud (Nicaragua)

Since 1999 World Community has been directing funds earned through its fair trade coffee sales to assist the organization ATENCION PRIMARIA EN SALUD (APS) in Nicaragua.

APS is a non-profit organization founded by Dr. Saul Contreras and established to improve the availability and quality of primary health care to rural Nicaraguan communities.

Aiming to build an alternative health care system grounded in community-based preventative and curative primary health care services, APS:

  • operates clinics that deliver free or low-cost care and medicines
  • extensively trains community health promoters in rural areas to be able to diagnose, treat and provide health education on a wide variety of health topics
  • supplies health promoters with a health kit
  • makes medicines available at reduced prices encouraging the restocking and use of the health kits; as well as encouraging continued contact and dialogue between APS and health promoters
  • delivers training and education sessions on a monthly basis in central locations to certified health promoters.

Health promoters, based from their homes, provide free consultations and sell medicines below-cost within their communities. As a result of providing primary health care to their communities, the promoters (the majority of whom are women) develop leadership skills and become community leaders.

Many have gone on to create and participate in their community health committee as well as become members of the community-wide council. These positions have led them to direct many development-oriented projects, such as creating access to clean water, building latrines and roads, as well as the creation of nutritional centers for children. They have also been involved with local Ministries of Health and other non-governmental organizations that are involved with many kinds of development activities.

Presently, Dr. Saul and APS are actively involved with health promoters in 176 communities. World Community contributes over $10,000/yr to APS .




APSIES is another programme which World Community has supported, through CoDevelopment Canada, since 2001.  Founded in 1983, and growing from a network of health committees in San Salvador, APSIES is currently active in three main areas: environmental management, primary health care and civil society participation.  It works in the micro region of Valle La Esperanza, in the Eastern provinces of Usulutan and San Miguel.

In CoDev’s ongoing project with APSIES, health committees in 11 individual communities near to Lolotique, as well as two small umbrella groups (intercomunales) further out in the region, are supported.  The committees are made up of health leaders within the communities who have experience in rural community health.  They receive monthly training and updating sessions at the APSIES office on topics such as reproductive health, analysis of the current health policy situation in El Salvador, AIDS and HIV, environmental health, and how to track health indicators in the community. Each committee runs an environmental health campaign in their communities, and is responsible for creating and updating community mapping projects.

APSIES offers technical assistance to these committees for work plans, policy work, internal organising, or any number of other topics.  There is also a significant natural medicine program, where the women are taught how to make various tinctures, salves and drops out of the plants in their communities.

The other main area of CoDev’s program with APSIES is women’s rights, and again there are many advances to be made. Women, especially in rural areas, suffer within the machista society, and while some advances have been made, there remains a long road ahead. The country is still a very violent place to live, and according to Oxfam International, in the first four months of 2004 there were 1,054 cases of domestic violence reported to El Salvador’s office on women’s affairs. Almost 94 percent of the victims were women. The combination of poverty, a culture of violence and machismo makes life for women extremely difficult.

CoDev supports women’s committees in four different communities. The two strongest groups have 45 and 65 members, their own internal statutes, works plans and organisational structure. The two smaller groups are still looking for training on these areas, and count on 25 and 35 women at meetings. Organisers agree, that if more resources became available, they would invest them in the women’s programmes.

World Community Alternate Gift Cards are the perfect opportunity for you to support our health promotion project run by Dr. Saul Contreras in Nicaragua. Buy a card and you are making a donation toward the empowerment of Nicaraguan health promoters to improve the health services in their under-served communities. For more info click here