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The Pan American Health Organization (PAHO), the United Nations Children’s Fund (UNICEF), and the United Nations Population Fund (UNFPA) have established a Joint Programme entitled “Support to Achieving Millennium Development Goals (MDG) 4 and 5 (A and B) in Nueva Segovia, Chontales and the South Atlantic Autonomous Region (RAAS) in Nicaragua”.

This Joint Programme (JP) aims at contributing towards reaching MDGs 4 and 5 (A and B), so that by 2015 the maternal mortality rate will have been lowered by 75%. In Nicaragua and in absolute numbers this means diminishing maternal deaths to 40 per 100,000 live births and to 24 infant deaths per 1,000 live births, using the 1990 baseline.

During the 2006-2010 period, the Maternal Mortality Ratio (MMR) declined from 92.8 deaths per 100,000 in 2006 to 66.6 deaths per 100,000 live births in 2010, representing a 25% reduction. The North and South Atlantic Autonomous Regions recorded maternal deaths at 2.1 times more than the rest of the country, the women of the Caribbean Coast and northern region accessed delivery care five times less than the women in the Pacific area. The main causes of maternal deaths are obstetric.

In the 2000-2010 period, mortality in children under five years represented 14.47% (26.241) of all deaths of all ages. Likewise the deceased under one year accounted for 82.3% of all under-five years deaths. Even with the significant efforts made in child health, it is necessary to strengthen the ability of solving neonatology services through, among other things, adequately equipping the hospitals.  The main causes of death in children under five years are those arising in the perinatal period, respiratory infections, diarrhea and congenital malformations. With regard to mother to child transmission of HIV, chronic child malnutrition in children and prevalence of anemia, efforts are being made at the national level.

In this context, the Duchy of Luxembourg proposed to the United Nations System the development of a Joint Programme to advance the MDGs 4 & 5.  The Ministry of Health, PAHO/WHO, UNICEF and UNFPA developed the Joint Programme based on UNDAF 2013-2017 and closely related to national policies and priorities. The Joint Programme sets goals and describes strategies by which to improve health and nutrition for women, children and adolescents.


Assistance Strategy

In order to achieve this aim, efforts will be concentrated on the most vulnerable sectors and adequate policies will be established in order to eliminate existing inequities among population groups and dwellers of rural and urban areas. It is therefore expected that boys, girls, adolescents and women, in particular those living in vulnerable conditions, will gain equitable access to health and its determinants by means of community interventions and health services provided with quality and warmth.

The JP is established in accordance with UNDAF 2013-2017 national priority to “Ensure the right to food security, health, education and the well-being of the Nicaraguan people”, and makes a direct contribution to outcome 2.2 (2.2 The most vulnerable population has access to and consumes healthy and nutritious food) and  2.4 (2.4 Prioritized populations gain equitable access to health care in the life-cycle framework, with emphasis on maternal and child health, as well as the health of women in general).

PAHO/WHO, UNFPA and UNICEF will be the Participating UN Organizations. The JP will have a three-year  duration in correspondence with the first three years of UNDAF 2013-2017, which coincides with the same term for the UNFPA and UNICEF cooperation programmes, as well as the biannual WHO programmes for 2012-2013 and 2014-2015.



The JP will be managed under the inter-agency governance and coordination structure framework established in the UNDAF Action Plan 2013-2017. To ensure the achievement of the programme’s  results, there will be two levels of coordination and strategic/operational management:

• National Steering Committee

• Programme Coordinating Committee

The National Steering Committee (NSC), which will be the same of the UNDAF Action Plan, will be the instance for strategic management of the program and will ensure the strategic achievement of program outcomes in line with the UNDAF Action Plan 2013-2017. The NSC shall consist of the Government of Nicaragua, through the office of the Ministry of Foreign Affairs, the United Nations system through the Resident Coordinator (RC), and, at the request of former members, the Grand Duchy of Luxembourg, as a donor to the program.

The Ministry of Health of Nicaragua (MINSA), as a leading national institution, will coordinate through its Local System of Integrated Health Care (SILAIS), the relationships with regional and local governments. Also, it will ensure the participation of existing social and community organizations.

PAHO/WHO as the lead agency and MINSA, through the Programme Coordinating Committee (PCC) will be the bearers of ongoing strategic and programmatic implementation and will report programme results to the NSC. Participating UN Organizations (PUNOs) and national counterparts will be part of an extended forum for dialogue and coordination for programme execution.

PAHO/WHO will facilitate coordination among the PUNOs and with the RC. It will provide management and technical coordination both internally within the United Nations System and also with the external implementing partners and it will be responsible for reporting on progress of the programme to the RC, the UN Country Team and the NSC.

The Resident Coordinator's Office will support PAHO/WHO in the coordination, monitoring and communication with the NSC, the PUNOs and the MPTF Office.

The RC will facilitate collaboration between the PUNOs to ensure that the programme is on track and expected results are achieved. The RC will be entrusted the leadership at all stages, including ongoing programmatic oversight, as co-chair of the NSC.

Administrative Agent

The UNDP Multi-Partner Trust Fund Office (MPTF Office) fulfills the Administrative Agent (AA) function. It will be  responsible for receiving, administering and managing contributions from Partners ; disburse funds to PUNOs, based on NSC decisions, consolidating annual and final financial reports; transmit annual/final Consolidated Reports to Partners and to the NSC.


Decision-Making Process

The NSC will be responsible for the strategic direction of the programme. Through the Programme Coordination Committee, the Lead Agency, in consultation with the Participating UN Organizations will keep the NSC informed of programme developments.  The NSC will meet twice a year, but may hold special meetings to address urgent and particular needs.

Recent Documents

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Key Figures
Funding Status
Participating Organizations are required to submit final year-end expenditures by April 30 in the following year; Interim expenditure figures are submitted on a voluntary basis and therefore current year figures are not final until the year-end expenditures have been submitted.
Total as of
Values in US$
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Funds with Administrative Agent
Contributions from Donors 3,816,212  
Interest and Investment Income (from Fund) 4,280  
Interest (from Participating Organizations) 0  
Refunds by Administrative Agent to Contributors -9,937  
Total source of funds   3,810,555
Transferred to Participating Organizations 3,781,426  
Refunds from Participating Organizations -9,112  
Administrative Agent Fee 38,162  
Direct Cost 0  
Bank Charges 80  
Total use of funds   3,810,555
Balance with Administrative Agent   0
As a percentage of deposits   0%
Funds with Participating Organizations
Transfers to Participation Organizations 3,781,426  
Total resources   3,781,426
Participating Organizations' Expenditure 3,772,313  
Refunds from Participating Organizations -9,112  
Total expenses     3,781,426
Balance with Participating Organizations   0
As a percentage of transfers   0%
Total Balance of Funds   0
As a percentage of deposits   0%
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Multi-Partner Trust Fund Office (MPTF Office), Bureau for Management Services, United Nations Development Programme; Fax: +1 212 906 6990;  

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