Advanced Practice Nursing in Nicaragua


APN Role Exists in Country Today:
No Role is Officially Identified

Treatment Authority:
Registered nurses do have treatment authority

Prescribing Authority:

Nicaragua Ministry of Health


Nicaragua has significantly underserved rural communities in the nation.  The local health system is primarily run by a low number of general practitioners,  and nurses.  Each individual may be a sole healthcare provider in the local health clinic (Sequeira et al., 2011).  According to Sequeira et al. (2011), the nation’s health force comprises of 1,539 nurses and 1,138 general practitioners for a population of approximately 5.9 million people (Google, 2013).  As a result of the lack of not just general practitioners but also nurses, the undersupply of health care professionals does not lend to development of Advanced Practice Nursing at this time.  To aide the deficit of nursing professionals, another group of more than 4,000 Auxillary Nurses (similar to that of a nursing assistant) drives much of the health care services in the country (Sequeira et al., 2011).  Because the number of trained health professionals in the rural areas are few to none, the Ministry of Health in Nicaragua has utilized a large number of health volunteers to assist as health promoters in the area called the “Red Communidad” (or Net Community).  The nursing role in Nicaragua often encompasses any of the skills required to perform and train these volunteer individuals so they may make better decisions for health promotion in their areas.  These volunteer positions include Promotoras, Parteras, and Brigadistas.

Parteras are the volunteer midwives, trained by their previous local midwife or governmental training.  Promotoras are a basic volunteer who desires to know more medical-based knowledge and will resultantly facilitate decision making when an ill individual should go to the hospital.  Brigadistas may administer immunizations and at times prescribe medications according to protocols established by the Nicaraguan Ministry of Health.  Because the majority of medications in country do not require prescriptions, writing of prescriptions is based on the suggestion of the local medical expert.

There is significant evidence of APNs going to Nicaragua from more developed nations to assist in short-term provision of medical care of the underserved.  APNs going to Nicaragua work according to their education and training in their nation.


The current education system for nurses requires a three year college experience with a forth year of practicum service in an assigned health clinic, post, or hospital.  Once completed, individuals receive a bachelor degree in nursing.  Further education for specialty is available in the capital, Managua for various hospital based nursing specialties (i.e. intensive care, pediatrics).

Have information to add to this page?

Google (2013).  Retrieved from:

Sequeira, M., Espinoza, H., Amador, J.J., Domingo, G., Quintanilla, M., & Santos, T. (2011).  The Nicaraguan Health System.  PATH Publications. .Retrieved from:

Updated: Jun 22, 2014
Previous Versions: Jul 30, 2013