International Initiative for Pediatrics and Nutrition (IIPAN)

Managua, Nicaragua

Children's Hospital Manuel de Jesus Rivera “La Mascota” (CHMJR)

Nicaragua is a middle-income country and the poorest in Central America. Almost 38% of the families live in either poverty or extreme poverty, and often experience concerns about food security. The national prevalence of children under-five with stunting, wasting and overweight is 17.3%, 2.2% and 8.3%, respectively. Older children and adolescents remain undernourished (10.9%); however, a growing proportion (40.1%) are either overweight and obese. Annual cases of newly diagnosed childhood cancer are approximately 300 cases each year. With 42% of the population under the age of 15, Nicaragua is one of the countries in Central America with a disproportionately high percentage of children and adolescents comprising the population.

IIPAN Center & Collaborators

The IIPAN site for Nicaragua is the Children's Hospital Manuel de Jesus Rivera, the largest pediatric hospital in Nicaragua and the only hospital where children with cancer can be treated. The implementation of the IIPAN nutrition program is overseen by Dr. Roberta Ortiz Sequeira, IIPAN’s pediatric oncologist, who recognizes the importance of nutrition in pediatric oncology. She has observed first-hand the difference that nutrition has made in improving outcomes and in the quality of life of children she provides care for at CHMJR. Under her supervision is the IIPAN nutritionist, Maria de los Angeles Carrillo, who has been trained to implement the recommended IIPAN protocols at CHMJR.

Site Challenges

  • Poor hospital infrastructure and lack of institutional resources (poor kitchen facility).
  • No local non-governmental organization partnership.
  • Limited access to nutritional supplies.
  • Food shortages for patients.
  • Lack of supplies to create educational seminars for families.

Site Needs

  • Collaborating non-governmental organization and leading world heath institutions to further develop institutional resources and practice.
  • Support to establish a nutrition education program to clinicians and families at CHMJR. 
  • Consistent access to oral supplements to deliver medical nutrition therapy, including RUTF, F-75, F-100, specialized formulas and multivitamin micronutrient powder.
  • Consistent access to essential supplies for medical nutrition therapy (nasogastric tubes, syringes, total parenteral nutrition)
  • Improved support for the food service program within the hospital and delivery of homemade formulas.

(Image Source: www.conanca.org)