Improving and decentralising neuropaediatric healthcare in Nicaragua by implementing an education programme. A pre-experimental study.

Objective: To improve and decentralize neuropediatric healthcare in Nicaragua by implementing an education program.

Method: This study was carried out as an international cooperation proyecto between September 2018 and June 2019. It was a pre-experimental and before-after design (on a single group) of the implementation of an education program. A total of 19 pediatrics and 6 nurses participated in a training program, and neuropediatric healthcare services were decentralized from the National Children's Hospital in Managua (La Mascota) to 19 regional and departmental hospitals in Nicaragua.

Results: For the implementation of this education program, nine Indicadors were measured during the training process and at the end of the proyecto and different results were obtained. The neuropediatric care, that was totally centered in a single hospital, has suffered drastic changes, increasing the number of electroencephalographs and follow up of patients in the regional hospitals, while reducing external consultations and waiting time for consultations in the central hospital. Likewise, a neuropediatric network was established, training was provided, and brochures were developed, resulting in an improving satisfaction of families with the care provided for their children.

Conclusions: Our results revealed the real-life effectiveness of this education program in improving neuropediatric care in Nicaragua, supporting nonspecialized pediatricians and nurses for acting as decentralizing agents. The proposal reinforces universal access to basic health by focusing on different social determinants and may serve as a model to other low-income countries.