By establishing and supporting public health laboratories TASCA has made and will continue to make a modest contribution towards improving the public health infrastructure of Nicaragua. We hope that with the continuing follow-up that we provide and with economic progress in Nicaragua that these physical improvements will provide a lasting benefit.
In the laboratories, health centers and hospitals supported by TASCA we work with people who are intelligent, dedicated and enthusiastic, but in many cases inadequately trained. Many laboratory technicians and nurses have only on-the-job training and many professionals lack training in Public Health, Epidemiology and other aspects of preventive health care. For this reason we have come to believe that to improve the professional qualifications of public health workers would be a contribution equally valuable and probably more lasting than our support of public health infrastructure.
To this end we began in 1996 a program of scholarships to those already working in the field. This was feasible because the universities of Nicaragua offer courses of part-time, primarily week-end study in various public health disciplines, allowing scholarship recipients to continue to work and earn while studying.
The program has been very successful and has grown to where it now occupies just over half of our efforts and resources.
Since beginning in 1996 with two doctors from El Cuá studying towards the Masters in Public Health at the UNAN in León we have granted one hundred thirty-nine scholarships. As of January 1st 2014 ninety-nine students have graduated, eleven of them during 2013. Nine new scholarships were granted in 2013 so that at this date TASCA is supporting the studies of thirty-seven health workers, primarily from the Departments of Chinandega, Jinotega, León and Matagalpa. We are currently considering several new applications for scholarships and will certainly receive many more during the coming year.
The fields of studies of graduates and current students are shown in the table below:
Program Summary, January 2014
We have seen the success of the program manifested in a clear improvement in the level of professionalism and of service offered by the graduates. What for some was just a job has now become a vocation. At least one laboratory previously staffed with people trained only on the job now has a majority of professionally trained technicians.
However there are more tangible indicators of success:
Of the 139 scholarships offered to date, only three persons have dropped out without graduating. Of those currently supported some are getting really excellent grades, others are doing the best they can, but all are passing and in good standing. We require that each student supply copies of their grades as they become available and continued support is contingent upon passing grades.
The great majority of graduates continue to work in the public health sector. Students are required to commit in writing to work for at least two years in public health after graduating; this is not legally binding but has been effective. Ninety-three of the ninety-nine graduates continue to work in public health; three of the remainder completed their two-year commitment before entering the private sector.
We believe the high success rate comes in large part from the fact that those applying for scholarships are dedicated to their work and really want to provide better health services.
Beginning in 2005 we placed more emphasis on offering scholarships to workers from rural areas, such as El Cuá and Wiwili in the Department of Jinotega, El Sauce and Malpaisillo in the Dept of León. A quarter of the current scholars and 43 of the 99 graduates are health workers from such communities. Most were born in these communities and as is customary will almost certainly continue to live and work there for many years. For this reason these scholarships could have a major impact on rural health care in the future.
Up until 2006 TASCA was able to offer scholarships to any well-motivated health worker who submitted a serious application. However beginning in that year the number of approvable applications has exceeded our resources, and we have had to select among the applicants favoring those working most directly in public health and those working in rural areas, and even then asking some to defer study until a later time.
We wish to be able to offer scholarships to all qualified applicants, while expanding the program to parts of the country where we have not yet offered scholarships. We are thus seeking funds to allow us to expand the program over the next five years. Costs of the program for 2007 - 2012 averaged $93,800 per year in direct grants and $2560 per year (3.7%) in expenses.
Application Criteria. At the moment applications for TASCA scholarships are accepted only from persons who are currently working in the public sector of health care in Nicaragua. Priority is given to those working in public health rather than in primary care, and to those from rural communities. A document describing in Spanish the requirements for applicants may be downloaded from this link.