ABSTRACT
A case study of NGO SCION NicaSalud for improving public health provides a robust and concrete example of the action theory model that provides guidelines for managers and international donors. Four important principles are (1) measurement system of health behaviors and knowledge, (2) diversity of intervention strategies to change health behaviors and knowledge, (3) additional measures of network effectiveness besides public health and (4) resources for the NCO to create leverage effects in the inter-organizational network. The case of Nicaragua, a lower-middle-income country, makes an ideal testing ground, especially in poor rural areas—whether an NGO SCION can overcome adverse social determinants of health and increase social equality. A brief review of the public health situation in Nicaragua and its political history is provided as well as some detail on the devastation caused by Hurricane Mitch.
