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Globally, an estimated 24 percent of the
disease burden (healthy life years lost) and an estimated 23
percent of all deaths (premature mortality) are attributable
to environmental risks (World Health Organization, or WHO
2006). The burden of disease is unequally shared, with the
children and the poor being particularly affected. Among
children between the ages 0 and 14, the proportion of deaths
attributable to environmental risks, such as poor water and
sanitation, indoor air pollution and vector-borne diseases,
is estimated to be as high as 36 percent (WHO 2006). Several
key messages have emerged from the process of putting
together this study: (i) environmental health risks impose a
significant burden on Nicaragua's economy, amounting to
2.6 billion Nicaraguan Cordoba (NIO) or 2.4 percent of the
country's Gross Domestic Product (GDP), and result in
premature deaths and infections, especially in children
under five; (ii) cost-effective interventions to address
these environmental health risks exist and should be
prioritized in Nicaragua; (iii) country-specific health and
environmental data are somewhat limited, especially in the
case of air quality, and data collection and monitoring need
to be further strengthened; and (iv) the capacity of
Ministry of Environment and Natural Resources (MARENA) and
Ministry of Health (MINSA) staff to conduct environmental
health costing analysis needs to be strengthened through
proper training.