World Bank2013-03-282013-03-282010-06-29https://hdl.handle.net/10986/13041Globally, 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.en-USCC BY 3.0 IGOACTION PLANSACTIVE ENGAGEMENTADVERSE EFFECTSADVERSE IMPACTSAGRICULTURAL ACTIVITIESAGRICULTURAL ACTIVITYAGRICULTURAL EXPANSIONAGRICULTURAL FIELDSAGRICULTURAL LANDAGRICULTURAL PRODUCTIONAGRICULTUREALGAEALGAL GROWTHALTERNATIVE LIVELIHOODSANECDOTAL EVIDENCEANIMALANNUAL PRECIPITATIONANNUAL RUNOFFAQUACULTUREAQUATIC LIFEAQUEDUCTSAROMATIC HYDROCARBONSBACTERIABASINSBEACHESBIODIVERSITYBIOLOGICAL COMMUNITIESBIOSPHEREBIOSPHERE RESERVEBIRDBIRD SPECIESBIRDSBREEDINGBREEDING GROUNDSBROAD RANGEBURNINGCARPCATTLECERTIFICATIONCIVIL UNRESTCLIMATECLIMATE CHANGECOASTCOASTAL AREASCOASTAL TOURISMCOASTAL ZONECONFLICT RESOLUTIONCONSERVATIONCONSERVATION STATUSCONSERVATION TILLAGECONSTRUCTIONCONTAMINANTSCRITICAL AREASCROP PRODUCTIONCROPSCULTIVATED AREADATA GAPSDEPTH ASSESSMENTDISCHARGEDOMESTIC USEDOMESTIC WATERDRAINAGEDREDGINGDRINKING WATERDRY SEASONECOLOGICAL PROCESSESECOLOGYECONOMIC GROWTHECOSYSTEMECOSYSTEM HEALTHECOSYSTEMSENCROACHMENTENDEMIC FISHENDEMIC FISH SPECIESENDEMIC SPECIESENVIRONMENTAL CONSERVATIONENVIRONMENTAL DEGRADATIONENVIRONMENTAL EDUCATIONENVIRONMENTAL IMPACT ASSESSMENTENVIRONMENTAL IMPACTSENVIRONMENTAL MONITORINGENVIRONMENTAL PROTECTIONENVIRONMENTAL RESEARCHEROSIONEUTROPHICATIONEUTROPHICATION PROBLEMSEXOTIC FISHEXOTIC FISH SPECIESEXPOSUREFARM MANAGEMENTFARMSFISHFISH KILLSFISH POPULATIONSFISH STOCKSFISHERIESFLOODSFORESTFOREST COVERFORESTSFRESHWATERGEOGRAPHIC INFORMATIONGEOGRAPHIC INFORMATION SYSTEMSGRASSLANDSGROUNDWATERGROUNDWATER DISCHARGEHABITATSHARMHIGH LEVELSHYDROLOGYINDUSTRIAL WATERINVASIVE SPECIESIRONIRRIGATIONIRRIGATION SYSTEMSIRRIGATION WATERISSUESLAKELAKE SEDIMENTSLAKESLAND DEGRADATIONLAND TENURELAND USELAND USESLIVESTOCKLIVESTOCK PRODUCTIONMAMMAL SPECIESMESOAMERICAN BIOLOGICAL CORRIDORMETEOROLOGICAL DATAMITIGATIONMONITORING PROGRAMMUNICIPAL WASTEWATERNATIONAL FISHERIESNATIONAL PARKNATIVE FISHNATIVE SPECIESNATURAL RESOURCESNATURAL WETLANDSNEW SPECIESNITROGENNON-NATIVE SPECIESNUTRIENT CONTENTNUTRIENT FLOWSNUTRIENT LEVELSNUTRIENT LOADSORGANIC COMPOUNDSOXIDATIONOXYGEN LEVELSPASTUREPASTURE PRODUCTIONPASTURESPESTICIDE USEPHOSPHORUSPHYTOPLANKTONPLANNING PROCESSPLANTPLANTATIONSPLASTIC BAGSPOINT SOURCEPOINT SOURCE POLLUTIONPOLLUTANTSPONDSPOPULATION GROWTHPOTABLE WATERPRECIPITATIONPRESSUREPROTECTED AREASPROTECTION OF WETLANDSPUBLIC AWARENESSPUBLIC HEALTHPUBLIC HEALTH RISKSPUMPINGQUALITY STANDARDSRAINFALLRAINFALL CHARACTERISTICSRAINFALL PATTERNSRANGESRECREATIONAL FISHINGREGIONAL CLIMATEREMOTE SENSINGREPTILESRESERVOIRRESTAURANTSRESTORATIONRIVERRIVER BASINSRIVER NETWORKRIVER WATERSHEDRIVERSRUNOFFSANITATIONSEDIMENTSEDIMENT LOADSEDIMENT LOADSSEDIMENTSSHORESHORESSHRUBSSIGNIFICANT WETLANDSSOIL DEGRADATIONSOIL EROSIONSOIL FERTILITYSOILSSPECIESSPECIES OF FISHSTABILIZATION PONDSSTORMSSTREAMSTREAM CHANNELSSTREAM FLOWSTREAMSSUGARCANESURFACE AREASUSTAINABLE AGRICULTURESUSTAINABLE TOURISMSUSTAINABLE USETILAPIATOPOGRAPHYTOURISM DEVELOPMENTTOURIST ATTRACTIONSTOXIC ALGAETREATING WASTEWATERTREEVEGETATIONWASTEWATER TREATMENTWASTEWATER TREATMENT SYSTEMSWATER CONTAMINATIONWATER POLLUTIONWATER QUALITYWATER QUANTITYWATER RESOURCESWATER RESOURCES MANAGEMENTWATER SOURCESWATER SUPPLYWATER TREATMENTWATERSHEDWATERSHED MANAGEMENTWATERSHED PROTECTIONWATERSHEDSWET SEASONWETLANDWETLAND MANAGEMENTWETLAND PROTECTIONWETLAND SYSTEMSWETLANDSWILDLIFEWILDLIFE REFUGEWILDLIFE REFUGESWorld Bank10.1596/13041