Observation (CEACR) - adoptée 2003, publiée 92ème session CIT (2004)

Article 3(c) of the Convention. (a). With reference to its previous comments, the Committee notes the report sent by the Government and the statistical information appended thereto. It notes in particular that at the end of 2000, the National Social Security Institute had 308,531 direct members and 894,740 dependants, i.e. a total of 1,203,271 persons covered. The Committee also notes a significant increase in the number of confinements covered by sickness and maternity insurance under the integrated scheme during the period from 1998 to 2000, and the increase, equally significant, in the number of insured persons who received maternity benefit. The Committee observes, however, that although it covers 76 per cent of workers the integrated social security scheme, which includes maternity protection, continues to apply to only part of the country. The Committee is therefore bound once again to point out that in the regions to which application of the integrated scheme has not yet been extended, the employer continues to bear directly the cost of cash maternity benefits, whereas the Convention requires these benefits to be provided either out of public funds or guaranteed by an insurance system. The Committee therefore hopes that the Government will continue to do its utmost to extend the provision of maternity benefits by the social security scheme to the whole country in order to cover all the women workers protected by the Convention. It trusts that the Government will be in a position to indicate progress in this respect in its next report.

(b). The Committee notes from the information in the Government’s report that since 1999 six new medical establishments have been created to provide preventive and remedial care to women who belong to the integrated social security scheme, bringing the total number of such establishments in the country to 47. It also notes that according to the statistics sent by the Government, medical insurance establishments had 195,228 members in 2000, i.e. an increase of 9.6 per cent over the previous year, although these persons did not account for the total membership of the integrated insurance scheme. The Committee also notes the information supplied by the Government on the various types of care dispensed to pregnant women in 2000 by medical insurance establishments, showing a clear increase in the number of consultations and confinements as compared to previous years. According to the statistics sent by the Government, the medical insurance establishments covered 9,023 confinements in 2000, which appears to be a relatively small number in view of Nicaragua’s population and birth rate. In these circumstances, the Committee hopes that the Government’s next report will contain information on the measures taken or envisaged to develop the medical infrastructure so that, in practice, all women workers covered by the Convention receive the free care prescribed by its provisions.

The Committee also requests the Government to continue to provide information on the practical implementation of the social security scheme in respect of maternity benefits both in cash and in kind, including statistics on the regions covered and the number of employed persons covered by the scheme as compared to the total number of employed persons.