As of 1999, there were an estimated 0.9 physicians and 1.5 hospital beds per 1,000 people. In 2000, Nicaragua had 5,656 general practitioners, 950 specialists, 323 registered nurses, 974 dentists, and over 1,000 pharmacists. As of 1999, total health care expenditure was estimated at 12.5% of GDP. In 2000, 79% of the population had access to safe drinking water and 84% had adequate sanitation.
Slow progress in health care was made from the 1960s through the 1980s, as the crude death rate dropped from 19 per 1,000 people in 1960 to and estimated 4.8 in 2002. During 2000, the infant mortality rate was 33 per 1,000 live births and average life expectancy was 69 years. The maternal mortality rate was 150 per 100,000 live births in 1998.
Malnutrition and anemia remain common, as do poliomyelitis, goiter, and intestinal parasitic infections (a leading cause of death). The prevalence of child malnutrition was 25% of children under five in 1999. The goiter rate was 4.3 per 100 school-age children. Immunization rates for children up to one year old in 1997 were as follows: tuberculosis, 99%; diphtheria, pertussis, and tetanus, 94%; polio, 99%; and measles, 94%.
The fertility rate was 3.5 births per woman in 2000; 44% of married women (ages 15 to 49) used some form of contraception in 1997.
As of 1999, the number of people living with HIV/AIDS was estimated at 4,800 and deaths from AIDS that year were estimated at 360. HIV prevalence was 0.2 per 100 adults. Common diseases reported in Nicaragua were malaria (70,235 cases in 1995), cholera (2,979 in 1996), and tuberculosis (2,836 in 1990–95). In 1999, there were 88 cases of tuberculosis per 100,000 people.