Nicaragua, the poorest country in Central America and the second poorest in the Western Hemisphere, has widespread underemployment and poverty. Known as the "Land of lakes and volcanoes", Nicaragua has abundant sources of freshwater, but little of it is safe to drink or readily accessible. Years of insufficient public investment following the upheaval and devastation of war and natural disasters, contamination from mining and agricultural activities and extensive cattle ranching causing deforestation and soil erosion, have left many people without safe water.


Similarly, over 2.8 million people, or nearly half the country's population, live without an adequate toilet.


According to the most recent Joint Monitoring Program Report by UNICEF and the World Health Organization, 85% of people in Nicaragua have access to improved water sources and 52% have improved sanitation facilities. However, there is a large disparity between rural and urban areas: in rural areas only 68% of people have access to safe drinking water and 37% have improved sanitation.


The effects of open defecation are serious; with urgent concerns of ground water resource pollution, contamination of agricultural produce. Consequently open defecation is a major contributing factor to a multiplicity of water and sanitation related diseases, such as diarrhea, cholera and typhoid.

Not only is open defecation (and lack of improved sanitation facilities) detrimental to human health but also to economic and social development, e.g., the productive activities of impoverished populations, such as schooling, are severely restricted by ill health from contaminated water. 

Lack of sanitation and adequate drinking water causes over 4.6 million episodes of diseases or infections, and almost 500 premature deaths in Nicaragua every year.