Nicaragua, located in Central America, is the second poorest country in the western hemisphere. Around half of its population of 5 million people lives on less than 1 USD per day. Nicaragua is facing a growing burden of non-communicable diseases. In 2000, the Ministry of Health reported that the leading causes of death were heart attack, stroke, perinatal death (foetal and new-born) and diabetes. In 2002, deaths due to chronic diseases represented 37% of the total; deaths due to communicable diseases fell from 14.5% in 1985 to less than 5% in 2002. Because of this shift in the disease burden and the challenge of caring for people with diabetes in resource-poor settings, it was decided by the International Insulin Foundation and Handicap International in Nicaragua to carry out a Rapid Assessment Protocol for Insulin Access in Nicaragua.