Over a million people live with no health care at all. Public spending in health in 1990 stood at 7%, but by 2000 had fallen to 2.3% of GDP.

Malnutrition among children is estimated at 40%. In Nicaraguan homes, poverty reduces the daily diet, often to one meal a day. The poor often only get 60-70% of the protein and calories they need, reducing their capacity to work, and further jeopardizing their economic situation.

The population growth rate is 2.8%. This means that roughly 10,000 babies are born a month. Half the population is under sixteen years of age, and a third of all babies are born to women age nineteen and under.

Mortality rates for infants under five years of age is sixty-six in every 1000 live births. Life expectancy in Nicaragua is 69.5 years. Nicaragua has a housing shortfall of 420,000 homes. Two thirds of the population does not have access to adequate sewer services.

Illiteracy in Nicaragua stands at 33.2%, compared to 17% in 1990. In the rural parts of the country, 50% of men and 60% of women cannot read. 75% of the population find themselves with the minimum of schooling, in the rural areas many scarcely complete primary school. The poor have an average of only 3.1 years of education. More than 15% of the population (800,000 boys and girls) does not attend school.

Public spending on education in the year 2000 stood at 5% GDP.

Nicaragua's geology, climate, and location have made it the victim of different kinds of disasters: volcanic eruptions, earthquakes, floods and droughts. Such disasters accelerate the cycle of poverty. This same poverty leads to environmental destruction, as poor peasant farmers take whatever measures they can to keep their families fed.

This leads to deforestation, reduced fish and fauna populations, dried-up rivers, water pollution, and soil erosion.

With 82.3% of the population living in extreme poverty, on less than a dollar a day, many people are migrating to the cities (or to Costa Rica) in search of security and opportunity. Hurricanes Joan, Mitch and Michelle accelerated this process.

From the early 1990s until the fall of 2001, Nicaragua was considered the second-poorest country in the Western Hemisphere, after Haiti. According to the World Bank, as cited by USAID, Nicaragua is now the poorest, with an average per capita annual income of $430. The UN's World Food Program estimates the per capita income lower still, at $300.

In 1995, Nicaragua had a Human Development Index (HDI) of 0.611 and came in 109th on the list of 174 countries. In 1998, according to the UN's Human Development program, the HDI had fallen to 0.547, and Nicaragua was in 126th place. In 2004, Nicaragua comes in at 118th place.

The economically-active population is made up of 1.2 million people (just under a quarter of the population). The official unemployment rate in 2001 was 13.8% compared with a Latin American average of 9.4%. However, if you take into account underemployment (many formally unemployed people work in the informal cash economy for subsistence wages) it is thought that a more realistic figure would stand at over 60%. Many Nicaraguans also move to Costa Rica or the U.S. to work. They send back roughly $700 million every year in remittances, which is substantially more than Nicaragua receives in foreign aid, and more than Nicaragua's Gross Domestic Product.

As the year 2000 began, the external debt was $6.5 billion. This averages out at over $1,000 for every man, woman, and child in Nicaragua. The Nicaraguan government could not even keep up with payments on the interest, thus the debt has continued to grow steadily. The World Bank and International Monetary Fund (IMF) imposed "structural adjustment" programs on Nicaragua that diverted funds from education, health, and infrastructure programs to debt repayment. This benefits wealthy lending institutions and foreign governments, and hurts impoverished Nicaraguans.

In early 2004, after finally meeting all of the requirements for entry into the World Bank's Highly Indebted Poor Countries (HIPC) initiative, 80% of Nicaragua's external debt was cancelled. The debt still stands at 6.2 million dollars and many question whether the further neo-liberal reforms the government is required by the World Bank to implement, might not do more harm than good.

Nicaragua's internal debt is of growing concern to its people. The internal debt is due mainly to the payment of bonds offered to indemnify persons whose properties were confiscated in the 1980s, and to the bankruptcy of several private banks a few years ago. Apparently the debt relief provided by Nicaragua's entrance into the HIPC Initiative did not free up funds for investment in public health and education, but to finance the internal debt.