The Government of Nicaragua, through its coordinating unit for public sector reform (UCRESEP), requested CIETnicaragua to assist in assessing worker satisfaction with the country’s new model for health insurance system reform (in Latin America called the Social Security system). During 1997 surveys in 115 separate work places collected perceptions of 4,383 employees covered by the new model. The most recent encounter for a common illness or accident was the point of reference. This study was intended as a baseline for periodic assessments of client satisfaction as a way of building the community voice into planning of social services.