'Salud Mesoamerica' Benefits 1.8 Million People, Strengthening Health Systems in Central America and Mexico

A regional health initiative administered by the Inter-American Development Bank (IDB) significantly improved maternal-neonatal and childcare for lower-income women, children, and adolescents across seven Central American countries and one Mexican state, according to an independent study released today. 

The Salud Mesoamerica Initiative (SMI) was launched in 2011 and is an alliance between the IDB, the national governments of Mesoamerica, and private and public donors including the Carlos Slim Foundation, the Gates Foundation, and the Spanish and Canadian governments. It focuses on improving maternal and child healthcare in Central America and the Mexican state of Chiapas. 

Across the region, the initiative helped increase the share of newborns receiving quality care by a factor of nearly five and boosted comprehensive emergency neonatal care – such as vital sign monitoring, oxygen administration, and antibiotics – by 14 percentage points, according to an independent impact evaluation by NORC at the University of Chicago. SMI also helped increase the quality of prenatal care and contributed to substantial improvements in services associated with pregnancy, childbirth, and newborn care. These are critical steps toward reducing maternal and infant mortality.  

The initiative was able to achieve impressive results among the target populations, including:  

• In Belize, the proportion of mothers and newborns receiving quality care for obstetric and neonatal complications more than doubled. 
• In Chiapas, Mexico, the proportion of women giving birth in health facilities increased from 37% to 48%, with significant improvements in antenatal and postpartum care. 
• El Salvador saw institutional deliveries by qualified personnel rise to 98%, and quality care for newborns with complications increased from 6% to 40%. 
• Costa Rica reduced teen pregnancies in its poorest cantons, achieving an 11.3% decline in adolescent fertility rates – surpassing wealthier areas in lowering these rates.  

“The Salud Mesoamerica Initiative not only improved access to healthcare, but also the quality of healthcare delivered to some of the most vulnerable in Central America,” said IDB President Ilan Goldfajn. “That has included not just improving maternal and neonatal care but doing it at twice the typical pace of improvement in low- and middle-income countries.”   

"The development of positive incentives and the measurement of results have been fundamental to ensure that this model not only achieves its goals, but that it is sustainable and replicable,” said Marco Antonio Slim Domit, from the Carlos Slim Foundation. “In fact, Salud Mesoamerica has inspired other successful initiatives, such as the Malaria Elimination Initiative." 

"Mesoamerica reminds us that development gains are fragile, unless they are intentional, equity-focused, and sustained,” said Christopher J. Elias, president of Global Development at the Gates Foundation. “And the Salud Mesoamerica Initiative has demonstrated a different path forward." 

SMI helped to foster systematic healthcare data collection that provided countries with their first comprehensive health care indicators in poor areas. Data supported the program’s results-based financing model in which a performance award was achieved when agreed-upon targets were met. This approach ensured that Ministries of Health focused on results and accelerated improvements through their healthcare networks. 

SMI has created a blueprint for impactful, scalable health programs worldwide. By addressing multiple barriers simultaneously, SMI accelerated change and significantly improved health outcomes for mothers and their babies.