Overview

The Salud Mesoamérica Initiative was an innovative public-private partnership that sought to improve the quality of maternal, newborn, and child health services and reduce equity gaps for the poorest populations in seven Central American countries–Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, and Panama–and the southern state of Chiapas, Mexico. 

Our work brought together strategic investments from the Bill & Melinda Gates Foundation, Carlos Slim Foundation, Government of Spain, Inter-American Development Bank, regional bodies, national governments, and local stakeholders in an innovative partnership that rewarded equity and quality. The initiative used results-based funding on a large scale, allocating funds at the national level based on measurable improvements in coverage and quality of maternal, newborn, and child health services. The implementation of quality improvement coupled with a unique model of technical assistance accelerated performance toward agreed upon health targets. 

Our unique approach to technical assistance involved placing technical advisors within targeted hospitals for a period of weeks or months, directly beside teams, to implement a continuous quality improvement process using easy-to-use, practical tools that produced measurable results. Through the project, we helped systematize and institutionalize continuous quality improvement at 52 health facilities in El Salvador, Guatemala, Honduras, Mexico, Nicaragua, and Panama. Documented improvements in quality of care included an increase from 17% to 61% in the management of obstetric complications in Belize, Honduras, and Nicaragua, and a 24% increase in antenatal care quality in El Salvador.