The Salud Mesoamerica Initiative (SMI, Mesoamerica Health Initiative) is a public-private partnership aimed to improve access to quality health for 1.8 million women and children in Panama, Costa Rica, Nicaragua, Honduras, El Salvador, Guatemala, Belize, and the State of Chiapas in Mexico.

Initiated in 2011, SMI is managed by the Inter-American Development Bank (IDB) and financed by the Bill & Melinda Gates Foundation, the Carlos Slim Foundation, and the governments of Canada and Spain. Its three operations were designed to increase supply, improve service, and generate demand for quality health services, respectively.