The Mesoamerica Health Initiative / Salud Mesoamerica Initiative (SMI) is a public-private partnership dedicated to improving 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, the 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 aim at increasing supply, improving service, and generating demand for quality health services, respectively.

• Focus on equity
• Blended finance approach
• Performance-based financing based on a series of indicators
• Independent verification of targets
• Comprehensive programing
• Advisory technical assistance

Between 2012 and 2017, all countries showed progress in intervention areas: in Nicaragua, quality of routine neonatal care improved by more than 35 percentage points, whereas in Belize, the routine application of oxytocin, a basic intervention to prevent bleeding after childbirth, increased from 60% to 99%. SMI also improved coverage on maternal neonatal and child health coverage indicators in indigenous populations, for example, in Chiapas and Guatemala. In SMI -beneficiary areas in Chiapas-, Mexico, prenatal care coverage for indigenous women increased by 10 percentage points and institutional births by 5 percentage points between 2012 and 2018. In the targeted areas of Guatemala, prenatal care for indigenous women increased by 11 percentage points and their institutional births by 7 percentage points between 2013 and 2018. The proportion of indigenous women in Chiapas and Guatemala who reported being treated with respect increased by more than 5 percentage points. 1 Please click on the flags to see more about each countries results. 

The Salud Mesoamerica Initiative (SMI) has compiled a series of toolkits based on their programmatic experience in the region. SMI has worked in partnership with Ministries of Health and other technical partners to increase the quality and use of the basic public health services in the areas of reproductive, maternal, child and neonatal health (RMNCH) care, maternal and child nutrition, and immunization.

These toolkits bring together a set of existing tools that are in use for various aspects of country level health programming, including situation analysis, planning, implementation, and monitoring and evaluation. The toolkits include products of the SMI and others used in addressing various technical health issues, presented in a user-friendly format for ease of use at the country level. These toolkits are aimed at professionals working in Latin America and the Caribbean in the fields of results-based finance, RNMCH, supply chain, quality improvement of health care, and ehealth/mhealth.

Through our work in eight Mesoamerican countries (including the state of Chiapas in Mexico), our efforts to improve health equity are focused on the most vulnerable women and children. Each country has their own story and experience with the SMI.

Find out more about our work across the region by clicking the map.