Valuable results of the Mesoamerica Health Initiative are presented in Washington, DC
The Mesoamerican Health Initiative (Iniciativa Salud Mesoamérica, ISM), which started in 2010, is a public-private partnership established between the Bill & Melinda Gates Foundation, Carlos Slim Foundation (FCS), the Government of Spain, the Inter-American Development Bank (IDB) and governments of the seven countries of Central America and the state of Chiapas in Mexico. The ISM seeks to reduce the morbidity and mortality of women of reproductive age and children under five years old in areas of extreme poverty of the region. The Initiative focuses on improving the supply of health services in communities where the poorest 20% of the population lives, most of them indigenous communities, with innovative interventions in maternal and perinatal health, infant nutrition and vaccination.
The conference ‘Obtaining Results in Health and Development’, organized by the Inter-American Development Bank (IDB) and the Global Development Center (GDC), was held from February 28 to March 1 in Washington, DC. The objective of this conference was reviewing and exposing the lessons learned from the ISM, and how its experiences can nurture and inform other programs in future health care.
The CGD has extensive experience with results-based financing. It has analyzed the utility of performance programs based on their results and has studied the use of cash assistance to promote social and health services. Additionally, the GDC has examined ways to maximize the impact of results-based financing on health. After 18 months of the start of the ISM, a first measurement of results was carried out to verify that the participating countries achieved their goals and thereby achieve their performance bonuses. Now, at the end of a second 18-months period, a second measurement is being made. The usefulness of the model is expected to be demonstrated with the resulting data.
At this conference, the results and analyzes obtained from the model in the Mesoamerican region were presented, for the first time, to international organizations such as the World Bank, the Global Fund, governments and organizations working in Africa and Asia, among other regions of the world, as well as organizations and donors.
The session called ‘The role and potential of results-based financing as a solution for the transition of aid’ included the participation of Chris Elias of the Bill & Melinda Gates Foundation; Santiago Levy, of the IDB; Fanny Mejía, Vice Minister of Health of Honduras; and Dr. Roberto Tapia-Conyer, CSF General Director. The participants discussed the utility of a results-based financing model, as a useful and successful method to support social and health development programs in low-income countries.
Additionally, Dr. Miguel Betancourt Cravioto, FCS Director of Global Solutions; Amanda Glassman, from the GDC; and Dr. Jaime Sepúlveda, of the University of California participated in the session called ‘How did it start? The origins of the ISM model’. They spoke about the conceptual design of the initiative, the first steps and the first lessons of the implementation of the model in the field.
In the ISM results-based financing model, donor institutions contribute a proportion of the resources, and the governments of each participating country contribute an equivalent amount; joint goals are established; and, if after the independent evaluation the countries reach 80% of the agreed goals, they receive 50% of their investment to be reused in other public health programs.
The main objective of the meeting was to share the progress and results of ISM with other organizations such as development banks, international donors and multilateral organizations dedicated to financing and international assistance, so that they can replicate the model in other regions of the planet to support interventions in health or in other important areas such as education and training of human resources.
The third and final phase of the Initiative is currently underway, with the participation of the five countries that have performed the best: Honduras, Nicaragua, El Salvador, Belize and Panama. These countries have achieved the greatest impact and efficiency in the use of resources and success in the implementation of the project.
With the actual results of the Mesoamerica Health Initiative, Carlos Slim Foundation reaffirms its commitment to the health of the most vulnerable population in the region and its active participation in projects of fundamental importance for the well-being of communities in Latin America.