$55 million to improve health conditions for Women and Children in Mesoamerica

Salud Mesoamerica 2015, a regional health initiative, will begin operations in Belize, El Salvador, Guatemala, Nicaragua, Honduras, Panama, and shortly in Costa Rica and the Mexican state of Chiapas, with investments totaling $55 million to improve health conditions for some 1.8 million women and children living in extreme poverty in 121 municipalities.

Inter-American Development Bank President, Luis Alberto Moreno, Instituto Carlos Slim de la Salud President, Marco Antonio Slim and Bill & Melinda Gates Foundation Senior Program Officer, Wolfgang Munar announced the start of the initiative's operations at a press conference held during the World Economic Forum on Latin America. Honduran Health Minister Arturo Bendana, acting president of the Mesoamerican Public Health System, represented the region's governments at the event.

The Mesoamerican governments played a crucial role in the design of the initiative's first eight operations, whose investment of $55 million is made up of $34 million from the initiative and $21 million in counterpart funds from the participating countries. These initial operations represent a direct investment of $30 per beneficiary, nearly three times the per capita public expenditure in basic health services that some Central American countries direct at the poorest 20 percent of their populations.

Moreno applauded the governments' financial, political, and operational commitment to implementing these initial operations. "This is the first regional public-private initiative in Latin America designed to improve equity in health for the poorest groups of the population. We expect it will become a reference point for other regions of the world," Moreno said.

Salud Mesoamerica 2015 has $142 million available to provide grants to countries and will leverage $54 million in counterpart funding from governments, for a total of nearly $200 million in investments for the target population. The funds will finance maternal, newborn, reproductive and child health services with emphasis on nutrition and vaccination for the poorest segments.

"We are here today to affirm our commitment that, at least in terms of health, national borders are erased and gaps are being closed for Mesoamerican women and children who have long been marginalized, guaranteeing them an opportunity to receive decent and quality health care. Better health and opportunities for development cannot and must not have borders," said Marco Antonio Slim

Salud Mesoamerica 2015 seeks to achieve the following goals:

* Reduce by 15 percent infant mortality among the poorest 20 percent of the region's population.

* Provide health services to 260,000 poor children to reduce chronic malnutrition.

* Reduce by 15 percentage points the rate of anemia among children under two years in seven of the eight countries in the region. In Chiapas the goal is to reduce it by 10 percentage points.

* Ensure that 90 percent of children under two years among the poorest 20 percent of the population complete their vaccination schedules.

* Increase by 50 percent births attended by skilled personnel, in order to reduce deaths of mothers and newborns.

"Under the results-based-financing model introduced by the initiative, each government has committed itself to achieving specific targets with the incentive that, on meeting goals, they will return to us half of the counterpart resources we provide. This requires changes in the planning and implementation of health interventions, aiming to improve not only coverage but also the quality of services," said Bendana.

The projects are being launched at a critical moment in which Mesoamerican countries are facing high mortality rates and maternal and infant morbidity. In Honduras, Guatemala, and El Salvador, 110 women die during pregnancy, childbirth or postpartum per 100,000 live births. This is compared with an average maternal mortality rate in Latin America and the Caribbean of 85 per 100,000 cases.

The initiative will also address the problem of malnutrition, which affects some 2.5 million children in the region. In some Central American countries, childhood malnutrition is more serious than in some African countries. Malnutrition can result in a difference in height of up to 6 centimeters between a poor child and a better-off child, in addition to affecting cognitive development, school performance, and chances of escaping from poverty. Numerous studies show that stunting occurs in the first 1,000 days of life, from the time children are in the womb until they are two years old. "We have 1,000 days to change the life prospects of these marginalized and vulnerable children," said Moreno.

Salud Mesoamerica 2015 was launched in 2010 as an innovative public-private partnership between the Bill & Melinda Gates Foundation, the Instituto Carlos Slim de la Salud, the government of Spain and the IDB. The 5-year initiative's goal is to reduce the health equity gaps people in extreme poverty face, in accordance with priorities established by the region's countries.