Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Apr 16;13(4):e0195292.
doi: 10.1371/journal.pone.0195292. eCollection 2018.

Supply-side interventions to improve health: Findings from the Salud Mesoamérica Initiative

Ali H Mokdad  1 , Erin B Palmisano  1 , Paola Zúñiga-Brenes  2 , Diego Ríos-Zertuche  2 , Casey K Johanns  1 , Alexandra Schaefer  1 , Sima S Desai  1 , Annie Haakenstad  1 , Marielle C Gagnier  1 , Claire R McNellan  1 , Danny V Colombara  1 , Sonia López Romero  3 , Leolin Castillo  4 , Benito Salvatierra  5 , Bernardo Hernandez  1 , Miguel Betancourt-Cravioto  6 , Ricardo Mujica-Rosales  6 , Ferdinando Regalia  7 , Roberto Tapia-Conyer  6 , Emma Iriarte  2
Affiliations

Supply-side interventions to improve health: Findings from the Salud Mesoamérica Initiative

Ali H Mokdad et al. PLoS One. .

Abstract

Background: Results-based aid (RBA) is increasingly used to incentivize action in health. In Mesoamerica, the region consisting of southern Mexico and Central America, the RBA project known as the Salud Mesoamérica Initiative (SMI) was designed to target disparities in maternal and child health, focusing on the poorest 20% of the population across the region.

Methods and findings: Data were first collected in 365 intervention health facilities to establish a baseline of indicators. For the first follow-up measure, 18 to 24 months later, 368 facilities were evaluated in these same areas. At both stages, we measured a near-identical set of supply-side performance indicators in line with country-specific priorities in maternal and child health. All countries showed progress in performance indicators, although with different levels. El Salvador, Honduras, Nicaragua, and Panama reached their 18-month targets, while the State of Chiapas in Mexico, Guatemala, and Belize did not. A second follow-up measurement in Chiapas and Guatemala showed continued progress, as they achieved previously missed targets nine to 12 months later, after implementing a performance improvement plan.

Conclusions: Our findings show an initial success in the supply-side indicators of SMI. Our data suggest that the RBA approach can be a motivator to improve availability of drugs and services in poor areas. Moreover, our innovative monitoring and evaluation framework will allow health officials with limited resources to identify and target areas of greatest need.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors declare that they have no competing interests. The Inter-American Development Bank is the largest source of development financing for Latin America and the Caribbean. It is not a commercial bank and all information about the Bank activities is available on www.iadb.org. SMI was funded by Bill and Melinda Gates Foundation, Carlos Slim Foundation, and the Spanish Government.

Figures

Fig 1
Fig 1. Percentage of facilities with selected equipment and supplies needed for the provision of basic antenatal and postnatal care services*.
Fig 2
Fig 2. Basic and complete health facilities with selected equipment and supplies needed for the provision of basic antenatal and postnatal care service.
Fig 3
Fig 3. Ambulatory health facilities with selected equipment and supplies needed for the provision of basic antenatal and postnatal care service.
See this image and copyright information in PMC

References

    1. Wang H, Liddell CA, Coates MM, Mooney MD, Levitz CE, Schumacher AE, et al. Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet. 2014. September; 384(9947):957–979. - PMC - PubMed
    1. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet. 2012. December; 380(9859):2095–2128. - PMC - PubMed
    1. Kassebaum NJ, Bertozzi-Villa A, Coggeshall MS, Shackelford KA, Steiner C, Heuton KR, et al. Global, regional, and national levels and causes of maternal mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet. 2014. September; 384(9947):980–1004. - PMC - PubMed
    1. Braveman P, Tarimo E. Social inequalities in health within countries: not only an issue for affluent nations. Soc Sci Med. 2002. June; 54(11):1621–1635 - PubMed
    1. Victora CG, Wagstaff A, Schellenberg JA, Gwatkin D, Claeson M, Habicht J-P. Applying an equity lens to child health and mortality: more of the same is not enough. The Lancet. 2003. July; 362(9379):233–241. - PubMed

Publication types

LinkOut - more resources