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

Autor: Mokdad AH; Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America., Palmisano EB; Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America., Zúñiga-Brenes P; Salud Mesoamérica Initiative / Inter-American Development Bank, Edificio Tower Financial Center (Towerbank), Panamá, Panamá., Ríos-Zertuche D; Salud Mesoamérica Initiative / Inter-American Development Bank, Edificio Tower Financial Center (Towerbank), Panamá, Panamá., Johanns CK; Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America., Schaefer A; Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America., Desai SS; Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America., Haakenstad A; Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America., Gagnier MC; Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America., McNellan CR; Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America., Colombara DV; Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America., López Romero S; UNIMER, San Francisco, San Salvador, El Salvador., Castillo L; University of Belize, Belmopan, Belize., Salvatierra B; El Colegio de la Frontera Sur, Barrio Maria Auxiliadora, San Cristóbal de las Casas, Chiapas, MÉXICO., Hernandez B; Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America., Betancourt-Cravioto M; Fundación Carlos Slim, Delegación Miguel Hidalgo, México, Distrito Federal., Mujica-Rosales R; Fundación Carlos Slim, Delegación Miguel Hidalgo, México, Distrito Federal., Regalia F; Inter-American Development Bank, NW, Washington, DC, United States of America., Tapia-Conyer R; Fundación Carlos Slim, Delegación Miguel Hidalgo, México, Distrito Federal., Iriarte E; Salud Mesoamérica Initiative / Inter-American Development Bank, Edificio Tower Financial Center (Towerbank), Panamá, Panamá.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2018 Apr 16; Vol. 13 (4), pp. e0195292. Date of Electronic Publication: 2018 Apr 16 (Print Publication: 2018).
DOI: 10.1371/journal.pone.0195292
Abstrakt: 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.
Databáze: MEDLINE
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