Emma Iriarte, Executive Secretary Salud Mesoamerica Initaitive
Adela lives in a small village in the Copan region. She had five children and in 2016 she became pregnant with her sixth child.
Her situation is one of extreme vulnerability. She gave birth to her five first children in a wooden cabin, with no type of medical support. However, in July 2017, her sixth child was born in a health center and her delivery was promptly controlled through her pregnancy and post-partum.
The advice she received from a health promoter that visited her household regularly prevented both mother and child from serious health risks.
Last July 21, 2017, a 37 year old mother gave birth in the San Felipe de Tegucigalpa Hospital. Everything was going well, until a severe hemorrhage endangered her life.
Hospital doctors acted quickly and thanks to the application of a balloon that is filled with water and stops the bleeding, the mother, who had already lost consciousness, was able to save her life. Additionally, this intervention prevented physicians from performing a hysterectomy which would have prevented her from having more children in the future.
The destiny of these two Honduran women changed in 2017. And it was not by chance. It was thanks to the commitment of the Health Secretariat of Honduras, managed by the Inter-American Development Bank, with the purpose of supporting the country in its efforts to bring quality health services closer to the most vulnerable women and children.
Since then, all levels of the Health Secretariat of Honduras have innovated, ambitious goals have been set and great progresses have been achieved in short periods of time. Their work and their effort have been able to transform the public health service of Honduras in favor of those most vulnerable in the country.
Political decision makers, physicians, health center directors, promoters, nurses, health managers, aides… Hundreds of women and men committed for over six years to work so that 67,624 women and 33,261 children under age five of the poorest regions in Honduras receive the health services they need and deserve.
The success story of both Adela and the mother that saved her life at the San Felipe Hospital are the face of outcomes that would have seemed impossible to achieve just six years ago.
Last year, this figure rose to 84.7 percent. In 2013, only 59.2 percent of pregnant women received prenatal care during the first quarter of pregnancy. The figure is currently 89%.
In 2013, post-partum care in the first seven days after birth was only 47 percent among the poorest women; it is now at 60.4 percent.
In 2013, only ten percent of neonatal complications were treated in accordance with the medical standards.
This figure is now 42.9 percent. These figures have been documented through an exhaustive measurement performed last year by the Institute for Health Metrics and Evaluation (IHME) that included a survey in 90 health centers and 2,439 households.
Behind these figures is the work of the Health Secretariat and of some public workers committed to providing a better service to the citizens, the commitment of private and public partners (the Carlos Slim Foundation, the Bill & Melinda Gates Foundation and the Government of Spain) and the coordination and management work of a multilateral agency such as the Inter American development Bank (IDB).
The Salud Mesoamerica Initiative is an innovative and efficient development model based on trust among public and private partners committed and focused on the same goal: the elimination of health gaps that affect the poorest women and children in Mesoamerica.
The project is based on a results-based financing model: the partners and IDB contribute 50 percent of the capital and the other 50 percent is contributed by the country. If the country meets the negotiated goals, it receives the equivalent of 50 percent of their original contribution and the governments may freely invest this money in the health sector of their countries.
In this case, apart from receiving 7.5 million Dollars to operate actions since 2012, the Government of Honduras will receive 1.75 million Dollars this year for complying with the goals agreed in the second operation. This amount is in addition to the two million Dollars it received in 2015 for meeting the goals agreed in the first operation.
The Salud Mesoamerica Initiative contributes a plus to this model. This plus has been achieved by establishing a trust relationship with the national governments and contributing with innovative, efficient and measurable technical assistance.
The Health Secretariat of Honduras has been a formidable partner that has assumed the risks of innovating, experimenting, failing, achieving and measuring, always in favor of the country’s most disadvantaged women and children.
Good evidence of this has been the training of over 300 medical professionals in the application of the intrauterine balloon to avoid post-partum hemorrhages in the country’s health centers and hospitals; the implementation of the Redes (Networks) project with a network of volunteers equipped with mobile devices that cover over 3,000 families that live in poverty in 154 municipalities in Copan; the creation of the Madre Estrella (Star Mother) program, which promotes controls during pregnancy and institutional delivery. All of them are innovative projects that have saved and improved the lives of thousands of women in the country.
The outcomes invite optimism. But we are aware that there is still much left to do.
That is why, as of this year, the Government of Honduras will begin the third operation with the Salud Mesoamerica Initiative with the purpose of continuing to bring quality health care services closer to women like Adela and her six children in Copan, who day after day continue demanding and deserving the best public health services.