How does Salud Mesoamérica 2015 work?

Operating Model

Result Based Funding

The Initiative uses an innovative results based funding model. In this model, financing funds are linked to rigorous, independent assessments, in order to change the incentives of the health program administrators. One portion of the funding is disbursed after the governments reach the targets in terms of broadening coverage or goals related to the quality of the health services provided.


The model provides the tools for monitoring performance and strengthening health information systems.

Investment Tranche
  • These are funds from donations used to finance a portion of the inputs and tasks required to reach the objectives proposed for each operation.
Performance Tranche
  • The performance tranche is equal to 50 percent of the country contribution.
  • Funds are granted if the country meets the pre-established coverage and quality goals and policy changes.
  • A baseline is established in order to determine coverage in targeted areas.
  • Performance indicators are jointly defined as coverage goals and policy changes, which will be included in a performance matrix.
  • Results will be measured independently.
  • Funds may be used for investments in the health sector determined by the national authorities.
Negotiated Counterpart Contribution
  • This refers to the national and local funds associated with the investment segment put towards the project.
  • This will assure the sustainability of the investments over time in the context of basic public health operations agreed upon in the context of the SMSP and the United Nations MDGs.
  • It may be funded through budget reallocation or a new budget allocation. Moreover, there may be an agreement to provide a portion of the contribution in kind, provided that this expenditure or input is used in the geographic areas that are the focus of the priorities agreed upon.
  • The amount will be negotiated jointly and will depend on the government revenues of each country. The minimum required counterpart contribution will be determined based on each country’s wealth.
Carlos Slim
Health Institute
international cooperation
Bill & Melinda Gates
Development Bank
We build on the work and collaborate with: