Learning from Systemic Change Over Time: The Salud Mesoamérica Initiative 2011-2024

The Salud Mesoamérica Initiative (SMI) was a multi-country, public-private initiative launched between 2011 and 2024 in eight Mesoamerican countries: Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama, and the Mexican state of Chiapas. Its initial focus was on enhancing maternal and child health outcomes for the poorest rural populations.

The Gill-Lebovic Inaugural Seminar, held May 28, 2025, focused on the evaluations conducted by the Gill-Lebovic Center in El Salvador and Honduras and the impact evaluation led by the University of Chicago.  Participants shared new standards for collaboration and knowledge-sharing, with lessons that could benefit communities across the Americas for years to come.  In her closing remarks, Dean Goldman thanked Holly Gill and Jim Lebovic, "You've given us an extraordinary platform to do work that matters, that strengthens health systems and improves lives across the Caribbean and Latin America."  A key takeaway from the panel discussion was the strong interest in building upon SMI’s approach to evaluation—not only as a tool for accountability, but also as a foundation for learning throughout implementation.  Participants discussed how similar models could more intentionally support adaptive learning in future efforts, recognizing that this would require new methods and closer integration between evaluation and implementation teams. The potential for such an approach resonated strongly among attendees, highlighting a promising direction for future initiatives.  

More than just a wrap-up—this learning collective was a launchpad for future innovation in evaluation, partnership, and health system transformation. 

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