Chelsea Simms lives in Punta Gorda, a fishing village on the southern Caribbean coast of Belize. She is 25 years old and has just given birth to her second child. The first was delivered by cesarean section. The second almost took her life.
In early April, Chelsea began feeling unwell but didn’t recognize the symptoms as signs of labor. Nevertheless, she went to the local community hospital. There, doctors identified that labor had begun and immediately referred her to the Southern Regional Hospital, more than two hours away by dirt road. Thanks to timely care, Chelsea underwent a C-section without complications.
This happy ending is the result of both Chelsea, as the patient, and the medical staff who attended her were able to recognize the warning signs and respond effectively by transferring her to a facility capable of providing quality care and preventing complications.
This experience is part of the lessons learned through the Salud Mesoamerica Initiative, led by the Inter-American Development Bank (IDB), which has been implemented in remote areas of Belize and is now being scaled up nationally by the government.
Advancing Health Care Quality in Belize: A Data-Driven Approach
In Belize, 75% of preventable deaths have been attributed to poor quality of care, while 25% were due to lack of utilization of health services, according to a study conducted across 137 low- and middle-income countries.
Moreover, although data on patient satisfaction is limited, past surveys by the National Health Insurance program show that quality of care is one of the main concerns among Belizeans.
With support from the Salud Mesoamerica Initiative, Belize has achieved notable improvements in the quality of maternal and newborn health services. Between 2012 and 2022, the percentage of mothers and newborns receiving high-quality care for obstetric and neonatal complications more than doubled—from 22% to 56% for mothers, and from 24% to 56% for newborns.
A Policy and Commitment to Improve Sustainable Change
The Ministry of Health and Wellness of Belize is currently working on the Belize Quality Health Policy which will be launched soon, marking a pivotal step toward improving health outcomes nationwide. This policy builds on a decade of lessons from the Salud Mesoamerica Initiative and the state of the art of quality of care. The Belize Quality Health Policy places person-centered care at its core—prioritizing the needs, preferences, and values of people over the perspective of providers. While it began with a focus on maternal and child health in the most vulnerable areas, the policy now expands to address broader health challenges, including non-communicable diseases, surgical and emergency services, and mental health.
This policy is a clear expression of political and financial commitment to transform the health system. It empowers Belizeans to shape their care based on both local experience and international best practices. Developed with participation from public and private sectors and technical partners like the IDB, the policy signals a long-term investment in high-quality, safe, and effective health services. This commitment includes institutionalizing care processes that meet well-defined standards and ensuring continuous support to health workers.
Measurement as a Driving Force
Belize’s experience with the Salud Mesoamerica Initiative underscored that progress requires rigorous monitoring. Since 2012, the proportion of mothers and newborns receiving quality care for obstetric and neonatal complications has more than doubled. As Dr. Natalia Beer of the Ministry of Health and Wellness notes, “The greatest lesson SMI has taught us is that measurement is a fundamental part of success”. This emphasis on tracking results -both technical and perceived quality- has shaped the country’s approach to accountability and system-wide improvement.
Evidence-Based and Scalable
This quality policy is rooted in evidence, aligning with international standards while responding to Belize’s unique context. It draws from successful models implemented through SMI and scales them across the country’s six districts, seven hospitals (including the Karl Heusner Memorial Hospital), and 68 outpatient care centers. The goal is to reduce preventable deaths, optimize waiting times, and improve patient experience.
Additionally, this national effort is bolstered by the Improving Efficiency, Quality, and Access in Belize’s Health System project, a new IDB-funded program launched in 2024. These efforts are being scaled through the expansion of the Quality and Efficiency Improvement Strategy, which extends quality protocols and continuous improvement processes to additional service areas including non-communicable diseases, emergency care, and surgical procedures.
Chelsea’s radiant smile as she embraced her newborn son is a testament to quality health care in Belize that saves lives. It is also a powerful reminder that every effort, every innovation, and every collaboration matters— because behind every policy, there is a family, a future, and a story of hope.
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