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Geographical Locations - Mexico
 The WWW Virtual Library: Public Health
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- (Statistical) Number of Inhabitants per Doctor: 800
- CIA - World Factbook: Mexico
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Reports, Guidelines, and Projects
- A case study of reproductive health supplies in Mexico
"This report provides overview of how RH [reproductive health] supplies, specifically contraceptives and condoms, are programmed, managed and funded in Mexico. It presents a distillation of information on policies, systems, budgets and key actors to help raise awareness of experienced advocates — who may lack technical knowledge about contraceptives — so that they strategically choose advocacy actions and targets. This information should also facilitate collaboration and coordination with advocacy efforts at the global and regional levels. Information and issues from one country may be useful to other countries facing similar challenges." [Population Action International, June 2009]
- Counseling in Mexico: History, Current Identity, and Future Trends
A brief history of the development of counseling in Mexico is presented. Counselor preparation, identity, and future trends in the profession are discussed. [publication summary] [Journal of Counseling & Development, Winter 2010, Volume 88, pp.33-37]
- Diabetes treatment and control: the effect of public health insurance for the poor in Mexico
Objective: To analyse the effect of enrolment in the public health insurance scheme known as Seguro Popular [People’s Insurance] on access to health resources, treatment and blood glucose control among poor adults with diabetes in Mexico. Methods: We analysed cross-sectional data from the 2006 National Health and Nutrition Survey and compared health care access and biological health outcomes, specifically glycosylated haemoglobin (HbA1c) levels, among adults with diabetes who were enrolled in the Seguro Popular (treatment group) and those who had no health insurance (control group). Standard propensity score matching was used to create a highly comparable control group. Findings: Adults with diabetes who were enrolled in the Seguro Popular had significantly more access than comparable uninsured adults to some type of blood glucose control test (by a difference of 9.5 percentage points; 95% confidence interval, CI: 2.4–16.6) and to insulin injections (3.13 more per week; 95% CI: 0.04–6.22). Those with insurance were also significantly more likely to have appropriately-controlled blood glucose levels (HbA1c ≤ 7%) than their uninsured counterparts (by a difference of 5.6 percentage points; 95% CI: 0.9–10.3). Very poor glucose control (HbA1c > 12%) was found in a significantly smaller proportion of adults in the insured group than in the uninsured group (by a difference of 17.5 percentage points; 95% CI: 6.5–28.5). Conclusion: The Seguro Popular appears to have improved access to health care and blood glucose control among poor adults with diabetes in Mexico, and it may have had a positive effect on the management of other chronic health conditions, but its long-term effects are yet to be demonstrated. Although the findings are most relevant to Mexico, they may also be applicable to other developing countries seeking to improve health-care coverage for the poor by expanding their public health insurance programmes. [author abstract] [Bull World Health Organ 2009; 87: 512–519]
- Equity of access to health care for older adults in four major Latin American cities
Objectives: To identify if older adults have equitable access to health services in four major Latin American cities and to determine if the inequities that are found follow the patterns of economic inequality in each of the four nations studied. Methods: Data from persons age 60 and over in the cities of São Paulo, Brazil (n = 2 143); Santiago, Chile (n = 1 301); Mexico City, Mexico (n = 1 247); and Montevideo, Uruguay (n = 1 450) were collected through a collaboration led by the Pan American Health Organization. For our study, three process indicators of access (availability, accessibility, and acceptability) and one indicator of actual health services use (visit to a medical doctor in the past 12 months) were analyzed by wealth quintiles, health insurance type, education, health status, and demographic characteristics. Results: Each of the four cities had a different level of access to care, and those levels of access were only weakly related to per capita national wealth. Given the relatively high level of wealth inequality in Brazil and the lower level in Uruguay, older persons in São Paulo had better-than-expected equity in access to care, while older persons in Montevideo had less equity than expected. Inequity in Mexico City was driven primarily by low levels of health insurance coverage. In Santiago, inequity followed socioeconomic status more than it did health insurance. Conclusions: In the four cities studied, health insurance and the operation of health systems mediate the link between economic inequality and inequitable access to health care. Therefore, special attention needs to be paid to equity of access in health services, independent of differences in economic inequality and national wealth. [author abstract] [Rev Panam Salud Publica, 2005; 17(5/6): 394–409]
- Evidence-based health policy: three generations of reform in Mexico
The Mexican health system has evolved through three generations of reform. The creation of the Ministry of Health and the main social security agency in 1943 marked the first generation of health reforms. In the late 1970s, a second generation of reforms was launched around the primary health-care model. Third-generation reforms favour systemic changes to reorganise the system through the horizontal integration of basic functions — stewardship, financing, and provision. The stability of leadership in the health sector is emphasised as a key element that allowed for reform during the past 60 years. Furthermore, there has been a transition in the second generation of reforms to a model that is increasingly based on evidence; this has been intensified and extended in the third generation of reforms. We also examine policy developments that will provide social protection in health for all. These developments could be of interest for countries seeking to provide their citizens with universal access to health care that incorporates equity, quality, and financial protection. [author abstract] [Lancet (15 November 2003); 362: 1667–71]
- Exploring the determinants of unsafe abortion: improving the evidence base in Mexico
Background: Despite the realized importance of unsafe abortion as a global health problem, reliable data are difficult to obtain, especially in countries where abortion is illegal. Estimates for most developing countries are based on limited and incomplete sources of data. In Mexico, studies have been undertaken to improve estimates of induced abortion but the determinants of unsafe abortion have not been explored. Methods: We analysed data from the 2006 Mexican National Demographic Survey. The sample comprises 14 859 reported pregnancies in women between 15 and 55 years old, of which 966 report having had an abortion in the 5 years preceding the survey. We use logistic regression to explore the relationship between unsafe abortion and various socio-economic and demographic characteristics. Findings: We estimate that 44% of abortions have been induced and 16.5% of those were unsafe. We find three variables to be positively and significantly associated with the probability of having an induced abortion: (1) whether the woman reported that the pregnancy was mistimed (OR=4.5, 95% CI=1.95–10.95); (2) whether the woman reported that the pregnancy was unwanted (OR=2.86, 95% CI=-1.40–5.88); and (3) if the woman had three or more children at the time of the abortion (OR=3.73, 95% CI=1.20–11.65). There is a steep socio-economic gradient in the probability of having an unsafe abortion: poorer women are more likely to have an unsafe abortion than richer women (OR=2.48, 95% CI=1.09–5.63); women with 6–9 years of education (OR=0.30, 95% CI=0.11– 0.81) and with more than 13 years of education are less likely to have an unsafe abortion (OR=0.065, 95% CI=0.01–0.43), and women with indigenous origin are more likely to have an unsafe abortion (OR=5.44, 95% CI=1.91–15.51). Thus, the probability for poor women with less than 5 years of education and indigenous origin is nine times higher compared with rich, educated and not indigenous women. We also find marked geographical inequities as women living in the poorest states have a higher risk of having an unsafe abortion. Interpretation: This analysis has explored the determinants of unsafe abortion and has demonstrated that there are large socio-economic and geographical inequities in unsafe abortions in Mexico. Further efforts are required to improve the measurement and monitoring of trends in unsafe abortions in developing countries. [author abstract] [Health Policy and Planning 2009; 1–11]
- Feasibility of deploying a medical information service in Mexico delivered via cell phone
"In Mexico, the national public health sector and users invest large amounts of resources and provide medical services at high-cost and in an inefficient manner. Electronic medical (information) technology has the capacity to address and improve such situations. The purpose of this research is to analyze the feasibility and chance of success of importing a medical information service such as Garmin InTouch, delivered via cell phone, to Mexico City as a pilot test." [Presented at the First AMA-IEEE Conference on Medical Technology on Individualized Healthcare (The American Medical Association (AMA) and the IEEE Engineering in Medicine and Biology (EMB) Society, 21-23 March 2010, Washington DC, USA)]
- Health care quality improvement in Mexico: challenges, opportunities, and progress
"The health care quality improvement effort is international: all nations seek to apply new knowledge and new technology for the health of their populations. However, the environment within which this effort takes place differs remarkably. In Mexico, for example, total expenditure on health care is only 5.6% of the gross national product — compared with about 15% in the USA, 11% or 12% in Canada, and an average of 6.1% in the Latin American countries. Further, 52% of Mexican health care expenditures are out of pocket in a country where poverty is prevalent and many people postpone care. Structurally, the health care system in Mexico is public and private. Mexico has 4000 hospitals. The 1000 public hospitals have 75% of the beds; 90% of the 3000 private hospitals have ≤20 beds, often as few as ≤5 beds. In fact, some ‘private hospitals’ can hardly be considered hospitals at all, since they have no laboratories, radiography equipment, or even nurses. The system also includes 20,000 primary care facilities. As soon as President Vicente Fox began his administration in December 2000, government leaders began working on a national strategy for improving health care. In this article, [the author discusses] the health care challenges, the objectives of this particular strategy, and the progress made to date." [BUMC Proceedings 2002; 15: 319–322]
- Health in the Americas 2007: Mexico
As a health agency, the Pan American Health Organization’s core discipline is epidemiology, which enables the measurement, definition, and comparison of health problems and conditions and their distribution from the perspectives of population, geography, and time. This publication on Mexico addresses the issue of health as a human right, taking into account both the individual and community contexts, and examines various critical determinants of health, including those of a biological, social, cultural, economic, and political nature. That examination reveals the existence of gaps, disparities, and inequities that persist in Mexico, especially those related to access to basic services, health, nutrition, housing, and adequate living conditions as well as to the lack of opportunities for human development—all of which contribute to the greater vulnerability to diseases and health risks of some population groups. [Adapted from the preface of Health in the Americas 2007]. The US-Mexico border area.
- Improvement of child survival in Mexico: the diagonal approach
Public health interventions aimed at children in Mexico have placed the country among the seven countries on track to achieve the goal of child mortality reduction by 2015. We analysed census data, mortality registries, the nominal registry of children, national nutrition surveys, and explored temporal association and biological plausibility to explain the reduction of child, infant, and neonatal mortality rates. During the past 25 years, child mortality rates declined from 64 to 23 per 1000 livebirths. A dramatic decline in diarrhoea mortality rates was recorded. Polio, diphtheria, and measles were eliminated. Nutritional status of children improved significantly for wasting, stunting, and underweight. A selection of highly cost-effective interventions bridging clinics and homes, what we called the diagonal approach, were central to this progress. Although a causal link to the reduction of child mortality was not possible to establish, we saw evidence of temporal association and biological plausibility to the high level of coverage of public health interventions, as well as significant association to the investments in women education, social protection, water, and sanitation. Leadership and continuity of public health policies, along with investments on institutions and human resources strengthening, were also among the reasons for these achievements. [author abstract] [Lancet 2006; 368: 2017–27]
- Improving Enrollment and Utilization of the Oportunidades Program in Mexico Could Increase Its Effectiveness
Oportunidades, Mexico’s most important antipoverty program, currently with 5 million enrolled households in all regions of the country, has been shown to significantly contribute to improving the nutrition, health, and education of the poor. Because the program has used different enrollment strategies in rural and urban areas and has both obligatory (e.g., health and nutrition education) and nonobligatory components (e.g., nutrition supplements for children younger than 2 y of age), it provides an excellent opportunity to study program enrollment and utilization of different program components. In urban areas enrollment was more complex, and hence enrollment was much lower then in rural areas where the process was quasiautomatic, and nearly all eligible households enrolled. Enrollment in urban areas was not associated with having a child younger than 2 y of age. Utilization was notably higher with the obligatory than with the nonobligatory program components, illustrated by the inadequate consumption of the nutrition program’s supplement as compared with near-universal compliance with well-baby visits. Innovative approaches, some of which are currently being tested, are needed to further increase the program’s impact. [author abstract] [J. Nutr. 138: 638–641, 2008]
- Improving Health Outcomes in Mexico
This paper examines the relationship between macroeconomics and health in Mexico by defining the concept of health in the broader sense - not just the absence of illness but the ability of people to develop to their potential throughout their entire lives. The paper was presented at the Wider Jubillee conference held in Helsinki in June 2005.
- Late-life depression in Peru, Mexico and Venezuela: the 10/66 population-based study
Background: The proportion of the global population aged 60 and over is increasing, more so in Latin America than any other region. Depression is common among elderly people and an important cause of disability worldwide. Aims: To estimate the prevalence and correlates of late-life depression, associated disability and access to treatment in five locations in Latin America. Method: A one-phase cross-sectional survey of 5886 people aged 65 and over from urban and rural locations in Peru and Mexico and an urban site in Venezuela. Depression was identified according to DSM–IV and ICD–10 criteria, Geriatric Mental State–Automated Geriatric Examination for Computer Assisted Taxonomy (GMS–AGECAT) algorithm and EURO–D cut-off point. Poisson regression was used to estimate the independent associations of sociodemographic characteristics, economic circumstances and health status with ICD–10 depression. Results: For DSM–IV major depression overall prevalence varied between 1.3% and 2.8% by site, for ICD–10 depressive episode between 4.5% and 5.1%, for GMS–AGECAT depression between 30.0% and 35.9% and for EURO–D depression between 26.1% and 31.2%; therefore, there was a considerable prevalence of clinically significant depression beyond that identified by ICD–10 and DSM–IV diagnostic criteria. Most older people with depression had never received treatment. Limiting physical impairments and a past history of depression were the two most consistent correlates of the ICD–10 depressive episode. Conclusions: The treatment gap poses a significant challenge for Latin American health systems, with their relatively weak primary care services and reliance on private specialists; local treatment trials could establish the cost-effectiveness of mental health investment in the government sector. [author abstract] [The British Journal of Psychiatry 2009 195: 510-515]
- Mexico and the tobacco industry: doing the wrong thing for the right reason?
By linking payments to a health fund with sales of cigarettes, the tobacco industry is undermining international agreements to control smoking. [publication summary] [BMJ (11 February 2006); 332: 353–4]
- Mexico: Tuberculosis Profile
"Tuberculosis (TB) is a public health problem in Mexico and remains of great interest to the United States, given the shared borders and immigration flow between the two countries. According to the World Health Organization’s (WHO’s) Global TB Report 2009, Mexico had an estimated 21,283 TB cases in 2007, with an estimated incidence rate of 20 cases per 100,000 population. The National TB Control Program (NTCP) began implementing DOTS (the internationally recommended strategy for TB control) in selected demonstration areas in 1996, and, according to WHO estimates, DOTS population coverage reached 100 percent in 2005, but declined slightly in 2007. Multidrug-resistant (MDR) TB is a concern, with 2.4 percent of new cases being drug resistant. Mexico received approval from the Green Light Committee (GLC) to expand access to second-line TB drugs. Extensively drug-resistant TB also was confirmed in Mexico in February 2007." [USAID, June 2009]
- Overweight and obesity: public health problems in Mexico (Editorial)
"Health is a right of the Mexican population and represents a public asset of strategic importance for national development; hence, preventive actions are required to improve the health status of the population and promote self-care by and for health, which will allow us to consolidate achievements and progress of the National Health System in the short term as well as to identify and pursue opportunities to expand its coverage, quality and efficiency and that address the increasingly complex health needs of the population. It is necessary to take this initiative and address the health needs of the population and not just treat the effects and complications of illness or injury to health.” [Cir Ciruj 2009; 77: 393-394]
- Preventing Impoverishment, Promoting Equity and Protecting Households from Financial Crisis: Universal Health Insurance through Institutional Reform in Mexico
"This study analyzes the evolution and determinants of catastrophic and impoverishing health expenditure in Mexico between 1992 and 2004. This includes a period of economic crisis, and subsequently the initial phases of health reform. Indicators are developed to measure equity aspects and absolute impoverishment from health spending, and these are applied to document financial protection before and after reform. Econometric analysis measures the effect of the reform based on differential coverage across states and a methodology is developed for projecting potential, future impact."
- Targeting Social Transfers to the Poor in Mexico
"Mexico's main social support program, Oportunidades, combines two methods to target cash to poor households: an initial self-selection by households who acquire knowledge about the program and apply for benefits, followed by an administrative determination of eligibility based on a means test. Self-selection improves targeting by excluding high-income households, while administrative targeting does so mainly by excluding middle-income households. The two methods are complementary: expanding program knowledge across households substantially increases applications from non-poor households, thus reinforcing the importance of administrative targeting. The [March 2009 IMF] paper shows that targeting can be further improved through redesigning the means test and differentiating transfers according to demographic characteristics."
- The Democratization of Health in Mexico: Extending the Right to Health Care
"Recent reforms in Mexico illustrate the importance of health for governance. The main message of this chapter is that these reforms, by extending the right to health care to all the population, have strengthened the procedures and institutions of democracy. Undoubtedly, the democratization of health can contribute to the health of democracy." [From Swiss Human Rights Book Vol. 3: Realizing the right to health (eds: Andrew Clapham and Mary Robinson) (rüffer & rub, Zurich, 2009), pp.463-471]
- The economic burden of out-of-pocket medical expenditures for patients seeking diabetes care in Mexico
"Mexico is an example of the staggering burden of diabetes; the prevalence of diabetes in this country has increased from 7.2% in 1993… to 10.7% in 2000, among those who are 20–64 years of age... There has been a huge increase in the number of diabetes-related deaths in Mexico over the same period, with the annual number of deaths attributed to diabetes increasing from a constant 40,000 between 1979 and 1999 to 64,000 in 2004... An original article published in 2004 presented the dimensions of the economic impact of diabetes on public health expenditures in Mexico... To further evaluate the problem of the burden of diabetes in Mexico, this brief report includes the results of an analysis of private health expenditures for diabetes care, determined through out-of-pocket costs and costs paid through private medical insurance." [Diabetologia (2007) 50(11): 2408–2409]
- World Bank Group - Documents and Reports - "Economic analysis of health care utilization and percieved illness; ethnicity and other factors"
Policy Research Working Paper
Educational Resources
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