The Mexican Health Care System Enrique Rios M.D. Dr.P.H. July 2008.
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Transcript of The Mexican Health Care System Enrique Rios M.D. Dr.P.H. July 2008.
The Mexican Health Care System Enrique Rios M.D. Dr.P.H.
July 2008
ContentsContents
1.Health Situation in Mexico
2.Organization of the Mexican Health Care
System
3.The Health Care Delivery Model
4.The Migrant Health Program
Health Situation in Health Situation in MexicoMexico
4
Demographic Transition in Mexico
Men Women
Millions
7 6 5 4 3 2 1 0 1 2 3 4 5 6 77 6 5 4 3 2 1 0 1 2 3 4 5 6 7
1975 2000 2025
Annual growth rate65 years and older: 3.8%Under 5 years old: -1.3%
85 +80-8475-7970-7465-6960-6455-5950-5445-4940-4435-3930-3425-2920-2415-1910-14
5-90-4
5
CHANGES IN THE DISTRIBUTION OF CAUSES OF DEATH IN MEXICO, 1955-2005
0
10
20
30
40
50
60
70
80
90
100
1955 1960 1970 1980 1990 2000 2006 2030
PER
CEN
TA
GE
Communicable diseases, reproductive and malnutrition related diseases.
Non communicable diseasesInjuries
6
Epidemiological Transition in MexicoEpidemiological Transition in Mexico Selected causes of deathSelected causes of death
Mexico, 1955-2005Mexico, 1955-2005
Source: INEGI/Sec Salud. Mortality Database
Ill-defined
Diabetes
Congenital A.
Maternal Cond.
Neuropsychiatric Cond
Genitourinary Dis.
Chronic Respiratory Dis.
Malignant Neoplasms
Malnutrition
Injuries
Cardiovascular Dis.
Perinatal Dis.
Respiratory Inf.
Diarroheal Dis.
Infectiuos and Parasitic
35% 25% 15% 5% 5% 15% 25% 35%0%
20051955
EpidemiologicEpidemiological backlogal backlog
Emerging Emerging problemsproblems
Ill-definedIll-defined
7
0 5 10 15 20 25
ChisMexOaxPueTlaxGro
MEXICOSLPDF
ChihVerYucMorZac
MichQroTabGto
CoahHgoNayJal
SonBC
TampsColSin
CampBCS
QrooDgoNL
Ags
PERCENTAGE
PORCENTAGE OF DEATHS IN CHILDREN UNDER 5 CAUSED BY INFECTIOUS DISEASES BY STATE, MEXICO 2005
In Chiapas one of every four deaths in children under 5 is caused by diarrhea or a respiratory disease. In Nuevo Leon, one on twenty.
Challenges to the Health Care Challenges to the Health Care SystemSystem
Increasing costs to treat the demand of chronic diseases and longer treatments
Continue to deal with infectious diseases
Emerging health risks: obesity, depression and smoking
Coping with re-emerging diseases (TB, SARS, Influenza Pandemic, HIV, etc)
Organization of the Organization of the Mexican Health Care Mexican Health Care
SystemSystem
Mexican Health Care SystemBasic Components
1. Governmental organizations: providing services for the uninsured population (Ministry of Health and IMSS-Oportunidades)
2. Social Security: covering workers in the formal private sector of the economy, state and federal workers, the armed forces and employees of the national oil company (IMSS, ISSSTE, PEMEX)
3. Private sector: made up of an unorganized myriad of health care providers working in hospitals and clinics on a for-profit basis
The Mexican Health Care SystemThe Mexican Health Care System
What is known in Mexico as “Social Security System”, provides the following services to their beneficiaries:
Health care coverage including medicines
Unemployment insurance
Disability insurance
Life insurance
Retirement benefits
50 million
50 million
5 out of 10 Mexicans lack social security
due to their labor or social status
Population without social Population without social
security coveragesecurity coverage
Mexican Mexican Population Population
100 100 millionmillion
Mexican Health Care SystemMexican Health Care System
The Mexican Health Care System
Main Problems :
Fragmentation and lack of coordination
Inequity in access to care
Dissatisfaction with services provided
Imbalance in resources
The Health Care The Health Care Delivery ModelDelivery Model
Institutional Health Services
Tertiary Care
Secondary Care
Primary Care
Population
Health Care Delivery ModelHealth Care Delivery Model
The Migrant Health The Migrant Health Program Program
BackgroundBackground
In September 2000, the Joint Statement for Migrant HealthJoint Statement for Migrant Health was signed by the Head of
Department of Health and Human Services of the United States of America (HHS) and the
Mexican Ministry of Health.
The two main objectives were:
to develop activities to meet the health needs of Mexican migrants and
to strengthen binational collaboration on Migrant Health issues
Therefore, the Ministry of Health included in its National Health Plan 2007-2012 two Programs
to address the health of the migrant population
Programa de Salud del Migrante (Migrant Health Program)
Programa Vete Sano Regresa Sano
ObjectiveObjective
To protect the health of the migrant
population and their families in their transit
and final destination, with specific
strategies for binational collaboration on
health promotion and health care delivery
services that are culturally appropriate.
Activities:
Workshops for Health Professionals (Jornadas Informativas, IME) Border Health Commission Mexico – USA Border Health Commission Mexico - GuatemalaCollaboration with the National Institute of Migration (INAMI)Collaboration with the Vete Sano Regresa Sano Program
Strategy 1. Strategy 1. To strengthen Mexican institutional To strengthen Mexican institutional
collaboration on migrant healthcollaboration on migrant health
Strategy 1. Strategy 1. To strengthen Mexican institutional To strengthen Mexican institutional
collaboration on migrant healthcollaboration on migrant health
Border Health Commission Mexico – USA
The United States-Mexico Border Health Commission was created in July 2000 between the US and Mexico governments.
Objective:To provide international leadership to optimize health and quality of life along the U.S.-Mexico border.
Main Programs:
• EWIDS – Early Warning Infectious Disease Surveillance• BIDS – Border Infectious Disease Survelillance• Healthy Border 2010
Strategy 1. Strategy 1. To strengthen Mexican institutional To strengthen Mexican institutional
collaboration on migrant healthcollaboration on migrant health
Border Health Commission Mexico – Guatemala
May 2003
Sign of the Agreement between Mexico-Guatemala.
Objectives:
• To support health promotion and disease prevention activities.
• To strengthen migrant health delivery and information systems .
• Provide protection against sanitary risks and laboratory infrastructure.
Strategy 1. Strategy 1. To strengthen Mexican institutional To strengthen Mexican institutional
collaboration on migrant healthcollaboration on migrant health
Collaboration with the National Institute of Migration (INAMI)
November 2006.
Sign of the Collaboration Agreement focus on actions that
guarantee the health protection and prevention of risk for those
foreigners assured in the 52 migratory stations in 22 States of
Mexico through a Specific Program.
Priority Topics:
- Health promotion and prevention of diseases
- Medical treatment
Strategy 2.Strategy 2. To promote binational public awareness of To promote binational public awareness of
migrant health issuesmigrant health issues
Activities:
Signing of binational health collaboration agreements (Oregon and New Mexico)
Collaboration with the Initiative of the Americas of California
Training workshops and health information sessions for “promotoras” (health promoters) within the migrant population.
Strategy 2. To promote binational public awareness
of migrant health issues
Binational Health Week and Binational Public Policy Forum:
An annual weeklong series of health promotion and education activities geared to the migrant population.
The goal is to highlight the cooperation between our two
countries to improve the health of Mexican migrants
Strategy 3. To provide support servicesStrategy 3. To provide support services to the migrant population and their families to the migrant population and their families
Activities:
Creation of a Binational Health Insurance
Collaboration with the National Center for Farmworker Health
Ventanillas de Salud (Health Windows): at the Mexican Consulates more than 150 thousand people have received counseling and referrals to medical services
Collaboration Program Mexico – California (Prevention of Cervical Cancer, Diabetes, Occupational Health, etc)
Strategy 3. To provide support servicesStrategy 3. To provide support services to the migrant population and their families to the migrant population and their families
Activities:
Mexico-Canada Temporal Agricultural Workers Program (PTAT) : 15,000 Mexican workers were employed in Canada in 2006
Sick Nationals Program
PAHO/WHO Regional Office in Chiapas
Affiliation of the Mexican migrant population to Popular Health Insurance
Strategy 4. Strategy 4. To foster binational research To foster binational research
on migrant healthon migrant health
Activities:
Publication of the results and conclusions of the Public Policies Forums on Health and Migration.
Financing binational research in collaboration with the UC
Collaboration and academic linkage with Mexican and American Universities
Publication of Migrant Health Fact Sheets, in collaboration with The Iniciative of the Americas
Thank you