1. The Mexican Health Care System
Enrique Rios M.D. Dr.P.H.
July 2008

2. Contents Health Situation in Mexico
Organization of the Mexican Health Care System
The Health Care Delivery Model
The Migrant Health Program

3. Health Situation in Mexico

4. Demographic Transition in Mexico
85 +
80-84
75-79
70-74
65-69
60-64
55-59
50-54
45-49
40-44
35-39
30-34
25-29
20-24
15-19
10-14
5-9
0-4
Men
Women
Annual growth rate
65 years and older: 3.8%
Under 5 years old: -1.3% 7 7 6 6 5 5 4 4 3 3 2 2 1 1 1 1 2 2 3 3 4 4 5 5 6 6 7 7
Millions
1975
2000
2025 4

5. CHANGES IN THE DISTRIBUTION OF CAUSES OF DEATH IN MEXICO, 1955-200510 20 30 40 50 60 70 80 90
100
1955
1960
1970
1980
1990
2000
2006
2030
PERCENTAGE
Communicable diseases, reproductive and malnutrition related diseases.
Non communicable diseases
Injuries

6. Epidemiological backlog
Epidemiological Transition in Mexico Selected causes of death Mexico,
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% 0%
2005
1955
Epidemiological backlog
Emerging problems
Source: INEGI/Sec Salud. Mortality Database

7. PORCENTAGE OF DEATHS IN CHILDREN UNDER 5 CAUSED BY INFECTIOUS DISEASES BY STATE, MEXICO 20055 10 15 20 25
Chis
Mex
Oax
Pue
Tlax
Gro
MEXICO
SLP DF
Chih
Ver
Yuc
Mor
Zac
Mich
Qro
Tab
Gto
Coah
Hgo
Nay
Jal
Son BC
Tamps
Col
Sin
Camp
BCS
Qroo
Dgo NL
Ags
PERCENTAGE
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.

8. Challenges to the Health Care System
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)

9. Organization of the Mexican Health Care System

10. Mexican Health Care System Basic 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

11. The 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

12. Population without social
security coverage
Mexican Population
100 million
50 million
50 million
5 out of 10 Mexicans lack social security due to their labor or social status

13. Mexican Health Care System

14. The Mexican Health Care System
Main Problems :
Fragmentation and lack of coordination
Inequity in access to care
Dissatisfaction with services provided
Imbalance in resources

15. The Health Care Delivery Model

16. Health Care Delivery Model
Institutional Health Services
Tertiary Care
Secondary Care
Primary Care
Population

17. The Migrant Health Program

18. Background
In September 2000, the Joint 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 two Programs to address the health of the migrant population
Programa de Salud del Migrante (Migrant Health Program)
Programa Vete Sano Regresa Sano

19. Objective
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.

20. Strategy 1. To strengthen Mexican institutional collaboration on migrant health
Activities:
Workshops for Health Professionals (Jornadas Informativas, IME)
Border Health Commission Mexico – USA
Border Health Commission Mexico - Guatemala
Collaboration with the National Institute of Migration (INAMI)
Collaboration with the Vete Sano Regresa Sano Program

21. Strategy 1. To strengthen Mexican institutional collaboration 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

22. Strategy 1. To strengthen Mexican institutional collaboration 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.

23. Strategy 1. To strengthen Mexican institutional collaboration 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

24. Strategy 2. To promote binational public awareness of migrant 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.

25. 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

26. Strategy 3. To provide support services 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)

27. Strategy 3. To provide support services 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

28. Strategy 4. To foster binational research on 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

29. Thank you