Health System Reform Strategies and Health Social Protection in Mexico, first part: financing effects and health system governance

Abstract

Objective: To identify effects of health system reform on heath financing and health governance. Methods and data sources: A design of evaluative research based on rapid assessment was developed. The research object it was the health system for uninsured population in Mexico, focusing on six States selected considering technical, political and financial feasibility. For primary data gathering structured interviews with key informants of selected States were done; for secondary data, official statistical data and research results of the macro project on heath reform, health policy, equity, financing and health governance, 1999-2006. Information processing and analysis were done by using Atlas-Ti and Policy Maker software. Results / Conclusions: Health system reforms have showed strong influence in financing amounts and important gains in financial co-responsibility. An actualized formula for resources allocation was identified; this formula has involved States and local levels on its revision, adjustments and appliances on allocated resources and health services provision model adopted for the States in relation with their health needs. Financial protection strategy has reported protection versus catastrophic health expenditure and vulnerable families’ impoverishment in some States. Accountability in federal government it is not absent, but it functions as a prescriptive policy, while transparency and accountability mechanisms at the States and municipalities are absent.