Decentralization of Ministry of Health services has been the main policy to expand the coverage of health services to the population, particularly the poor. Decentralization also aimed at redistributing resources in favour of local communities and to improve the capacity of health services to respond to local health care needs. The study of programs targeted to women such as family planning, antenatal care, and cervix and breast cancer screening, was considered important due to political priority, the resources involved, and epidemiological significance. Using a multi-level, qualitative/quantitative approach, the study was able to identify the modes of decentralization in four states (Chihuahua, Jalisco, Oaxaca and Campeche). The definition of the political context was basic to understanding the differences regarding the distribution of material and human resources among states, but particularly among urban and rural areas, as well as the particularities in the production of services. According to our data, decentralization has been a problematic and discontinuous process and its potentially positive effects have yet to be apparent. Despite the inequalities in the provision of resources, the overall level of satisfaction of users is high, especially in urban areas. Nonetheless, levels of satisfaction regarding specific aspects vary according to state, urban/rural location, and age of the population group. There is still a significant ground to cover in order to transform coverage expansion and participation into real mechanisms to guarantee access to health services, equity in the distribution of the resources available, quality of care, and respect for women’s rights and preferences.
Learning Objectives: No learning objectives
Keywords: Reproductive Health Research, Health Care Reform
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.