Stern C, Núñez R M, Tolbert K, Cárdenas V, Goodwin M
Population Council, Oficina Regional para América Latina y el Caribe.
Salud Publica Mex. 1990 Sep-Oct;32(5):532-42.
Conditions of infant and child survival in Mexico have improved considerably over the last 60 years. Infant mortality rates were reduced from more than 250 deaths per 1,000 infants born alive in 1929-1931, to a rate of less than 50 in the period 1982-1987, a figure which still places Mexico among the countries with a high infant mortality rate. Though improvements in the living conditions of the population have undoubtedly played a part in the reduction of infant and child mortality, the early introduction of sanitation campaigns and, more recently of immunization, antibiotics and other modern health techniques have probably been more important. Health services have been extended throughout the country. However, significant portions of the population, especially in the rural areas, but also in the growing urban marginal ones, are to a large extent underserved. As a result, great inequalities in the health status of the population and in their access to health services remain. The problem of providing services to the whole population has become aggravated by the economic and financial crisis which has plagued Mexico since 1982. Reduced revenues for exports and the high cost of servicing the external and the internal debt have significantly decreased government revenues. As a result, public resources directed to health-related services diminished by 50 per cent in real terms between 1982 and 1987. This trend has to be reversed through enforced measures directed to the mobilization of untapped external and internal resources. But improving the conditions of child survival in Mexico requires more than financial resources. It is necessary to integrate and coordinate the fragmented services offered by the government, to give a much higher priority to preventive measures, and to research and to the adequate training of professionals and paraprofessionals in order to re-orient the health system for serving the real needs of the more underprivileged groups of the population (understanding and respecting their cultural beliefs and practices). In this way, Mexico can reverse the trend toward greater inequality which pervades the present system.
在过去60年里，墨西哥婴幼儿的生存状况有了显著改善。婴儿死亡率从1929年至1931年每1000名活产婴儿中超过250例死亡，降至1982年至1987年期间的不到50例，这一数字仍使墨西哥处于婴儿死亡率较高的国家之列。尽管人口生活条件的改善无疑在降低婴幼儿死亡率方面发挥了作用，但早期开展的卫生运动，以及最近的免疫接种、抗生素和其他现代医疗技术可能更为重要。医疗服务已扩展至全国。然而，很大一部分人口，特别是农村地区的人口，以及城市中不断增加的边缘地区人口，在很大程度上得不到充分的医疗服务。因此，人口健康状况及其获得医疗服务的机会方面仍存在巨大不平等。自1982年以来困扰墨西哥的经济和金融危机加剧了为全体人口提供服务的问题。出口收入减少以及偿还外债和内债的高昂成本大幅减少了政府收入。结果，用于与健康相关服务的公共资源在1982年至1987年期间实际减少了50%。必须通过采取强制措施调动未开发的国内外资源来扭转这一趋势。但改善墨西哥儿童的生存状况需要的不仅仅是财政资源。有必要整合和协调政府提供的分散服务，更加优先重视预防措施、研究以及对专业人员和辅助专业人员进行适当培训，以便调整卫生系统，使其服务于人口中更弱势群体的实际需求（理解并尊重他们的文化信仰和习俗）。这样，墨西哥才能扭转目前体系中普遍存在的不平等加剧的趋势。
