Rouvier Mariel, González-Block Miguel A, Becerril-Montekio Víctor, Sesia Paola, Duarte María Beatriz, Flores-Collins Estrella
Instituto Nacional de Salud Pública, Morelos, México.
Salud Publica Mex. 2011 Jan-Feb;53(1):48-56. doi: 10.1590/s0036-36342011000100008.
To analyze the characteristics of problems in the health system that present barriers to maternal care, according to their representation and rating by officials in different positions and social contexts.
Workshops were held with state health system officials from Mexican states with high maternal mortality (Mexico, Guerrero, Oaxaca and Veracruz) as well as with federal officials. A total of 99 health system problems were identified. Using concept mapping, 94 officials rated problems according to importance and feasibility; they were grouped into issues. Data was analyzed according to state/federal levels and the responsibilities of participants. The association was measured between responsibility profile/social context and priority issues.
The issues of highest priority for maternal health care are infrastructure, personnel hiring and financial resources. The importance of certain issues depends on context and, to an extent, on the actors' responsibilities.
There is consensus among actors to address the principal maternal health problems in Mexico. Important differences correspond to context. The usefulness of concept mapping to analyze problems was demonstrated.
根据不同职位和社会背景的官员对卫生系统中存在的孕产妇护理障碍问题的表述和评级，分析这些问题的特征。
与墨西哥孕产妇死亡率高的州（墨西哥州、格雷罗州、瓦哈卡州和韦拉克鲁斯州）的州卫生系统官员以及联邦官员举办了研讨会。共确定了99个卫生系统问题。通过概念映射，94名官员根据重要性和可行性对问题进行了评级；这些问题被归类为不同议题。数据根据州/联邦层面以及参与者的职责进行了分析。测量了责任概况/社会背景与优先议题之间的关联。
孕产妇保健的最高优先议题是基础设施、人员招聘和财政资源。某些议题的重要性取决于背景，在一定程度上也取决于行为者的责任。
在解决墨西哥主要孕产妇健康问题上，各行为者达成了共识。重要差异与背景相关。证明了概念映射在分析问题方面的有用性。
