[Problem mapping by state and federal actors for maternal health attention].

OBJECTIVE

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.

MATERIAL AND METHODS

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.

RESULTS

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.

CONCLUSIONS

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.