Lazcano-Ponce Eduardo, Schiavon Raffaela, Uribe-Zúñiga Patricia, Walker Dilys, Suárez-López Leticia, Luna-Gordillo Rufino, Ulloa-Aguirre Alfredo
Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
IPAS, México, DF, México.
Salud Publica Mex. 2013;55 Suppl 2:S214-24.
To evaluate health coverage for birth care in Mexico within the frame of maternal mortality reduction.
Two information sources were used: 1) The comparison between the results yield by the Mexican National Health and Nutrition Surveys 2006 and 2012 (ENSANUT 2006 and 2012), and 2) the databases monitoring maternal deaths during 2012 (up to December 26), and live births (LB) in Mexico as estimated by the Mexican National Population Council (Conapo).
The national coverage for birth care by medical units is nearly 94.4% at the national level, but in some federal entities such as Chiapas (60.5%), Nayarit (87.8%), Guerrero (91.2%), Durango (92.5%), Oaxaca (92.6%), and Puebla (93.4%), coverage remains below the national average. In women belonging to any social security system (eg. IMSS, IMSS Oportunidades, ISSSTE), coverage is almost 99%, whereas in those affiliated to the Mexican Popular Health Insurance (which depends directly from the Federal Ministry of Health), coverage reached 92.9%. In terms of Maternal Mortality Ratio (MMR), there are still large disparities among federal states in Mexico, with a national average of 47.0 per 100 000 LB (preliminary data for 2012, up to December 26). The MMR estimation has been updated using the most recent population projections.
There is no correlation between the level of institutional birth care and the MMR in Mexico. It is thus necessary not only to guarantee universal birth care by health professionals, but also to provide obstetric care by qualified personnel in functional health services networks, to strengthen the quality of obstetric care, family planning programs, and to promote the implementation of new and innovative health policies that include intersectoral actions and human rights-based approaches targeted to reduce the enormous social inequity still prevailing in Mexico.
在降低孕产妇死亡率的框架内评估墨西哥的分娩保健覆盖情况。
使用了两个信息来源：1）2006年和2012年墨西哥国家卫生与营养调查（ENSANUT 2006和2012）的结果比较；2）2012年（截至12月26日）监测孕产妇死亡情况的数据库，以及墨西哥国家人口委员会（Conapo）估算的墨西哥活产数（LB）。
全国范围内医疗单位提供的分娩保健覆盖率接近94.4%，但在一些联邦实体中，如恰帕斯州（60.5%）、纳亚里特州（87.8%）、格雷罗州（91.2%）、杜兰戈州（92.5%）、瓦哈卡州（92.6%）和普埃布拉州（93.4%），覆盖率仍低于全国平均水平。属于任何社会保障系统（如IMSS、IMSS Oportunidades、ISSSTE）的女性，覆盖率几乎为99%，而隶属于墨西哥大众健康保险（直接隶属于联邦卫生部）的女性，覆盖率达到92.9%。就孕产妇死亡率（MMR）而言，墨西哥各联邦州之间仍存在巨大差异，全国平均为每10万例活产47.0例（2012年截至12月26日的初步数据）。已使用最新的人口预测数据更新了MMR估算值。
墨西哥机构分娩保健水平与MMR之间不存在相关性。因此，不仅有必要保证卫生专业人员提供普遍的分娩保健，还需要在功能健全的卫生服务网络中由合格人员提供产科护理，加强产科护理质量、计划生育项目，并促进实施新的创新性卫生政策，这些政策应包括部门间行动以及基于人权的方法，以减少墨西哥仍然普遍存在的巨大社会不平等现象。
