Center for Health Systems Research, The National Institute of Public Health, 62100, Cuernavaca, Morelos, Mexico.
CLACSO's Regional Working Group On International Health, Guanajuato, Leon, Mexico.
Health Res Policy Syst. 2024 Apr 11;22(1):46. doi: 10.1186/s12961-024-01125-7.
Mexico and other low- and middle-income countries (LMICs) present a growing burden of non-communicable diseases (NCDs), with gender-differentiated risk factors and access to prevention, diagnosis and care. However, the political agenda in LMICs as it relates to health and gender is primarily focused on sexual and reproductive health rights and preventing violence against women. This research article analyses public policies related to gender and NCDs, identifying political challenges in the current response to women's health needs, and opportunities to promote interventions that recognize the role of gender in NCDs and NCD care in Mexico.
We carried out a political mapping and stakeholder analysis during July-October of 2022, based on structured desk research and interviews with eighteen key stakeholders related to healthcare, gender and NCDs in Mexico. We used the PolicyMaker V5 software to identify obstacles and opportunities to promote interventions that recognize the role of gender in NCDs and NCD care, from the perspective of the political stakeholders interviewed.
We found as a political obstacle that policies and stakeholders addressing NCDs do not take a gender perspective, while policies and stakeholders addressing gender equality do not adequately consider NCDs. The gendered social and economic aspects of the NCD burden are not widely understood, and the multi-sectoral approach needed to address these aspects is lacking. Economic obstacles show that budget cuts exacerbated by the pandemic are a significant obstacle to social protection mechanisms to support those caring for people living with NCDs.
Moving towards an effective, equity-promoting health and social protection system requires the government to adopt an intersectoral, gender-based approach to the prevention and control of NCDs and the burden of NCD care. Despite significant resource constraints, policy innovation may be possible given the willingness among some stakeholders to collaborate, particularly in the labour and legal sectors. However, care will be needed to ensure the implementation of new policies has a positive impact on both gender equity and health outcomes. Research on successful approaches in other contexts can help to identify relevant learnings for Mexico.
墨西哥和其他中低收入国家（LMICs）面临着不断增长的非传染性疾病（NCDs）负担，存在性别差异化的风险因素以及获取预防、诊断和治疗的机会。然而，LMICs 中的卫生和性别政策议程主要集中在性健康和生殖健康权利以及预防针对妇女的暴力方面。本文分析了与性别和非传染性疾病相关的公共政策，确定了当前应对妇女健康需求的政策反应所面临的政治挑战，以及促进干预措施的机会，这些措施认识到性别在非传染性疾病和非传染性疾病护理中的作用。
我们在 2022 年 7 月至 10 月期间进行了政治图谱和利益相关者分析，基于结构化的案头研究和对墨西哥与医疗保健、性别和非传染性疾病相关的 18 位关键利益相关者的访谈。我们使用 PolicyMaker V5 软件，从接受采访的政治利益相关者的角度，确定了促进干预措施的障碍和机会，这些干预措施认识到性别在非传染性疾病和非传染性疾病护理中的作用。
我们发现，作为一个政治障碍，解决非传染性疾病问题的政策和利益相关者没有采取性别视角，而解决性别平等问题的政策和利益相关者没有充分考虑非传染性疾病。非传染性疾病负担的社会和经济方面的性别差异没有得到广泛理解，也缺乏解决这些方面所需的多部门方法。经济障碍表明，大流行导致的预算削减加剧了支持照顾非传染性疾病患者的人的社会保护机制的障碍。
迈向有效的、促进公平的卫生和社会保护系统，需要政府采取跨部门的、基于性别的方法，预防和控制非传染性疾病以及非传染性疾病护理的负担。尽管资源严重受限，但由于一些利益相关者有合作的意愿，特别是在劳工和法律部门，政策创新是可能的。然而，需要谨慎行事，以确保新政策的实施对性别平等和健康结果都产生积极影响。对其他背景下成功方法的研究可以帮助确定对墨西哥相关的学习内容。
