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      Implementation of Mexico’s Health Promotion Operational Model

      research-article
      , MD, PhD, MPH , , MD, , MD, MS, , MD, MPH, , MD, , MD, MA, , MD, MBA
      Preventing Chronic Disease
      Centers for Disease Control and Prevention

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          Abstract

          Mexico is undergoing profound health reform, extending health insurance to previously uninsured populations and changing the way health care services are delivered. Legislation enacted in 2003 and implemented in 2004 mandated funding and infrastructure that will allow 52% of Mexico's population to access medical care at no cost by 2010. This ambitious social reform has not been without challenges, particularly financial sustainability. Health promotion, because of its potential to prevent or delay chronic diseases and injuries and their associated costs, is a key component of health care reform ( 1).

          In 2006, the Ministry of Health's General Directorate of Health Promotion developed the Health Promotion Operational Model. Based on Ottawa Charter functions, the model integrates health promotion activities within the overall health care system. The main goal of this model is to build strong human capital and to improve organizational capacity for health promotion starting at the local level by training health care personnel to implement health promotion activities. Organizational development workshops started in 2006, and implementation plans in all 32 Mexican states were in place by end of 2008 ( 2).

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          Most cited references5

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          Bridging the divide: global lessons from evidence-based health policy in Mexico.

          During the past 6 years, Mexico has undergone a large-scale transformation of its health system. This paper provides an overview of the main features of the Mexican reform experience. Because of its high degree of social inequality, Mexico is a microcosm of the range of problems that affect countries at all levels of development. Its health system had not kept up with the pressures of the double burden of disease, whereby malnutrition, common infections, and reproductive health problems coexist with non-communicable disease and injury. With half of its population uninsured, Mexico was facing an unacceptable paradox: whereas health is a key factor in the fight against poverty, a large number of families became impoverished by expenditures in health care and drugs. The reform was designed to correct this paradox by introducing a new scheme called Popular Health Insurance (Seguro Popular). This innovative initiative is gradually protecting the 50 million Mexicans, most of them poor, who had until now been excluded from formal social insurance. This paper reports encouraging results in the achievement of the ultimate objective of the reform: universal access to high-quality services with social protection for all.
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            Assessing the effect of the 2001-06 Mexican health reform: an interim report card.

            Since 2001, Mexico has been designing, legislating, and implementing a major health-system reform. A key component was the creation of Seguro Popular, which is intended to expand insurance coverage over 7 years to uninsured people, nearly half the total population at the start of 2001. The reform included five actions: legislation of entitlement per family affiliated which, with full implementation, will increase public spending on health by 0.8-1.0% of gross domestic product; creation of explicit benefits packages; allocation of monies to decentralised state ministries of health in proportion to number of families affiliated; division of federal resources flowing to states into separate funds for personal and non-personal health services; and creation of a fund to protect families against catastrophic health expenditures. Using the WHO health-systems framework, we used a wide range of datasets to assess the effect of this reform on different dimensions of the health system. Key findings include: affiliation is preferentially reaching the poor and the marginalised communities; federal non-social security expenditure in real per-head terms increased by 38% from 2000 to 2005; equity of public-health expenditure across states improved; Seguro Popular affiliates used more inpatient and outpatient services than uninsured people; effective coverage of 11 interventions has improved between 2000 and 2005-06; inequalities in effective coverage across states and wealth deciles has decreased over this period; catastrophic expenditures for Seguro Popular affiliates are lower than for uninsured people even though use of services has increased. We present some lessons for Mexico based on this interim evaluation and explore implications for other countries considering health reforms.
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              Otawa Charter for health promotion

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                Author and article information

                Contributors
                Role: Director General for Health Promotion,
                Ministry of Health
                ,
                General Directorate of Health Promotion, Mexico City, Mexico
                General Directorate of Health Promotion, Mexico City, Mexico
                General Directorate of Health Promotion, Mexico City, Mexico
                General Directorate of Health Promotion, Mexico City, Mexico
                General Directorate of Health Promotion, Mexico City, Mexico
                General Directorate of Health Promotion, Mexico City, Mexico
                Journal
                Prev Chronic Dis
                Preventing Chronic Disease
                Centers for Disease Control and Prevention
                1545-1151
                January 2009
                15 December 2008
                : 6
                : 1
                : A32
                Affiliations
                Ministry of Health
                General Directorate of Health Promotion, Mexico City, Mexico
                General Directorate of Health Promotion, Mexico City, Mexico
                General Directorate of Health Promotion, Mexico City, Mexico
                General Directorate of Health Promotion, Mexico City, Mexico
                General Directorate of Health Promotion, Mexico City, Mexico
                General Directorate of Health Promotion, Mexico City, Mexico
                Article
                PCDv61_08_0085
                2644590
                19080038
                59ed0012-338a-4b3c-81e8-3097fd98c13c
                Copyright @ 2009
                History
                Categories
                Tools and Techniques

                Health & Social care
                Health & Social care

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