RESUMO
2023 marks the 20-year anniversary of the creation of Mexico's System of Social Protection for Health and the Seguro Popular, a model for the global quest to achieve universal health coverage through health system reform. We analyse the success and challenges after 2012, the consequences of reform ageing, and the unique coincidence of systemic reorganisation during the COVID-19 pandemic to identify strategies for health system disaster preparedness. We document that population health and financial protection improved as the Seguro Popular aged, despite erosion of the budget and absent needed reforms. The Seguro Popular closed in January, 2020, and Mexico embarked on a complex, extensive health system reorganisation. We posit that dismantling the Seguro Popular while trying to establish a new programme in 2020-21 made the Mexican health system more vulnerable in the worst pandemic period and shows the precariousness of evidence-based policy making to political polarisation and populism. Reforms should be designed to be flexible yet insulated from political volatility and constructed and managed to be structurally permeable and adaptable to new evidence to face changing health needs. Simultaneously, health systems should be grounded to withstand systemic shocks of politics and natural disasters.
Assuntos
COVID-19 , Cobertura Universal do Seguro de Saúde , Humanos , Idoso , México/epidemiologia , Pandemias/prevenção & controle , COVID-19/epidemiologia , COVID-19/prevenção & controle , Política , Política Pública , Reforma dos Serviços de Saúde , Política de SaúdeRESUMO
OBJECTIVE: To estimate human resources (HR) needed to deliver prevention and health promotion actions to the population of 20 years and more in units of primary health care (UPHC). MATERIALS AND METHODS: We included 20 UPHC; one urban and one rural for each of the ten selected Mexican states. HR were estimated based on the time to do prevention and health promotion activities, from which a budget was calculated. Measures of central tendency and dispersion were reported, using the ANOVA test and the Wilcoxon test. RESULTS: The number of health professionals estimated in UPHC with spent time is less than the number estimated with required time. CONCLUSIONS: The estimated density of health professionals per population needed to offer prevention and health promotion activities for people 20 years and more in UPHC is greater than the current density of health professionals.
Assuntos
Promoção da Saúde , Serviços Preventivos de Saúde , Atenção Primária à Saúde , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Recursos Humanos , Adulto JovemRESUMO
OBJETIVO: Estimar los recursos humanos (RH) para brindar acciones de prevención y promoción de la salud a la población de 20 años o más en unidades de primer nivel de atención (UPA). MATERIAL Y MÉTODOS: Se incluyeron 20 UPA, una urbana y otra rural, por cada uno de los diez estados seleccionados de la República mexicana. Los RH se estimaron en función del tiempo para realizar actividades de prevención y promoción de la salud, y con ellos se calculó el presupuesto requerido para su financiamiento. Se reportaron medidas de tendencia central y de dispersión, utilizando el test ANOVA y la prueba de Wilcoxon. RESULTADOS: El número de profesionales de salud estimados en la UPA con el tiempo utilizado es menor que el estimado con el tiempo requerido. CONCLUSIONES: La densidad estimada de profesionales de salud por habitante para realizar acciones de prevención y promoción de la salud en la población de 20 años o más es mayor que la densidad actual de profesionales de salud en las UPA.
OBJECTIVE: To estimate human resources (HR) needed to deliver prevention and health promotion actions to the population of 20 years and more in units of primary health care (UPHC). MATERIALS AND METHODS: We included 20 UPHC; one urban and one rural for each of the ten selected Mexican states. HR were estimated based on the time to do prevention and health promotion activities, from which a budget was calculated. Measures of central tendency and dispersion were reported, using the ANOVA test and the Wilcoxon test. RESULTS: The number of health professionals estimated in UPHC with spent time is less than the number estimated with required time. CONCLUSIONS: The estimated density of health professionals per population needed to offer prevention and health promotion activities for people 20 years and more in UPHC is greater than the current density of health professionals.