Factors Affecting Anemia among Women of Reproductive Age in Mexico: A Mixed-Methods Country Case Study.

BACKGROUND: In Mexico, anemia prevalence among women of reproductive age (WRA) decreased from 16.4% in 2006 to 11.6% in 2012, only to increase to 18.3% in 2016. The factors associated with this fluctuation are uncertain. OBJECTIVE: We conducted a systematic in-depth assessment of the quantitative and qualitative determinants of anemia among WRA in Mexico between 2006 and 2018. METHODS: Using multivariate stepwise linear regression, we analyzed Mexico's Encuesta Nacional de Salud y Nutrición (ENSANUT) surveys from 2006, 2012, and 2018 to identify determinants of WRA anemia. We also conducted a review of anemia-relevant programs and policies, including financing documents, and conducted in-depth interviews and focus group discussions with key stakeholders in Mexico. RESULTS: Among non-pregnant women (NPW) 15-49 years, mean hemoglobin (Hb) increased from 13.8 g/dL in 2006 to 14.0 g/dL in 2012, decreasing to 13.2 g/dL in 2018 (p<0.001). Inequities by geographical region and household wealth persisted throughout this period, with household wealth, urban residence and gravidity emerging as significant predictors of Hb among NPW. Qualitative analyses generally supported these findings. The most discussed program was Progresa-Oportunidades-Prospera (POP), where most resources for health were invested and most participants acknowledged that its cancellation in 2019 would lead to worsening in health and nutrition among the poor. Financing analyses showed a drop of funding for nutrition-related programs between 2014 and 2018. Cultural norms around gender roles were still prevalent, along with increasing rates of teenage pregnancy. CONCLUSIONS: Anemia prevention efforts need to refocus on poverty alleviation, continuity of adequate coverage and financing of nutrition programs, especially with safety nets, and increase in uptake of family planning, especially among adolescent girls.

Results From Mexico's 2016 Report Card on Physical Activity for Children and Youth.

BACKGROUND: The 2016 Mexican Report Card on Physical Activity for Children and Youth aims to assess how Mexico is doing in terms of providing physical activity (PA) opportunities for Mexican children and youth. The purpose of this article is to summarize results from the Mexican 2016 Report Card. METHODS: A literature search was conducted in Spanish and English languages using major databases, and complemented with a review of government/nongovernment documents, websites, and national health surveys. Information on the 9 indicators outlined in the Global Matrix of Report Card Grades was extracted. A team of Mexican experts met to discuss and assign a grade on each indicator based on the best available evidence and established benchmarks. RESULTS: Daily behaviors grades were Overall PA (C), Organized Sport Participation (D), Active Play (D-), Active Transportation (C), and Sedentary Behavior (D). For Settings and Sources of Influence, grades were Family and Peers (INC), School (D-), and Community and Environment (D). Strategies and Investments grades were Government Strategies (C) and Non-Government (F). CONCLUSIONS: PA and sedentary behaviors among Mexican children and youth remain below the recommended levels. Government and communities are far from providing appropriate and sufficient physical activity opportunities for children and youth.