ABSTRACT
Mexican President Andrés Manuel López Obrador's historic election victory in 2018 marked a sharp break from past decades of neoliberal socioeconomic policies. López Obrador campaigned on the promise of deep reform, with health care high on his agenda. The public health care sector had been decimated by decades of budget cuts, eroding workers' morale and patients' confidence, and crippling all aspects of the system. This article looks back to the creation of the nation's public health care system in the early twentieth century during the administration of President Lázaro Cárdenas (1934-1940). This "universal" system was designed to implement a central social justice goal of the Mexican Revolution of health care for all. The program rested on two pillars: providing care to the nation's vast, impoverished rural population and actively engaging communities in their own health care. Our objective is to critically assess the two presidents' health care initiatives within the distinct historical contexts of their administrations.
Subject(s)
Health Care Reform , Politics , Health Care Reform/history , Health Care Reform/organization & administration , Mexico , History, 20th Century , Humans , Social Justice/historyABSTRACT
The challenges of meeting global health care needs in communities throughout the developing world are becoming increasingly complex. Understanding what motivates volunteers is important for organizations that seek to harness and develop long-term volunteers in order to meet the need for global health care services. Here we report a case study of a successful volunteer clinic that has provided medical, dental and surgical services to under-served residents of northern Mexico for more than 20 years. Our objective was to understand what promotes sustained volunteerism. Thirty semi-structured interviews were conducted with students, residents, nurses, dentists, oral surgeons and community volunteers, in addition to four full days of participant observation. We analysed volunteers' experiences with a real-life global medical mission and offer recommendations. Motivating factors included psychological and emotional rewards, career-related benefits, opportunities for interpersonal interaction, the opportunity to serve disadvantaged communities and personal relevance of the mission. We demonstrate the paramount importance of volunteer-patient interaction, having a dedicated facilitator to recruit and pave the way for first-time volunteers and the value of using multiple recruitment strategies. Most important, we show that organizations must focus on facilitating first-time volunteers' experiences, particularly by ensuring that they are given specific roles and responsibilities, one of the best predictors of volunteer satisfaction and sustained volunteerism.
Subject(s)
Global Health , Medical Missions , Motivation , Volunteers , Adult , Female , Humans , Male , Mexico , Middle Aged , Organizational Case Studies , Qualitative ResearchABSTRACT
A common assumption is that women who decline prenatal testing distrust biomedicine and trust embodied/experiential knowledge sources, while women who accept testing trust biomedicine and distrust embodied/experiential sources. Another major assumption about prenatal testing utilisation is that women who are open to abortion will undergo prenatal testing while those who are opposed to abortion will decline testing. Yet, previous research has produced inconsistent findings as to what, if anything, distinguishes women who accept or decline the offer of prenatal diagnosis. Analysing interviews with 147 pregnant women, this paper questions these assumptions about the role of abortion views and pregnant women's relative trust in various knowledge sources on their decisions to accept or decline an amniocentesis offer after a positive result on an initial diagnostic screening. We found that pregnant women's attitudes toward different knowledge sources were equally, if not more, important factors than abortion views in affecting whether individual women accepted or declined amniocentesis. At the same time, our data reveal that the relationship between 'expert' and 'lay' knowledge sources is often complex and synergistic.
Subject(s)
Amniocentesis , Decision Making , Genetic Counseling , Health Knowledge, Attitudes, Practice , Patient Acceptance of Health Care , Trust , Amniocentesis/psychology , Amniocentesis/statistics & numerical data , Clinical Competence , Female , Hispanic or Latino , Humans , Mexico/ethnology , Patient Acceptance of Health Care/ethnology , Patient Education as Topic , Patient Satisfaction , Power, Psychological , Pregnancy , Problem-Based Learning , Qualitative Research , United StatesSubject(s)
Attitude to Health/ethnology , Lung Neoplasms/ethnology , Mexican Americans/psychology , Physician-Patient Relations , Truth Disclosure , Aged , Anecdotes as Topic , Anthropology, Cultural , Attitude to Death/ethnology , Bioethics , Decision Making , Humans , Interviews as Topic , Los Angeles , Lung Neoplasms/psychology , Male , Sociology, Medical , Terminal CareABSTRACT
This study explored how couples of Mexican origin define power in intimate relationships, what makes men and women feel powerful in relationships, and the role of each partner in decision making about sexual and reproductive matters. Interviews were conducted with each partner of 39 sexually active couples and data were analyzed using content analysis. Results indicate that power is perceived as control over one s partner and the ability to make decisions. Women say they feel more powerful in relationships when they make unilateral decisions and have economic independence. Men feel powerful when they have control over their partner and bring home money. Respondents agreed that women make decisions about household matters and children, while men make decisions related to money. Findings indicate that whereas couples share decision making about sexual activities and contraceptive use, men are seen as initiators of sexual activity and women are more likely to suggest condom use.