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A Performance Analysis of Public Expenditure on Maternal Health in Mexico

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  • Edson Servan-Mori
  • Leticia Avila-Burgos
  • Gustavo Nigenda
  • Rafael Lozano

Abstract

We explore the relationship between public expenditure, coverage of adequate ANC (including timing, frequent and content), and the maternal mortality ratio -adjusted by coverage of adequate ANC- observed in Mexico in 2012 at the State level. Additionally, we examine the inequalities and concentration of public expenditure between populations with and without Social Security. Results suggest that in the 2003–2011 period, the public expenditure gap between women with and without Social Security decreased 74%, however, the distribution is less equitable among women without Social Security, across the States. Despite high levels of coverage on each dimension of ANC explored, coverage of adequate ANC was lower among Social Security than non-Social Security women. This variability results in differences up to 1.5 times in State-adjusted maternal mortality rate at the same level of expense and maternal mortality rate, respectively. The increase in the economic resources is only a necessary condition for achieving improved health outcomes. Providing adequate health services and achieving efficient, effective and transparent use of resources in health, are critical elements for health systems performance. The attainment of universal effective coverage of maternal health and reducing maternal mortality in Mexico, requires the adjustment of policy innovations including the rules of allocation and execution of health resources. Health policies should be designed on a more holistic view promoting a balance between accessibility, effective implementation and rigorous stewardship.

Suggested Citation

  • Edson Servan-Mori & Leticia Avila-Burgos & Gustavo Nigenda & Rafael Lozano, 2016. "A Performance Analysis of Public Expenditure on Maternal Health in Mexico," PLOS ONE, Public Library of Science, vol. 11(4), pages 1-14, April.
  • Handle: RePEc:plo:pone00:0152635
    DOI: 10.1371/journal.pone.0152635
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    Cited by:

    1. Edson Serván‐Mori & Miguel Ángel Mendoza & Carlos Chivardi & Carlos Pineda‐Antúnez & Roxana Rodríguez‐Franco & Gustavo Nigenda, 2019. "A spatio‐temporal cluster analysis of technical efficiency in the production of outpatient maternal health services and its structural correlates in México," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1417-1436, October.
    2. Edson Serván-Mori & Carlos Chivardi & Fato Fene & Ileana Heredia-Pi & Miguel Ángel Mendoza & Gustavo Nigenda, 2020. "Tackling maternal mortality by improving technical efficiency in the production of primary health services: longitudinal evidence from the Mexican case," Health Care Management Science, Springer, vol. 23(4), pages 571-584, December.
    3. Rocío García-Díaz & Sandra G Sosa-Rubí & Edson Serván-Mori & Gustavo Nigenda, 2018. "Welfare effects of health insurance in Mexico: The case of Seguro Popular de Salud," PLOS ONE, Public Library of Science, vol. 13(7), pages 1-18, July.
    4. Leticia Avila-Burgos & Julio César Montañez-Hernández & Lucero Cahuana-Hurtado & Aremis Villalobos & Patricia Hernández-Peña & Ileana Heredia-Pi, 2020. "Government Expenditure on Maternal Health and Family Planning Services for Adolescents in Mexico, 2003–2015," IJERPH, MDPI, vol. 17(9), pages 1-17, April.
    5. Roxana Rodríguez-Franco & Edson Serván-Mori & Octavio Gómez-Dantés & David Contreras-Loya & Carlos Pineda-Antúnez, 2018. "Old principles, persisting challenges: Maternal health care market alignment in Mexico in the search for UHC," PLOS ONE, Public Library of Science, vol. 13(7), pages 1-14, July.

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