Financing Maternal Health and Family Planning: Are We on the Right Track? Evidence from the Reproductive Health Subaccounts in Mexico, 2003–2012

Presenter: Lucero Cahuana-Hurtado, Instituto Nacional de Salud Pública

Background: In the past decade, Mexican government introduced a series of MHFP policies designed to remove financial barriers and provide women with greater access to health services for pregnancy, childbirth and family planning. The aim of this study is to analyze whether changes observed in the level and distribution of resources for maternal health and family planning (MHFP) policies are consistent with the financial goals of the policies in this area implemented in Mexico from 2003 to 2012.

Methodology:  A longitudinal descriptive analysis of the Mexican Reproductive Health Subaccounts was performed by insurance scheme and health function. Changes in indicators of financial imbalances addressed by MHFP policy were tracked: (a) public and household out-of-pocket (OOP) expenditure as percentages of total MHFP expenditure; (b) ratio of expenditure per woman of reproductive age (15–49 years) for the social security vs. uninsured population; (c) ratio of public expenditure on treating complications of pregnancy and childbirth vs. preventive care and (d) public expenditure on women of reproductive age at state level. Statistical analyses of trends and distributions were performed.

Results: Public expenditure for the uninsured population grew by around 300%. The share of total MHFP expenditure financed by the public sector therefore increased and the financial imbalance between the social security-funded and uninsured populations decreased. The financial burden of households declined, particularly for uninsured households. Expenditure on preventive care grew by 16%, narrowing the funding gap between complication treatment and preventative care. Public expenditure per number of uninsured women of reproductive age nearly doubled at the state level, but serious disparities persist.

Conclusions: Changes in the level and distribution of funding for MHFP services were consistent with policy goals. To improve efficiency and achieve the Post-2015 Development Agenda goals, further analysis is required to ascertain the relation between health achievements and investments.