Using Routine Health Information to Map Maternal Mortality in Mexico and How It Influenced Maternal Health Public Policy

Session: New Horizons in Measurement for Maternal and Newborn Health

Presenter: Juan Eugenio Hernández-Ávila, National Institute of Public Health
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Background: The reduction of Maternal Mortality Ratio (MMR) in Mexico is short of achieving MDG-5.1 set at 22.3 maternal deaths per 100,000 live births; MMR in 2012 was 42.7, ranging between 21.2 and 74.6 in the states of Queretaro and Guerrero, respectively. Access to health care in Mexico has improved during the last decade, especially to uninsured population. However, despite of a threefold increment in the expenditure by the Ministry of Health, the MMR showed little change since 2002. This indicated the need to assess the distribution, availability, and utilization of maternal health services at state and local levels, and to investigate how these conditions were related to the country’s slow progress.

Methodology: A Geographic Information System (GIS) was constructed to map the location of all public hospital and clinics. Using data from routine health information systems such as hospital discharge data and vital events registries, travel time to the nearest facility offering emergency obstetric care (EmOC) as well as travel patterns of women seeking childbearing care and were estimated and mapped in the GIS and presented to the National Health Council on October 2008.

Results: Visualization of geographical and institutional barriers to access EmOC services aided in the development of a new maternal health policy in Mexico: Regardless on health insurance status, any woman should receive free-of-charge EmOC services in any public hospital in Mexico; this was extended later to include also childbearing services.

Conclusions: Mapping and visualization of routine health information can help to better understand processes involved in saving mothers lives and to support decision making at all levels of the health system. Further more routine health information systems should be strengthened to map and monitor UN signal functions such as EmOC an Emergency Newborn Care at micro regional/facility level in order to ensure quality of care and Maternal mortality prevention.