title: Financing Maternal Health and Family Planning: Are We on the Right Track? Evidence from the Reproductive Health Subaccounts in Mexico, 2003-2012.
abstract: OBJECTIVE
  To analyze whether the changes observed in the level and distribution of resources for maternal health and family planning (MHFP) programs from 2003 to 2012 were consistent with the financial goals of the related policies.
  
  
  METHODS
  A longitudinal descriptive analysis of the Mexican Reproductive Health Subaccounts 2003-2012 was performed by financing scheme and health function. Financing schemes included social security, government schemes, household out-of-pocket (OOP) payments, and private insurance plans. Functions were preventive care, including family planning, antenatal and puerperium health services, normal and cesarean deliveries, and treatment of complications. Changes in the financial imbalance indicators covered by MHFP policy were tracked: (a) public and OOP expenditures as percentages of total MHFP spending; (b) public expenditure per woman of reproductive age (WoRA, 15-49 years) by financing scheme; (c) public expenditure on treating complications as a percentage of preventive care; and (d) public expenditure on WoRA at state level. Statistical analyses of trends and distributions were performed.
  
  
  RESULTS
  Public expenditure on government schemes grew by approximately 300%, and the financial imbalance between populations covered by social security and government schemes decreased. The financial burden on households declined, particularly among households without social security. Expenditure on preventive care grew by 16%, narrowing the financing gap between treatment of complications and preventive care. Finally, public expenditure per WoRA for government schemes nearly doubled at the state level, although considerable disparities persist.
  
  
  CONCLUSIONS
  Changes in the level and distribution of MHFP funding from 2003 to 2012 were consistent with the relevant policy goals. However, improving efficiency requires further analysis to ascertain the impact of investments on health outcomes. This, in turn, will require better financial data systems as a precondition for improving the monitoring and accountability functions in Mexico.
authors.affiliation: Center for Health Systems Research, National Institute of Public Health, Morelos, Mexico.
authors.forename: Leticia
authors.initials: L
authors.lastname: Avila-Burgos
authors.affiliation: Center for Health Systems Research, National Institute of Public Health, Morelos, Mexico.
authors.forename: Lucero
authors.initials: L
authors.lastname: Cahuana-Hurtado
authors.affiliation: Center for Health Systems Research, National Institute of Public Health, Morelos, Mexico.
authors.forename: Julio
authors.initials: J
authors.lastname: Montañez-Hernandez
authors.affiliation: Center for Health Systems Research, National Institute of Public Health, Morelos, Mexico.
authors.forename: Edson
authors.initials: E
authors.lastname: Servan-Mori
authors.affiliation: Research Center for Evaluation and Surveys, National Institute of Public Health, Morelos, Mexico.
authors.forename: Belkis
authors.initials: B
authors.lastname: Aracena-Genao
authors.affiliation: National Center for Gender Equity and Reproductive Health, Ministry of Health, Mexico City, Mexico.
authors.forename: Aurora
authors.initials: A
authors.lastname: Del Río-Zolezzi
mesh_terms: D005193:Family Planning Services / Q000191:economics* / Q000592:standards*; D005260:Female; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D008137:Longitudinal Studies; D000068097:Maternal Health / Q000191:economics*; D008800:Mexico
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