A health system hit by the pandemic and historical budget shortfalls.
Highlights:
- The health system in Mexico is hard hit by the SARS-CoV-2 pandemic, with deficiencies and shortcomings that will not be solved only with more doctors, as has historically been proposed.
- The health system in Mexico needs to be more cohesive.
- For specialist doctors to be assigned outside the country’s large cities, the conditions of these rejected positions must first be ensured.
- The solution lies in a multidisciplinary approach to formulating public policies, which has been complex because “evidence is not valued as an input,” says Dr. Pizarro.
- Using Evidence-Informed Policies, “tools that seek the use of evidence as an input for the policy formulation and implementation process.”
The health system in Mexico is hard hit by the SARS-CoV-2 pandemic, with deficiencies and shortcomings that will not be solved only with more doctors, as has historically been proposed. Is the problem of doctors in Mexico about their distribution or quantity? The answer includes both, but we must start with the distribution. For this, proper planning and evidence-based quality management are required. It is enough to take indicators, such as mortality in regions that do not have adequate access to health, or to analyze the indicators of the Human Development Index, to know that equity in allocating health resources is insufficient in Mexico.
The health system in Mexico needs to be more cohesive.
María Fernanda Pizarro
“The health system in Mexico is fragmented,” says Dr. María Fernanda Pizarro, a recognized specialist in Health Systems. Therefore, it is necessary to improve the conditions in which the vast majority of health professionals work, correcting the distribution of these throughout the country, strengthening the infrastructure, and ensuring that the necessary supplies exist to practice the profession. Dr. Mauricio Sarmiento, a defender of the rights of doctors and participant in the documentary Resiste Residente, uses an analogy that compares our health system to a bucket with holes: before filling it with more doctors, “we must first cover the holes.” Although it is true that, according to OECD figures, in Mexico, there are 2.4 doctors for every thousand inhabitants, which is lower than the average of the member countries, we must also work to prevent these professionals from continuing to leave through the holes in the system. Improving planning and managing the quality of the various health institutions in Mexico.
We must first cover the holes.
Mauricio Sarmiento
The strategies adopted recently by the government, such as doubling the spaces to carry out a medical specialty in the year 2020 or, recently, opening a call for hiring medical specialists in hospitals outside the big cities, become unsustainable if the root problem still needs to be addressed. On the one hand, it has caused the existence of deficient training places, which still need a university endorsement that is necessary to issue a professional certificate that certifies that the specialist is undoubtedly a specialist at the end of the academic program. On the other, some of the jobs offered last month precisely need the working conditions, infrastructure, and supplies necessary to exercise the profession adequately. For specialist doctors to be assigned outside the country’s large cities, the conditions of these rejected positions must first be ensured.
The solution lies in a multidisciplinary approach to formulating public policies, which has been complex because “evidence is not valued as an input,” says Dr. Pizarro. She proposes using Evidence-Informed Policies, “tools that seek the use of evidence as an input for the policy formulation and implementation process.” However, this sometimes competes with other factors in the policy-making process. For example, the speed with which decisions must be made, or the evidence is not easy to use because it does not communicate with decision-makers in an agile way. Finally, as the scientific community itself, we tend to avoid getting involved in creating policies due to multiple factors, including the lack of education in these areas in university programs. “We need to reach a midpoint of analysis,” says Dr. Fernanda Pizarro.
Tools that seek evidence as input for the policy formulation and implementation process.
María Fernanda Pizarro
Equity in allocating health resources is the prerequisite for equity in health services. Dr. Pizarro sees a promising path using the media that increases the reach we have with communication. “What is important is that, as a medical profession, we communicate the evidence […] Knowledge will give us this power of action”, she concludes.
