The Road to Healthcare is Paved with Good Intentions: Perceptions of Mexico City's Government-Managed Healthcare...

The Médico en Tu Casa and Salud en Tu Vida (MTC/STV) government-led health programs bring free healthcare services to the homes of Mexico City residents. Despite international recognition of the program, program evaluation has thus far adopted a top-down perspective, mostly excluding the point of view of recipients and other locals in reports on the program. Driven by the culture-centered approach, this study employs interview research methods to investigate perceptions of the program by centering the voices of residents whom the MTC/STV healthcare program is designed to serve. These perspectives were gathered via face-to-face interviews that took place in Mexico City and analyzed using a grounded, iterative approach with sensitizing concepts from the culture-centered approach. Results show an overall lack of program awareness, and perceptions of the program as both a critical resource and inefficient. Finally, we conclude with suggestions from participants for improving the implementation of state-funded healthcare programs. Findings highlight the importance of cultural competence and input from healthcare recipients when conceptualizing, designing, and assessing government-led healthcare programs. Further, the interpretations suggest that the delivery of effective in-home health care requires communication and coordination with patient family members and a provision of care that recognizes the structural barriers to accessible healthcare in Mexico City.