墨西哥的分散医疗保健和有效的孕产妇覆盖,2009-2023年
Edson Serván-Mori1, Diego Cerecero-García1,2, Thomas Hone2
1Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
BMC medicine
|January 9, 2026
概括
在墨西哥,分片化的孕产妇医疗保健显著降低了有效的覆盖率,特别是对弱势妇女. 需要进行改革,以改善护理协调,实现全民医疗覆盖.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
背景情况:
- 医疗保健的碎片化破坏了母亲护理的连续性和覆盖范围.
- 墨西哥细分的医疗保健系统可能会加剧获得和质量不平等.
- 在墨西哥 (2009-2023) 检查了分散的孕产妇保健 (FHC) 和有效的孕产妇保健 (EMHC) 覆盖率.
研究的目的:
- 确定FHC在墨西哥EMHC的流行,决定因素和后果.
- 在14年的时间内分析FHC和EMHC的趋势.
- 为了确定不成比例地受到FHC影响的人口.
主要方法:
- 从2014年,2018年,2023年ENADID调查中对71,874名女性进行了回顾性,重复的横截面分析.
- EMHC被定义为适当的产前护理 (ANC),熟练/机构分娩,及时的产后护理和无并发症的产后期.
- FHC定义为从不同的提供者那里接受ANC和分娩护理;多变量回归评估了协会.
主要成果:
- 大约16.7%的女性经历了FHC;只有33.3%的人实现了EMHC.
- 在有补贴保险的妇女,土著妇女,农村居民和具有高产科风险的妇女中,FHC更为常见.
- FHC将EMHC的概率降低了4.7个百分点 (aOR=0.80),概率降低了20%,对卫生部用户的影响最大.
结论:
- 分散的孕产妇护理显著降低了有效覆盖率,不成比例地影响了弱势群体.
- 碎片化是一个结构性挑战,需要改善护理协调,健康信息互操作性和基于连续性的融资.
- 解决FHC对于预防不安全的护理和促进墨西哥和类似国家的全民健康覆盖至关重要.
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