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Ethnic Disparities in Sexual and Reproductive Health in Mexico After 25 Years of Social Policies

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Abstract

Introduction

This paper analyzes the current sexual and reproductive health (SRH) situation of Mexican women according to their ethnic status and evaluates the effects, achievements, and challenges of relevant policies, programs, and interventions implemented over the last 25 years.

Methods

A repeated, retrospective cross-sectional study based on a pooled analysis of data from the 2012 and 2018 waves of the National Health and Nutrition Survey (ENSANUT by its initials in Spanish) on 43,382 women between the ages of 12 and 49 years at the time of their last obstetric event (population N = 64,805,153). Analysis included three SRH interventions and eleven antenatal and perinatal maternal-health indicators. Adjusted coverage and 95% CIs were estimated using a pooled and multivariable logistic model.

Results

The raw estimates of all indicators yielded lower values for indigenous as compared to non-indigenous women. However, the results of our models showed that the SRH interventions analyzed — the Seguro Popular and Progresa-Oportunidades-Prospera (POP) Programs — were associated with greater coverage of the following services for indigenous women who did vs. those who did not participate in these programs: HIV testing; monitoring of weight, height, blood pressure, and uterine fundus; laboratory studies of blood and urine; contraception and breastfeeding counseling; and provision of postpartum contraceptive methods.

Conclusions

Notwithstanding their contributions to improving SRH indicators, policies implemented throughout the past 25 years — particularly the Seguro Popular and POP Programs — have been insufficient to bridge the gaps between indigenous and non-indigenous women. The design of future SRH policies and programs should include specific interventions and assessment models to measure the impact of their efforts on the reduction of structurally induced disparities between these populations.

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Availability of data and materials

The dataset analyzed during this study is available from the corresponding author on request.

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Acknowledgements

We acknowledge the valuable assistance of Patricia E. Solís in translating this manuscript into English.

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Authors and Affiliations

  1. Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico

    Sergio Meneses-Navarro, Edson Serván-Mori, Ileana Heredia-Pi & Blanca Pelcastre-Villafuerte

  2. National School of Nursing and Obstetrics, National Autonomous University of Mexico, Mexico City, Mexico

    Gustavo Nigenda

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  1. Sergio Meneses-Navarro
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Contributions

SMN and ESM conceived the idea of the paper and contributed equally to this work; therefore, they share first authorship. ESM designed the study and analyzed the data. SMN and ESM wrote the first draft of the manuscript. GN, IHP, and BPV revised the drafts critically. All the authors were involved in the revision of the paper and approved the final manuscript.

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Correspondence to Edson Serván-Mori.

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Memorial Dedication

We dedicate this paper to our colleague Dr. Sandra Sosa-Rubi who passed away in March 2021. Dr. Sosa will be remembered as a remarkable health economist, friend, and human being.

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Meneses-Navarro, S., Serván-Mori, E., Heredia-Pi, I. et al. Ethnic Disparities in Sexual and Reproductive Health in Mexico After 25 Years of Social Policies. Sex Res Soc Policy 19, 975–990 (2022). https://doi.org/10.1007/s13178-022-00692-0

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