Financing Maternal Health 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 distribution of resources for maternal health family planning (MHFP) programs from 2003 to 2012 were consistent with the financial goals of the related policies. MATERIALS METHODS: A longitudinal descriptive analysis of the Mexican Reproductive Health Subaccounts 2003 2012 was performed by financing scheme health function. Financing schemes included social security, government schemes, household out of pocket (OOP) payments, private insurance plans. Functions were preventive care, including family planning, antenatal puerperium health services, normal cesarean deliveries, treatment of complications. Changes in the financial imbalance indicators covered by MHFP policy were tracked: (a) public 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; (d) public expenditure on WoRA at state level. Statistical analyses of trends distributions were performed. RESULTS: Public expenditure on government schemes grew by approximately 300%, the financial imbalance between populations covered by social security 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 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 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 accountability functions in Mexico.