3102.1: Monday, October 22, 2001 - 2:50 PM

Abstract #32691

Health reform and the decentralization of the Mexican states bordering Texas

Nuria Homedes, MD, DrPH, University of Texas at El Paso and Antonio Ugalde, PhD, Department of Sociology, University of Texas-Austin, 1802 Westridge, Austin, TX 78704, 512-471-1122, augalde@mail.la.utexas.edu.

In developing nations the transformation of the State is promoted by the multilateral banks and some bilateral assistance agencies as part of a modernization package and a pre-condition for economic growth. The neoliberal vision of the State is a lean institution, whose functions are significantly reduced by transferring the production of services to the private sector and decision-making power to local governments.

This article discusses the decentralization of the health sector (1994 to present) in Mexico and reports on data collected in 1998 and 2001 in the three states that border Texas. Data collection methods included a review of archival information and in-depth interviews with spokespersons for the three main political parties, worker unions, professional associations, and health administrators. The study concludes that the decentralization of decision-making in Mexico is still very limited and asserts that the decentralization, as it is being implemented, may result in greater inequity at the national and at the state levels. Most decision-makers interviewed recognized decentralization as window of opportunity and identified factors that hinder its implementation. The most frequently mentioned constraints are limited financial resources, fears by labor unions, and limited managerial capacity in the decentralized entities.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to articulate and discuss the Mexican health reform and the decentralization of the Mexican states bordering Texas.

Keywords: Health Care Reform, International Health

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA