Reviewer's report
Title:A comprehensive approach to women's health: lessons from the Mexican
health reform
Version: 1Date:1 August 2012
Reviewer: Sandra G. Sosa-Rubi
Reviewer's report:
In a context in which old and emerging health challenges are part of the main
agenda in developing and mid-income countries, women’s health is one of the
most relevant not only because of the traditional and emerging needs that
women face but also because the importance to generating mechanisms to
address and approach population health problems in a more equitable way. The
creation of mechanisms to tackle women’s unmeet health needs is a pritority and
this paper describes one relevant experience in a mid-income country such as
Mexico.
In general I think this is an excellent paper that describes the Mexican
experience about the introduction of specific initiatives to improve women’s
access to health services and reduce inequalities in health. I have some
comments in some specific sections that I would like to clarify, specifically the
main crux of the argument from the section entitled: Addressing Women’s
Concerns in the Context of the Mexican Health Reform.
General Comments:
Authors mentioned an initiative named Fair Start in Life which was launched to
address maternal morbidity and mortality. When this initiative was implemented?.
Which was the target population? Women in rural and urban areas?. Was this
initiative part of the framework of the MHealth Reform?.
It seems like in the Mexican context there was not an articulate initiative to
improve women’s condition in terms of their access to basic health services but a
series of initiatives trying to reduce a series of gaps in different areas. Could the
authors clarify this specific point?.
The section entitled: “Addressing Women’s Concerns in the Context of the
Mexican Health Reform” describes the specific policies that were implemented
during the period 2000 to 2006 in order to promote specific measures to
ameliorate women’s health. However it is unclear whether these initiatives to
improve health care access to women were part of the general health reform
implemented during 2000 to 2006 period or were specific initiatives targeting the
most vulnerable groups of population i.e. women living in rural areas. In other
words the measures that are described in this section to promote the
improvement of women’s health are part of an initiative formed specifically to
promote access to health services for women? or are part of a larger initiative
that aims to improve access of services to vulnerable population groups?.
It seems that different initiatives were implemented in different areas of the health
system in order to improve the access to health services, the quality of the health
services and the financial coverage of women without any health insurance
coverage. These aspects were improved in health services targeting women
according to the gap faced in each type of health service. I would like to clarify
with the autores if this is one of the main cruxes of this section's argument.
The authors mentioned general achievements in terms of the coverage of
specific services such as Pap smears. The coverage increased at national level
between 2000 and 2006 but what is the scenario of Pap smears access among
women in rural and urban área or differences of maternal mortality among
different states. The gaps have been reduced?
There is a reference that is missing in some of the information that the authors
are providing:
1. Page 5. When authors mention a 95% of coverage. We would need a
reference.