Evidence-based health policy: Three generations of reform in Mexico

Julio Frenk, Jaime Sepúlveda, Octavio Gómez-Dantés, Felicia Knaul

Research output: Contribution to journalArticlepeer-review

87 Scopus citations

Abstract

The Mexican health system has evolved through three generations of reform. The creation of the Ministry of Health and the main social security agency in 1943 marked the first generation of health reforms. In the late 1970s, a second generation of reforms was launched around the primary health-care model. Third-generation reforms favour systemic changes to reorganise the system through the horizontal integration of basic functions - stewardship, financing, and provision. The stability of leadership in the health sector is emphasised as a key element that allowed for reform during the past 60 years. Furthermore, there has been a transition in the second generation of reforms to a model that is increasingly based on evidence; this has been intensified and extended in the third generation of reforms. We also examine policy developments that will provide social protection in health for all. These developments could be of interest for countries seeking to provide their citizens with universal access to health care that incorporates equity, quality, and financial protection.

Original languageEnglish (US)
Pages (from-to)1667-1671
Number of pages5
JournalLancet
Volume362
Issue number9396
DOIs
StatePublished - Nov 15 2003
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

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