Budget allocations to prevent maternal
mortality in Mexico
In 2001, five women died daily in Mexico
because of complications during pregnancy, birth or the
immediate period following birth. Twenty-one percent of
maternal deaths took place at home; and 68 % of the deceased
women lacked access to social security.
Yet, one of the explicit goals is the
reduction of the level of maternal mortality to half of
its level in 1990. The Mexican government had committed
itself to this goal at the international level, and it was
enlisted as one of the government’s main health objectives
for 2000-2006.
In 2002, Fundar, a centre for analysis
and research working on budget issues in Mexico, engaged
in a project aimed at evaluating the extent to which public
resources were being allocated to the reduction of maternal
mortality.
Despite having worked as one of the leading
groups in Mexico’s gender budget initiative, Fundar
did not have the specific knowledge necessary to analyse
to what extent the budget provided the resources needed
to reduce maternal mortality. In order to carry out meaningful
research and produce politically relevant information, the
organisation had to link up with groups that had substantial
experience working on maternal mortality and reproductive
health issues.
In order to achieve this, two paths were
followed:
- Formal collaboration with longstanding
experts in the area
- Consulting CSOs and networks working
on maternal mortality on the research design and process.
The research document that resulted from
the project offered more than a hundred pages of data, analysis
and argument. In order to turn this document into a tool
for advocacy, several steps had still to be taken, namely:
- Providing an accessible summary of
the information
- Dissemination through workshops
- Linking the research to current political
debates
- Using the research to open doors with
officials
- Media publicity.
The strategy had several different results,
which can be grouped in four categories:
Effect on the policy:
The federal government earmarked a substantial amount of
decentralised health resources to programs specifically
targeting maternal health.
Moment building: The
strategic alliance between Fundar and the network of groups
dedicated to the reduction of maternal mortality has been
continuing uninterruptedly. Furthermore, the profile of
maternal mortality was raised, building sustained momentum
for advocacy.
What worked, what didn’t
work and what was discarded: One of the important
strategic choices made within the wider network was to contrast
the money allocated to maternal and reproductive health
with other areas of spending. to the campaign highlighted
that resources were indeed available, but had been spent
on something else – to the detriment of health expenditures.
This made the argument defensible, even for officials of
the health ministry themselves.
Lessons learned:
- The research responded to the issues
identified by the groups working on the topic on a daily
basis. This made the results meaningful to their efforts.
- The information was presented in a
timely fashion, making use of the political opportunities
offered by the discussion of the budget—as well
as by the strength stemming from a broad coalition.
- A shared perspective and a common
understanding were built, thus allowing for a constructive
alliance and future collaboration.
- The differing strengths of the various
actors were made use of, in order to achieve better results.
- The ground was established for further
collaboration with the Health Ministry, in order to turn
the effort into a continued struggle.
Factors that contributed to the success
of the strategy:
- The Mexican government had committed
itself at the international level to the reduction of
maternal mortality. This commitment was also enshrined
in the administration’s health program. The analysis
could therefore be directly related to what the government
was saying and expressing as concerns.
- In 2003 an access to information law
was passed in Mexico. This has made it possible, in subsequent
efforts, to request more information and access more detailed
data.
- In 2003 as well, a change in the structure
of the Ministry of Health contributed to a stronger interaction
and discussion within the Department.
- Networks and women’s groups
working on maternal mortality were craving solid and unquestionable
policy information for their struggle. Fundar’s
willingness to define its research and later findings
in a collaborative way gave them the assurance of a strengthened
perspective.
- The committee on gender equity in
Congress was headed by the left-wing PRD, which was willing
to question the decisions of the right-wing Executive.
(Extracted from case study by Helena Hofbauer,
FUNDAR, Center for Analysis and Research)