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Systematic literature review on vulnerable groups in Mexico

Date: Tuesday 30 October 13.30–15.00
Source: Forum 11
Authors: Miguel Angel Gonzalez Block, Executive Director, Centre for Health Systems Research, National Institute for Public Health, Mexico
with Victor Becerril, Leticia Robles, John Scott, Maria Beatriz Duarte and Nelly Salgado

Abstract

A systematic literature review on the problems of health systems in addressing the needs of four vulnerable groups in Mexico: indians, the poor, the elderly and migrants, was the starting point of an effort to identify and develop local capacities to produce, adapt and use health policy and systems research in the Mexico health system.

Four experts, one per vulnerable group, conducted what can be considered a pioneering research synthesis in a developing country. Two steps were followed: an initial broad-based review of the literature and a synthesis of a subset of papers. Various search engines were used to identify 1940 papers. Independent selection by two researchers assured objective paper selection. Further research permitted identification, classification and review of the literature best suited to the Latin America and Mexico contexts.

The initial review showed that most of the literature refers to North America (excluding Mexico), Europe and Central Asia (80.6%) and is published in English (90.3%). Literature on the poor accounts for 51.8% of all the references, the elderly18.8%, indigenous populations 17.8%, and migrants 11.6%.

Literature on poverty and health is abundant, so a selective rather than exhaustive review was undertaken. A broad gap has been recognized between the ambitions of international projects to promote health equity and the practicality of the literature produced to this aim.

Successful long-term health interventions for the elderly imply a strong engagement on the part of governments to respond to the needs of this group. Interventions must be led by multidisciplinary teams on a communitarian basis.

Theoretical papers, as well as those dealing with successful interventions targeting indigenous populations, point to the importance of this group's autonomy in planning and evaluating all actions related to their health care.

Literature on migrants in Mexico is scarce, particularly for the southern border. The lack of literature points to the fact that, while systematic reviews may inform on certain topics, health policies and programmes must also consider the points of view of migrant groups in addressing their needs.