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for Health DataTechnical PackageAssessment Summaryfor MexicoDATA FROM 2013-2018Survey populationand health risksCount births, deathsand causes of deathOptimize healthservice dataReview progressand performanceEnable data usefor policy and actionLOWER CAPACITYHIGHER CAPACITYv

SCORE ASSESSMENT SUMMARY – MEXICOAvailability of latestdata to monitor thehealth-related SDGs94%of indicators have data available tomonitor the health-related SDGsOne data point over the last 5 yearsindicator20131. MATERNAL MORTALITY RATIO (PER 100 000 LIVE BIRTHS)2. PROPORTION OF BIRTHS ATTENDED BY SKILLED HEALTH PERSONNEL3. NEONATAL MORTALITY RATE (PER 1000 LIVE BIRTHS)4. UNDER-FIVE MORTALITY RATE (PER 1000 LIVE BIRTHS)5. NEW HIV INFECTIONS (PER 1000 UNINFECTED POPULATION)6. TUBERCULOSIS (TB) INCIDENCE (PER 100 000 POPULATION)7. MALARIA INCIDENCE (PER 1000 POPULATION AT RISK)8. HEPATITIS B SURFACE ANTIGEN (HBSAG) PREVALENCE AMONGCHILDREN UNDER 5 YEARS9. REPORTED NUMBER OF PEOPLE REQUIRING INTERVENTIONSAGAINST NTDS10. PROBABILITY OF DYING FROM ANY OF CVD, CANCER, DIABETES,CRD BETWEEN AGE 30 AND EXACT AGE 7011. SUICIDE MORTALITY RATE (PER 100 000 POPULATION)12. TOTAL ALCOHOL PER CAPITA ( 15 YEARS OF AGE) CONSUMPTION(LITRES OF PURE ALCOHOL)13. ROAD TRAFFIC MORTALITY RATE (PER 100 000 POPULATION)14. PROPORTION OF MARRIED OR IN-UNION WOMEN OF REPRODUCTIVEAGE WHO HAVE THEIR NEED FOR FAMILY PLANNING SATISFIED WITHMODERN METHODS15. ADOLESCENT BIRTH RATE (PER 1000 WOMEN AGED 15-19 YEARS)16. ANTENATAL CARE, FOUR OR MORE VISITS (ANC4)17. ANTIRETROVIRAL THERAPY (ART) COVERAGE18. CARE-SEEKING BEHAVIOUR FOR CHILD PNEUMONIA19. CERVICAL CANCER SCREENING AMONG WOMEN AGED 30-49 YEARS20. DENSITY OF PSYCHIATRISTS (PER 100 000 POPULATION)21. DENSITY OF SURGEONS (PER 100 000 POPULATION)22. HOSPITAL BEDS PER 10 000 POPULATION23. HOUSEHOLDS WITH AT LEAST ACCESS TO BASIC SANITATION24. MEAN FASTING PLASMA GLUCOSE (mmol/L)25. POPULATION AT RISK SLEEPING UNDER INSECTICIDE-TREATED NETSFOR MALARIA PREVENTION26. PREVALENCE OF NORMAL BLOOD PRESSURE, REGARDLESSOF TREATMENT STATUS AVAILABLE NOT AVAILABLE22014201520162017Any year

SCORE ASSESSMENT SUMMARY – MEXICOindicator201327. TB EFFECTIVE TREATMENT COVERAGE28 AND 29. PROPORTION OF A COUNTRY’S POPULATION WITH LARGEHOUSEHOLD EXPENDITURE ON HEALTH AS A SHARE OF HOUSEHOLDTOTAL CONSUMPTION OR INCOME ( 10% OR 25%).30. AGE-STANDARDIZED MORTALITY RATE ATTRIBUTED TO HOUSEHOLDAND AMBIENT AIR POLLUTION (PER 100 000 POPULATION)31. MORTALITY RATE ATTRIBUTED TO EXPOSURE TO UNSAFE WASHSERVICES (PER 100 000 POPULATION)32. MORTALITY RATE FROM UNINTENTIONAL POISONING(PER 100 000 POPULATION)33. AGE-STANDARDIZED PREVALENCE OF TOBACCO SMOKING AMONGPERSONS 15 YEARS AND OLDER34. DIPHTHERIA-TETANUS-PERTUSSIS (DTP3) IMMUNIZATION COVERAGEAMONG 1-YEAR-OLDS35. MEASLES-CONTAINING-VACCINE SECOND-DOSE (MCV2) IMMUNIZATIONCOVERAGE BY THE NATIONALLY RECOMMENDED AGE36. PNEUMOCOCCAL CONJUGATE 3RD DOSE (PCV3) IMMUNIZATIONCOVERAGE AMONG 1-YEAR OLDS37. TOTAL NET OFFICIAL DEVELOPMENT ASSISTANCE TO MEDICALRESEARCH AND BASIC HEALTH SECTORS PER CAPITA (USD)38. DENSITY OF DENTISTRY PERSONNEL (PER 1000 POPULATION)39. DENSITY OF NURSING AND MIDWIFERY PERSONNEL(PER 1000 POPULATION)40. DENSITY OF PHARMACEUTICAL PERSONNEL (PER 1000 POPULATION)41. DENSITY OF PHYSICIANS (PER 1000 POPULATION)42. AVERAGE OF 13 INTERNATIONAL HEALTH REGULATIONS CORECAPACITY SCORES43. DOMESTIC GENERAL GOVERNMENT HEALTH EXPENDITURE (GGHE-D) ASPERCENTAGE OF GENERAL GOVERNMENT EXPENDITURE (GGE) (%)44. PREVALENCE OF STUNTING IN CHILDREN UNDER 545. PREVALENCE OF OVERWEIGHT CHILDREN UNDER 546. PREVALENCE OF WASTING IN CHILDREN UNDER 547. PROPORTION OF POPULATION USING SAFELY MANAGEDDRINKING-WATER SERVICES (%)48. PROPORTION OF POPULATION USING SAFELY MANAGEDSANITATION SERVICES49. PROPORTION OF POPULATION WITH PRIMARY RELIANCE ONCLEAN FUELS50. ANNUAL MEAN CONCENTRATIONS OF FINE PARTICULATE MATTER(PM2.5) IN URBAN AREAS (µg/m 3)51. AVERAGE DEATH RATE DUE TO NATURAL DISASTERS(PER 100 000 POPULATION)52. MORTALITY RATE DUE TO HOMICIDE (PER 100 000 POPULATION)53. ESTIMATED DIRECT DEATHS FROM MAJOR CONFLICTS(PER 100 000 POPULATION)54. COMPLETENESS OF CAUSE-OF-DEATH DATA AVAILABLE NOT AVAILABLE32014201520162017Any year

SCORE ASSESSMENT SUMMARY – MEXICOLowerCapacityHigherCapacitySurvey populations and health risks1System of regular population-based health surveysSurveillance of public health threatsRegular population censusCount births, deaths and causes of deathFull birth and death registrationCertification and reporting of causes of deathOptimize health service dataRoutine facility reporting system with patient monitoringRegular system to monitor service availability, quality and effectivenessHealth service resources: health financingHealth service resources: health workforceReview progress and performanceRegular analytical reviews of progress and performance, with equityInstitutional capacity for analysis and learningEnable data use for policy and actionData and evidence drive policy and planningData access and sharingStrong country-led governance of data1Scores of the 5 interventions (bolded) are weighted averages of scores of individual subcomponents (elements).4

SCORE ASSESSMENT SUMMARY – MEXICOSurvey populationand health risksSYSTEM OF REGULAR POPULATION-BASED HEALTH SURVEYSA system of regular and comprehensive population healthsurveys that meets international standards4Number of surveys in 5 years3/13 (23,1%)Cover major health issuesYearCovers majordimensionsof inequality(# dimensions/ sum relevantdimensions) 1Aligned withinternationalstandards(# / 8 standards) 2Funded bygovernmentSurveyscore % 31 ENCUESTA NACIONAL DE CONSUMO DEDROGAS EN ESTUDIANTES*20145/6 (83%)8/8 (100%)YES93%2 ENCUESTA NACIONAL DE SALUD YNUTRICIÓN DE MEDIO CAMINO*20164/6 (67%)8/8 (100%)YES87%4 ENCUESTA NACIONAL DE CONSUMO DEDROGAS, ALCOHOL Y TABACO*2016 20173/6 (50%)8/8 (100%)YES80%3 ENCUESTA GLOBAL DE TABAQUISMO ENADULTOS (GATS)*20153/6 (50%)8/8 (100%)YES80%Survey name* Only surveys with asterisks contribute to the overall score above.1Inequality dimensions comprise wealth, education, sex/gender, age, urban/rural and subnational (where relevant).2International standards include: sample design described, sample size given, sampling errors provided, implementation process described,analysis of data described, data and report available and nationally representative.3Score is a weighted average of 3 components (40% for health topics; 50% for attributes; maximum 10% for number of surveys: 5 10%, 4 9%,3 8%, 2 7%, 1 6%), based on the 5 highest scoring surveys.5

SCORE ASSESSMENT SUMMARY – MEXICOUnderlying responses for each surveyENCUESTA NACIONAL DE CONSUMO DE DROGAS ENESTUDIANTES - 2014COVERS MAJOR DIMENSIONS OF INEQUALITYCOVERS MAJOR HEALTH PRIORITIES(SELECTED SET OF PRIORITIES)WEALTH / INCOMEFAMILY PLANNINGEDUCATIONDELIVERY / SKILLED BIRTH ATTENDANCESEX / GENDERCHILD IMMUNIZATIONAGE / AGE GROUPCHILD WEIGHT / HEIGHTURBAN / RURALMALARIA PARASITE PREVALENCE AMONG CHILDRENSUBNATIONALCHILD MORTALITYHIV PREVALENCEIS ALIGNED WITH INTERNATIONALLYACCEPTED STANDARDSTB PREVALENCESAMPLE DESIGN DESCRIBEDTOBACCO USESAMPLE SIZE GIVENCERVICAL CANCER SCREENINGSAMPLING ERRORS PROVIDEDPREVALENCE OF RAISED BLOOD PRESSUREIMPLEMENTATION PROCESSES DESCRIBEDPREVALENCE OF RAISED FASTING BLOOD GLUCOSENATIONALLY REPRESENTATIVEHEALTH EXPENDITURE AS A PERCENT OF TOTALHOUSEHOLD EXPENDITUREANALYSIS OF DATA IS DESCRIBEDDATA FROM THE SURVEY IS AVAILABLE IN THE PUBLICDOMAIN (TO BONA FIDE USERS)IS FUNDED BY GOVERNMENTGOVERNMENT FUNDED YES-NO DATAREPORT IS ON WEBNANOT APPLICABLE TO THE SURVEY6

SCORE ASSESSMENT SUMMARY – MEXICOENCUESTA NACIONAL DE SALUD Y NUTRICIÓN DE MEDIOCAMINO - 2016COVERS MAJOR DIMENSIONS OF INEQUALITYCOVERS MAJOR HEALTH PRIORITIES(SELECTED SET OF PRIORITIES)WEALTH / INCOMEFAMILY PLANNINGEDUCATIONDELIVERY / SKILLED BIRTH ATTENDANCESEX / GENDERCHILD IMMUNIZATIONAGE / AGE GROUPCHILD WEIGHT / HEIGHTURBAN / RURALMALARIA PARASITE PREVALENCE AMONG CHILDRENSUBNATIONALCHILD MORTALITYHIV PREVALENCEIS ALIGNED WITH INTERNATIONALLYACCEPTED STANDARDSTB PREVALENCESAMPLE DESIGN DESCRIBEDTOBACCO USESAMPLE SIZE GIVENCERVICAL CANCER SCREENINGSAMPLING ERRORS PROVIDEDPREVALENCE OF RAISED BLOOD PRESSUREIMPLEMENTATION PROCESSES DESCRIBEDPREVALENCE OF RAISED FASTING BLOOD GLUCOSENATIONALLY REPRESENTATIVEHEALTH EXPENDITURE AS A PERCENT OF TOTALHOUSEHOLD EXPENDITUREANALYSIS OF DATA IS DESCRIBEDDATA FROM THE SURVEY IS AVAILABLE IN THE PUBLICDOMAIN (TO BONA FIDE USERS)IS FUNDED BY GOVERNMENTGOVERNMENT FUNDED YES-NO DATAREPORT IS ON WEBNANOT APPLICABLE TO THE SURVEY7

SCORE ASSESSMENT SUMMARY – MEXICOENCUESTA NACIONAL DE CONSUMO DE DROGAS, ALCOHOLY TABACO - 2016 - 2017COVERS MAJOR DIMENSIONS OF INEQUALITYCOVERS MAJOR HEALTH PRIORITIES(SELECTED SET OF PRIORITIES)WEALTH / INCOMEFAMILY PLANNINGEDUCATIONDELIVERY / SKILLED BIRTH ATTENDANCESEX / GENDERCHILD IMMUNIZATIONAGE / AGE GROUPCHILD WEIGHT / HEIGHTURBAN / RURALMALARIA PARASITE PREVALENCE AMONG CHILDRENSUBNATIONALCHILD MORTALITYHIV PREVALENCEIS ALIGNED WITH INTERNATIONALLYACCEPTED STANDARDSTB PREVALENCESAMPLE DESIGN DESCRIBEDTOBACCO USESAMPLE SIZE GIVENCERVICAL CANCER SCREENINGSAMPLING ERRORS PROVIDEDPREVALENCE OF RAISED BLOOD PRESSUREIMPLEMENTATION PROCESSES DESCRIBEDPREVALENCE OF RAISED FASTING BLOOD GLUCOSENATIONALLY REPRESENTATIVEHEALTH EXPENDITURE AS A PERCENT OF TOTALHOUSEHOLD EXPENDITUREANALYSIS OF DATA IS DESCRIBEDDATA FROM THE SURVEY IS AVAILABLE IN THE PUBLICDOMAIN (TO BONA FIDE USERS)IS FUNDED BY GOVERNMENTGOVERNMENT FUNDED YES-NO DATAREPORT IS ON WEBNANOT APPLICABLE TO THE SURVEY8

SCORE ASSESSMENT SUMMARY – MEXICOENCUESTA GLOBAL DE TABAQUISMO EN ADULTOS (GATS) 2015COVERS MAJOR DIMENSIONS OF INEQUALITYCOVERS MAJOR HEALTH PRIORITIES(SELECTED SET OF PRIORITIES)WEALTH / INCOMEFAMILY PLANNINGEDUCATIONDELIVERY / SKILLED BIRTH ATTENDANCESEX / GENDERCHILD IMMUNIZATIONAGE / AGE GROUPCHILD WEIGHT / HEIGHTURBAN / RURALMALARIA PARASITE PREVALENCE AMONG CHILDRENSUBNATIONALCHILD MORTALITYHIV PREVALENCEIS ALIGNED WITH INTERNATIONALLYACCEPTED STANDARDSTB PREVALENCESAMPLE DESIGN DESCRIBEDTOBACCO USESAMPLE SIZE GIVENCERVICAL CANCER SCREENINGSAMPLING ERRORS PROVIDEDPREVALENCE OF RAISED BLOOD PRESSUREIMPLEMENTATION PROCESSES DESCRIBEDPREVALENCE OF RAISED FASTING BLOOD GLUCOSENATIONALLY REPRESENTATIVEHEALTH EXPENDITURE AS A PERCENT OF TOTALHOUSEHOLD EXPENDITUREANALYSIS OF DATA IS DESCRIBEDDATA FROM THE SURVEY IS AVAILABLE IN THE PUBLICDOMAIN (TO BONA FIDE USERS)IS FUNDED BY GOVERNMENTGOVERNMENT FUNDED YES-NO DATAREPORT IS ON WEBNANOT APPLICABLE TO THE SURVEY9

SCORE ASSESSMENT SUMMARY – MEXICOSURVEILLANCE OF PUBLIC HEALTH THREATSCompleteness and timeliness of weekly reportingof notifiable conditions*-Percentage of public reporting sites that submit weekly report*-Percentage of non-public reporting sites that submit weekly report*-Indicator and event-based surveillance system(s) in placebased on International Health Regulations standards1SPAR, JEE or IHR assessmentSPARSPAR score100%National IHR Focal Point functions under IHR100%Early warning function: indicator-and event-based surveillance100%Mechanism for event management(verification, risk assessment, analysis investigation)100%REGULAR POPULATION CENSUS MEETS INTERNATIONAL STANDARDSCensus conducted in last 10 years in line with internationalstandards with population projections for subnational unitsCensus conducted in last 10 yearsYesPost enumeration survey carried outYesWith disaggregationsPopulation projections with all disaggregations* Asterisked items are not included in overall score.1Based on either SPAR, JEE assessment or IHR.10

SCORE ASSESSMENT SUMMARY – MEXICOCount births, deathsand causes of deathFULL BIRTH AND DEATH REGISTRATIONCompleteness of birth registration99%Completeness of death registration100%Core attributes of a functional CRVSsystem in place to generate vitalstatistics** Legal framework for CRVS: adequate and enforced legislationwhich states that registration of births and deaths is compulsoryFramework and SOPs meetbest practice and in place* The country has sufficient locations where citizens can registerbirths and deaths: proportion of population with easy accessFull coverage includingrural areasAll registrars have trainingopportunities* Registrars have adequate training* CRVS interagency collaborationFormally establishedFormal interagency committeeOversees CRVS planning-Includes key stakeholdersAll relevant stakeholdersMeets regularly-* All data are exchanged electronically from local to regional officesand then to central officesElectronic at all levels* Data quality and analysis: there are reports that provide evidenceof data quality assessment, adjustment and analysis of vitalstatistics using international standardsChecks on individual andaggregate data* Monitoring of system performanceRegular monitoring, keyindicators at subnationaland central levels* High quality vital statistics reports have been publishedin the last five yearsYes, for 3 or more annualpublication cycles* Asterisked items are not included in overall score.11

SCORE ASSESSMENT SUMMARY – MEXICOCERTIFICATION AND REPORTING OF CAUSES OF DEATHDeaths with medical certificatewith cause of death (MCCD) and ICDcoding as a percentage of total deaths100%Quality of cause of death1 10%Core attributes of a functioning systemto generate cause-of-death statistics*Policy in place* Legislation for MCCDComplete* ICD compliant MCCD are used* Medical students trained in correct death certification practicesComplete* Statistical clerks trained in mortality coding-* Verbal autopsy (if applicable) appliedRegular and complete* Data quality assurance and disseminationRegular with both in- and out-offacility deaths* Cause of death statistics available* Asterisked items are not included in overall score.1At least 50%-99% of schoolsMeasured as percentage of records with ill-defined or unknown causes of death.12

SCORE ASSESSMENT SUMMARY – MEXICOOptimize healthservice dataROUTINE FACILITY REPORTING SYSTEM WITH PATIENT MONITORINGAvailability of annual statistic for selected indicatorsderived from facility dataData available atnational levelData available atsubnational levelDisaggregationby ageDisaggregationby gender1OPD VISITSHOSPITAL ADMISSION /DISCHARGE RATES BY DIAGNOSIS0,75HOSPITAL DEATHS BY MAJORDIAGNOSTIC CATEGORY (ICD)0,75DTP/PENTA 3 IN ONE YEAR-OLDSNANA1INSTITUTIONAL MATERNALMORTALITY RATIONANA10,75TB TREATMENT SUCCESS RATESNALOW BIRTH WEIGHT PREVALENCEAMONG INSTITUTIONAL BIRTHSNAART COVERAGE10,8751SURGERY BY TYPE0,75SEVERE MENTAL HEALTHDISORDERS0,75NEW CANCER DIAGNOSIS BY TYPE Total score(0-1)1AVAILABLE NOT AVAILABLE1NANOT APPLICABLE FOR THIS INDICATORScore is a weighted average based on availability of national and relevant disaggregations (depending on indicator and country context). See SCOREAssessment methodology for details.13

SCORE ASSESSMENT SUMMARY – MEXICOFunctional facility/patient reporting system in placebased on key criteria*Documented data quality checks for primary care facility dataComprehensiveDocumented data quality checks for hospital dataComprehensiveCompleteness of reporting by public, primary care facilities 75%Completeness of reporting by public hospitals 75%Completeness of reporting by private health facilities 75%Partial* National unique patient identifier system* Cancer registries for all types of cancerComplete* Master facility list up to dateComplete* Institutional system of data quality assuranceComplete* Data management SOPsComplete* Standardized system of electronic data entry (aggregate reporting)at the district or comparable levelPartial* System of electronic capture of patient level health data in primarycare health facilities which is standardized and fully interoperable withaggregated routine HISPartial* System of electronic capture of patient level health data in hospitalswhich is standardized and fully interoperable with aggregated routine HISCompletePartial* Interoperability - standards based data exchange between systemsREGULAR SYSTEM TO MONITOR SERVICE AVAILABILITY, QUALITY AND EFFECTIVENESSWell established system to independently monitorhealth servicesRegular independent assessments of the quality of carein hospitals and health facilitiesAd hoc - service qualitySystem of accreditation of health facilities based on dataComprehensiveSystem of adverse event reporting following medical interventions*Comprehensive* Asterisked items are not included in overall score.14

SCORE ASSESSMENT SUMMARY – MEXICOHEALTH SERVICE RESOURCES: HEALTH FINANCINGAvailability of latest data on national health expenditureData available within last five years on public health expenditureYes, all based on standardsData available within last five years on private health expenditureYes, all based on standardsData available within last five years on catastrophic spendingYes, all based on standardsHEALTH SERVICE RESOURCES: HEALTH WORKFORCEHealth workforce – knowledge of density of cadre anddistribution updated annuallyData available atnational levelDisaggregationby ageDisaggregationby sexData availablesubnationallyData availablefor public/privatefacilitiesOverallscore MIDWIVES0National human resources health information system is in placeand functional** HRHIS tracks number of entrants to the labour marketComplete* HRHIS tracks number of active stock on the labour marketNo* HRHIS tracks number of exits from the labour marketNo* HRHIS tracks demographic distribution of health workersComplete* HRHIS tracks subnational level data of active health workersComplete* HRHIS tracks number of graduates from education and training institutionsComplete* HRHIS tracks information on foreign-born and/ or foreign-trained health workers* Asterisked items are not included in overall score.15Partial

SCORE ASSESSMENT SUMMARY – MEXICOReview progressand performanceREGULAR ANALYTICAL REVIEWS OF PROGRESS AND PERFORMANCE, WITH EQUITYHigh quality analytical report on of health sector progress andperformance of health sector strategy/plan produced regularlyYesAnalytical report produced within last 5 yearsYear of report2018All data sources usedCompleteAssesses progress against targetCompleteInequality, subnationalCompleteInequality, socioeconomicCompleteInequality, genderCompleteLinking performance to health inputsCompleteProvides comparative analysisLimitedIncludes subnational rankingsLimitedPerformance of hospitals includedLimitedLinks finding to policyLimitedINSTITUTIONAL CAPACITY FOR ANALYSIS AND LEARNINGInstitutional capacity in data analysis at nationaland subnational levelsInvolvement of public health institutes*StrongSubnational capacity in Ministry of Health or independentinstitutions*StrongCapacity at national Ministry of HealthStrongCapacity at NBS to:Draw sampleStrongImplement surveysStrongAnalyseNo/little* Asterisked items are not included in overall score.16

SCORE ASSESSMENT SUMMARY – MEXICOEnable data usefor policy and actionDATA AND EVIDENCE DRIVE POLICY AND PLANNINGNational health plans and policies are basedon data and evidenceYesHas a national health sector planIncludes review of past performance (trends)1Includes burden of disease analysis2Includes health system strength analysis (response strength)2Presence of a central unit or function in Ministry of Health for data andevidence to policy translationLevel of output of a central unit or function in Ministry of Health fordata and evidence to policy translationCoordination function between Ministry of Health and partners*YesAt least quarterlyYesDATA ACCESS AND SHARINGHealth statistics are publicly availableYesHas a national health data portalFrequency of updating national data portalAnnualContents of national data portalSome coverage of health statisticsNavigation ease of national data portalModerately difficultYesNational statistical report availableStatistical report publication frequencyEvery two to five yearsStatistical report include

for Mexico DATA FROM 2013-2018 Assessment Summary LOWER CAPACITY HIGHER CAPACITY for Health Data Technical Package Survey population and health risks Count births, deaths and causes of death Optimize health service data Review progress and performance Enable data use for policy and action. 2