Government expenditure on health and maternal mortality in México: A spatial‐econometric analysis. (7th January 2019)

• Record Type: Journal Article
• Authors: Pérez‐Pérez, Eduardo; Serván‐Mori, Edson; Nigenda, Gustavo; Ávila‐Burgos, Leticia; Mayer‐Foulkes, David
• Is Part Of: International journal of health planning and management. Volume 34:Number 2(2019)
• Page Start: 619
• Page End: 635
• Publication Date: 2019-01-07
• Subjects: government expenditure -- maternal health -- primary health care -- spatial econometrics; Health planning -- Periodicals; Health services administration -- Periodicals; Santé publique -- Planification -- Périodiques; Santé, Services de -- Administration -- Périodiques; 362.1068
• DOI: 10.1002/hpm.2722
• Languages: English
• ISSNs: 0749-6753

Abstract

Summary: Objective: To assess the relationship between government expenditure on maternal health (GE) and maternal mortality (MM) in Mexican poor population between 2000 and 2015 in the 2457 Mexican municipalities. Methods: Using administrative data, we performed the analysis in three stages: First, we tested the presence of selection bias in MM. Next, we assessed the presence of spatial dependence in the incidence and severity of MM. Finally, we estimated a spatial error model considering the correction of estimates for the spatial dependence and selection bias assessed before. Results: MM and GE were not randomly distributed throughout the Mexican territory; the most socially vulnerable municipalities exhibited the highest levels of MM severity but the lowest levels of GE and available human and physical resources for maternal health; the incidence of MM was independent of GE; elasticity of GE‐severity in MM was −4% ( P < 0.01). Conclusions: Resource allocation for maternal health must move towards a more comprehensive vision, and efforts to achieve an effective delivery of universal health services must improve, particularly regarding the most vulnerable municipalities.