Mexico

Evaluation of Statewide Surgical Capacity in Chiapas

Challenge

Chiapas is Mexico’s poorest state, with the majority of the population living below the poverty line and facing a range of barriers when accessing healthcare. Understanding surgical capacity in the state of Chiapas is essential for expansion of critical services and resource allocation within both the public and private sectors.

Where We Started

In partnership with the state Ministry of Health and Compañeros en Salud, the Mexican affiliate of Partners in Health, we visited 37 hospitals in the public and private sectors to implement a validated Surgical Assessment Tool and conduct qualitative interviews. The healthcare domains evaluated included workforce, infrastructure, service delivery, information management, and financing.

Our Impact

Areas for investment were identified through our preliminary results, and stakeholders across the state have been involved in this assessment. Through our collaboration with Compañeros en Salud, we have provided training and support to local medical students in research methods and scientific writing.

Moving Forward

We will analyze our complete data and share our results with the Ministry of Health. This research will inform policy changes to improve access to safe and affordable surgery across the state.

Contact

Zachary Fowler, MD

Surgical Quality Assessment at a Community Hospital in Rural Mexico

Challenge

As access to surgical care increases, surgical quality must expand with it. However, many quality measurement tools require resources and advanced systems of information management.

Where We Started

For the past five years, the community public hospital in Jaltenango, Chiapas, Mexico, was unable to provide surgical care due to a lack of infrastructure and surgical providers. In partnership with Compañeros en Salud, a new surgical program was developed. To ensure that this care would be high quality, we used a new tool that was developed for use in resource-poor settings and that is evidence-based, comprehensive, and feasible to implement.

Our Impact

Surgical quality was measured over a six-month pilot period, and the tool was adapted to the local setting. Subsequently, monthly quality reports were generated and provided to the hospital to identify areas for improvement.

Moving Forward

The outcome of this project will be shared with regional Ministry of Health officials and hospital directors. Planning will begin to expand this quality measurement program to other hospitals in the region.

Contact

Zachary Fowler, MD

Epidemiological Assessment of Burns in Mexico

Challenge

Burns disproportionately affect individuals in regions with lower socioeconomic status, often exacerbating economic, social, and health disparities. Little has been documented about the burden of burn injuries in Mexico.

Where We Started

Through partnerships with Compañeros en Salud and Anáhuac University, we compiled information from public databases to analyze epidemiology of burns and trends at the population level.

Our Impact

Analysis of the data has uncovered the most vulnerable demographic groups, the most common causes of burns, and regions of the country with the highest numbers of burn injuries. The partnerships developed through this project have also allowed medical students to gain experience in public health research.

Moving Forward

Additional stakeholders with a commitment to reducing the burden of injury because of burns will be identified and will include members of professional surgical organizations and the academic community. The initial results of this project will guide further research and opportunities to improve burn care.

Contact

Zachary Fowler, MD

Surgical Indicator Measurement in Mexico

Challenge

The Lancet Commission on Global Surgery outlines six key indicators to be measured by all countries: access to timely surgical care, surgical volume, specialist surgical workforce density, post-operative mortality rates, risk of catastrophic expenditures, and risk of impoverishing expenditures. None of these indicators have been reported in Mexico.

Where We Started

We collaborated with Anáhuac University and Compañeros en Salud to use public databases to compile data. Methodologies were developed to appropriately filter large datasets and use a variety of technological resources.

Our Impact

Data to report the indicator on timely access to surgical care were obtained for the state of Chiapas. These results have been shared with key stakeholders, and we have begun collecting national-level data for several indicators. Through this work, medical students at Anáhuac University have gained skills in data management and analysis.

Moving Forward

The information from public databases will be complemented by data collected from healthcare facilities to fill in the knowledge gaps that have been identified. By using several methodologies and with strong partnerships, we will work to measure the six indicators for the country of Mexico.

Contact

Zachary Fowler, MD