Study Overview
Quality is high on the Mexican health policy agenda. In this paper we evaluate the quality of prenatal care for rural low-income women. Women who obtained care from private practitioners and non-MDs received fewer procedures on average. Poverty predicts poor quality; however, indigenous women in private settings received fewer procedures, after household wealth was controlled for. We recommend strengthening clinical skills and providing incentives to adhere to quality standards. Quality reporting could promote informed employer care-purchasing and individual care-seeking choices. The national health reforms should be monitored to determine their success in not only increasing access among the poor and indigenous but also ensuring that such care meets quality norms.
Study Results
Women who used public facilities were poorer than those who used private settings, as measured by fewer households with piped water and solid wall construction and higher household spending on food—a key indicator of poverty. They were also slightly older (29.9 years compared with 28.8 years) and had experienced more pregnancies; moreover, a higher proportion also had previous negative birth outcomes. We found major variations in prenatal care quality by provider qualifications, clinical settings, income, and indigenous status.