January 2002January 2002January 2002January 2002
Programa Nacional de Salud Programa Nacional de Salud 2001-20062001-2006
THEY MOVE: 13.9 millon
Internally 11.8
To Foreign Countries 3.0
THEY COME FROM: Large Cities 32% <15000 habs 68%
THEY WORK IN: Agriculture 50% Industry 26% Services 25%
¿Who are migrants?
Mobility Patterns
2.8%2.8%
502 municipalities very high mobility20.5% of the total
3 millon to Foreign Countries11.8 millons internally
RISKS FOR MIGRANTS : IN THE MOVE, FAMILY DISINTEGRATION. IN THE CHANGE OF ENVIRONMENT AND
CULTURE. LACK OF ACCESS TO HEALTH SERVICESEXPOSURE TO: ADDICTIONS AND MENTAL DISORDERS STD AND HIV/AIDS PULMONARY TUBERCULOSIS
DIARRHEIC DISEASES
RESPIRATORY INFECTIONS
OTHER PROBLEMS:
INCOMPLETE IMMUNIZATION SCHEDULE
WOMEN HEALTH
Health IssuesDrug use in rural communuties with high levels of migration
Inhalants
Marijuana
Cocaine
Heroine
Use 11+ times
3.2% 0.8%
10.5% 3.5%
5.3% 1.3%
0.3% ----
-- -- 0.7% --
--- ---
--- ---
MigrantsNon
migrants MigrantsNon
migrants
Source: Salgado de Snyder & Díaz, Jalisco, México. INP, 1997
HEALTH ISSUES
The risk of exposure to
HIV/AIDS is 5 times greater
in migrant population.
For ex: Intravenous Drugs
California 13.6% Mexicans
vs. 1% national level.
HEALTH ISSUES
20 percent of the total new
cases of tuberculosis notified
yearly in the United States
corresponds to Mexican
migrants.
HEALTH ISSUES
The prevalence of diabetes
mellitus in the rural areas is
twice as much as the one
observed in the general
population.
Objective“Health Shield:Leave Healthy, Return Healthy Program”“Blindaje en Salud: Programa Vete Sano, Regresa Sano”
Protect the health of
migrant population,
through information and
health care in their place
of origin and the place of
destination.
Integrated Services to Migrant Health Model (MAIS)
NATIONAL ORIGEN AND DESTINATION
10 STATES
502 MUNICIPALITIES
11.8 millonpersons
MOVE
ENTIRE FAMILIES
PERSONS IN ORGANIZED OR
CHANCE GROUPS
TO FOREIGN COUNTRIES
INTERNATIONALDESTINATION
3 millonpersons
FROM THE TRADITIONAL SERVICES PARADIGM TO THE SERVICES TO MOBIL POPULATIONS MODEL
OPTIMIZATION OF THE
SERVICES
SOCIAL NETWORKS
ORIENTED TO LIFE CYCLE
STRATEGIC SURVEILLANCE
SUBSTANTIVES
1. Information to the population
2. Preventive services
3. Health, medical and mental services
STRATEGIES
1. Epidemiological surveillance
2. Evaluation
Program actions “Health Shield”
Information to the population
Information GuideDisease managementFirst aidPersonal hygiene and sanitationHealth promotionOrientation with regards to addictions and mental health
Social participation Identification of social networksCommunity meeting sitesMigrant AssociationsMutual help groups
Preventive Services
Immunization Nutritional surveillance Counseling in reproductive health Prevention of sexually
transmitted infections Early detection of cancer Accident and injury prevention Alcohol and addictions prevention Oral health
Preventive Services
National Health Weeks
Immunization Card
Women’s Health Card
Coordination with civic and
community based organizations
and health sector for joint actions
Medical Services“In the migrant’s life cycle”
“Arranque Parejo” – “Fair Start” Doctor’s appointments, emergencies and
treatments Chronic Degenerative Diseases Infectious Diseases Adolescent Health Community and Migrant Health Care and
Hospital referral Early detection and treatment of
addictions and mental health
Epidemiological Surveillance
Simplified Epidemiological Surveillance System
Evaluation of: Process Impact
Proposals
Development and distribution of “health guides” in the mexican consulates of neighbor countries
Exchange of epidemiological information
Training of community health workers promotores/as for migrant population
Exchange of health professionals and practitioners
Mexico-CaliforniaCooperation
Cooperation Topics
Inmunizations
HIV/AIDS
Tuberculosis
Addictions* (ATOD)
Reproductive Health*
Mexico-CaliforniaCooperation
*Pending to set counterpart
PHASE I: introductory Binational Health Week
( October ) Communication products of
promotionPHASE II: First National Health Week / Mexico
(February) Binational Initiative National Children’s Health Week /
California (April)Health guidesPromotores/as TrainingAgenda ( health in your pocket )
Health Week
3SNS -Action in
municipalities of mobile population
Counseling visits for planning of binational
activities
Preparation of a communication and joint social
mobilization strategy.
MEXICO CALIFORNIA
October 12-14, 2001
BNTL HEALTH WEEK-Promote information on
health self-care in Clinics, DHS and counties
Health Week
Health Promotion Exchange of materials Pamphlets for health week
Training Exchange of Personnel Short residencies
Information Epidemiological Surveillance
HIV/AIDS
PROMOTION
INFORMATION SYSTEM
REFERRAL SYSTEM
BINATIONAL CARD
Tuberculosis
10 federal entities selected with high mobility criteria by CONAPO. (Baja California, Colima, Guanajuato, Guerrero, Jalisco, Michoacán, Oaxaca, Puebla, San Luis Potosí y Zacatecas).
Current situation
8 sent their diagnostic. (Col., Gro., Mich., Nay., Oax., Pue., S.L.P., Zac.)
4 integrate for state interest. (Coahuila, Nayarit, Sinaloa and Tamaulipas)
6 have a work program. (Col., Gro., Gto, Pue, Oax., S.L.P.)
Current situation
1. Strengthening of sectorial and intersectorial coordination
2. Diagnosis of the health situation
3. Social participation with the organized communities
4. Utilization of the primary health care system
5. Human development
6. Marketing and social mobilization
7. Programming of actions and evaluations
8. Operating investigation
STRATEGIC ACTIONS
ARTICULATION
SYNCHRONIZATION
COMPLEMENTARIZATION
CONTINUITY
CHALLENGES AND OPPORTUNITIES