ReviewLancet (London, England)2023
Setbacks in the quest for universal health coverage in Mexico: polarised politics, policy upheaval, and pandemic disruption.
Review in Lancet (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 40 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
40 citing papers in PubMed.
- Determinants of patient delay and its association with quality of life among young women with breast cancer in China: A cross-sectional study.Asia-Pacific journal of oncology nursing · 2026Article
- Financial protection in flux: longitudinal evidence on out-of-pocket spending among middle-aged and older Mexicans during the 'Seguro Popular'-INSABI transition.Health policy and planning · 2026Article
- Beyond Efficiency Scores: Explaining Health System Performance Using Two-Stage Bootstrap DEA and Machine Learning.Healthcare (Basel, Switzerland) · 2026Article
- Epidemiology of children and adolescents undergoing surgery at Mexican public hospitals: a retrospective registry-based analysis from 2010 to 2022.BMC pediatrics · 2026Article
- Healthcare Deserts and Avoidable Mortality in Mexico: A Municipal-Level Ecological Analysis of Health System Resources, Social Deprivation, and Preventable Deaths, 2015-2024.Healthcare (Basel, Switzerland) · 2026Article
- Out-of-pocket healthcare expenditures in older Mexican people based on their social security status.Health policy and planning · 2026Article
- Beyond numbers: the missing conceptual foundation in evaluating Mexico's health system performance.Lancet regional health. Americas · 2026Article
- Catastrophic and impoverishing health expenditures in fragmented public health systems: lessons from Mexico, 2000-2022.Health economics review · 2026Article
- Health financing inequality in fragmented health systems: evidence from Mexico, 2000-2023.International journal for equity in health · 2026Article
- Fragmented healthcare and effective maternal coverage in Mexico, 2009-2023.BMC medicine · 2026Article
- Health policies and reforms in Mexico (2000-2024): segmentation and challenges for universal rights.Cadernos de saude publica · 2026Article
- Drivers and barriers for the implementation of value-based healthcare in Latin America: a cross-country qualitative policy analysis.Lancet regional health. Americas · 2026Article
- The compounding burden of disability in Mexico: social protection gaps, chronic disease excess, and prospective mortality from national open data sources.Frontiers in public health · 2026Article
- 23 years of public policy towards universal health coverage in Mexico. A cross-sectional time-series analysis using routinely collected health data, 2000-2022.Lancet regional health. Americas · 2025Article
- Examining the roles, relationships and power dynamics shaping universal health system policy processes in high- and upper-middle-income countries: a scoping review.BMC health services research · 2025Article
- Changes in health insurance coverage and healthcare utilization of middle-aged and older adults after the transition from Seguro Popular to INSABI.BMC health services research · 2025Article
- Health insurance coverage in Mexico: progress, inequalities and remaining challenges towards UHC2030.Health research policy and systems · 2025Article
- The role of patient navigation programs in early cancer care in Mexico: a multi-case qualitative study.The oncologist · 2025Article
- Why expanding public health insurance coverage is not enough to provide effective ambulatory care: policy lessons from Mexico, 2000-2022.Journal of public health policy · 2025Article
- The association between becoming uninsured and forgoing medical care among middle-aged and older adults in Mexico with chronic health conditions.Innovation in aging · 2025Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
2023 marks the 20-year anniversary of the creation of Mexico's System of Social Protection for Health and the Seguro Popular, a model for the global quest to achieve universal health coverage through health system reform. We analyse the success and challenges after 2012, the consequences of reform ageing, and the unique coincidence of systemic reorganisation during the COVID-19 pandemic to identify strategies for health system disaster preparedness. We document that population health and financial protection improved as the Seguro Popular aged, despite erosion of the budget and absent needed reforms. The Seguro Popular closed in January, 2020, and Mexico embarked on a complex, extensive health system reorganisation. We posit that dismantling the Seguro Popular while trying to establish a new programme in 2020-21 made the Mexican health system more vulnerable in the worst pandemic period and shows the precariousness of evidence-based policy making to political polarisation and populism. Reforms should be designed to be flexible yet insulated from political volatility and constructed and managed to be structurally permeable and adaptable to new evidence to face changing health needs. Simultaneously, health systems should be grounded to withstand systemic shocks of politics and natural disasters.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.