Lynne Rienner Publishers Logo

Decentralizing Health Services in Mexico: A Case Study in State Reform

Núria Homedes and Antonio Ugalde, editors
Decentralizing Health Services in Mexico: A Case Study in State Reform
ISBN: 978-1-87836-757-0
ISBN: 978-1-87836-756-3
2006/332 pages/LC: 2006012427
Distributed for the Center for US-Mexican Studies at the University of California, San Diego

"This academic but passionate and controversial work should be read by specialists on Mexico and Latin America, as well as by those interested in healthcare and social policy in general."—Carmelo Mesa-Lago, University of Pittsburgh


Has Mexico, twenty years after beginning the process of decentralizing its health system, realized the anticipated benefits of increased community participation and improvements in efficiency and quality? Addressing this question, Decentralizing Health Services in Mexico presents a thorough historical and theoretical grounding, as well as representative case studies of decentralization at the state and local levels.

The authors combine qualitative and quantitative data in their examination of the transfer of authority over fiscal, human, and physical resources in the health sector. The result is a major contribution to the ongoing debate over the advantages and disadvantages of decentralization in varying political, cultural, and economic contexts.


Núria Homedes is associate professor at the University of Texas School of Public Health-Houston. Antonio Ugalde is emeritus professor at the Department of Sociology, University of Texas at Austin.


  • Decentralization: The Long Road from Theory to Practice—the Editors.
  • Decentralization of Health Services in Mexico: A Historical Review—the Editors.
  • THE FIRST ATTEMPT, 1983-1988.
  • Decentralizing Health Services in Mexico: Formulation, Implementation, and Results—M. González-Block, R. Leyva, Ó. Zapata, R. Loewe, and J. Alagón.
  • Federalist Flirtations: The Politics and Execution of Health Services Decentralization for the Uninsured Population in Mexico, 1985-1995—A-E. Birn.
  • "Decentralized" in Quotes: Baja California Sur, 1996-2000 —L. Olvera Santana.
  • The Slow and Difficult Institutionalization of Health Care Reform in Sonora: 1982-2000—R. Abrantes Pêgo.
  • Guanajuato: Invisible Results—S. Arjonilla Alday.
  • Nuevo León and Tamaulipas: Opening and Closing a Window of Opportunity—the Editors.
  • Decentralization at the Health District Level in Nuevo León—the Editors.
  • Conclusion—the Editors.