Administrative effectiveness in the production of maternal health services in four Mexican states.

Abstract

To generate evidence on the influence of good management of resources in the delivery of maternal health services in Mexico. We studied the managerial processes involved in the provision of maternal health services in four states of Mexico exhibiting differences in maternal mortality, maternal health service coverage, and maternal health expenditure. Analysis was based on five analytical dimensions of the cyclic process model designed by the National Council for the Evaluation of Social Development Policy in Mexico. We describe the processes, identify areas of opportunity, and discuss opinions concerning the relevance, timeliness, and sufficiency of human and material resources employed in the delivery of maternal health services. Managerial performance in the four entities was very heterogeneous. In most of the analyzed entities, implementation of the processes was rated from "average" to "very good." In order to contribute to universal coverage of maternal health services, managerial processes at the state level need to ensure an adequate, timely, and sufficient supply of resources.