Revista Panamericana de Salud Pública/Pan American Journal of Public Health (RPSP/PAJPH)
April 2014 Vol. 35, No. 4
http://www.paho.org/journal/index.php?option=com_content&view=article&id=143&Itemid=236&lang=en
Contribution of Mexico’s Universal Immunization Program to the Fourth Millennium Development Goal [Contribución del Programa de Vacunación Universal de México al cuarto Objetivo de Desarrollo del Milenio]
Vesta Richardson,1 Edgar Sánchez-Uribe,1 Marcelino Esparza-Aguilar,1
Alejandra Esteves-Jaramillo,1 and Lorena Suárez-Idueta1
Abstract
Objective. To identify and describe 1) progress achieved thus far in meeting the commitments of the Fourth Millennium Development Goal (MDG 4) in Mexico, mainly the contribution
of the Universal Immunization Program (UIP) over the last 20 years, and 2) new opportunities for further reducing mortality among children under 5 years old.
Methods. An observational, descriptive, retrospective study was carried out to examine registered causes of death in children under 5 between 1990 and 2010. Indicators were built
according to the recommendations of the United Nations.
Results. In 2010, deaths among children under 5 decreased 64.3% compared to the baseline (1990) figure. Of the total deaths of the children under 5, the neonatal period was the most
affected (52.8%), followed by the 1 to 11 months (30.9%), and the 12 to 59 months (16.2%) groups. A 34% overall mortality reduction was observed after the universalization of immunization
against influenza, rotavirus, and pneumococcus in children under 5.
Conclusions. Despite a significant reduction in under-5 mortality in Mexico over the last 20 years, largely due to the successes of the UIP, several challenges remain, particularly in
improving preventive and curative services during pre- and postnatal care.

La desigualdad en salud de grupos vulnerables de México: adultos mayores, indígenas y migrantes [Health inequality among vulnerable groups in Mexico: older adults, indigenous people, and migrants]
Clara Juárez-Ramírez, Margarita Márquez-Serrano, Nelly Salgado de Snyder, Blanca Estela elcastre-Villafuerte, María Guadalupe Ruelas-González y Hortensia Reyes-Morales
Synopsis
Health vulnerability refers to a lack of protection for specific population groups with specific health problems, as well as the disadvantages they face in solving them in comparison
with other population groups. This major public health problem has multiple and diverse causes, including a shortage of trained health care personnel and the lack of family, social, economic, and institutional support in obtaining care and minimizing health risks. Health vulnerability is a
dynamic condition arising from the confluence of multiple social determinants. This article attempts to describe the health situation of three vulnerable groups in Mexico—older adults, indigenous people, and migrants—and, after defining the needs of each, explore measures that could contribute to the design and implementation of public health policies better tailored to their respective needs.