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