Maternal Mortality and the Coverage, Availability of Resources, and Access to Women’s Health Services in Three Indigenous Regions of Mexico: Guerrero Mountains, Tarahumara Sierra, and Nayar

  • Sergio Meneses Navarro
  • Blanca Pelcastre Villafuerte
  • Marisol Vega Macedo
Part of the Global Maternal and Child Health book series (GMCH)


According to pertinent health indicators such as life expectancy at birth (LEB), maternal mortality (MM), and infant mortality (IM), the three poorest regions in Mexico include the Guerrero Mountains, the Tarahumara Sierra, and the Nayar. Access to health for all people in Mexico is important—it is a human right and helps to prevent inequity between different groups in our population. In this chapter, we demonstrate how gaps in the access of indigenous women to obtain health services contribute to maternal and infant morbidity and mortality. Our analysis concentrates on several elements of the health system necessary to guarantee the right of health protection for indigenous women: health coverage, availability of resources, access to services, and quality of obstetric care. We emphasize indigenous women’s health because they experience the greatest barriers to access services as a result of social inequalities based on gender, ethnicity, and social class. We would like to also highlight the MM indicator, given that it exemplifies the social determinants of health, inequities, and the barriers to guarantee the ability to exercise the right to health. Finally, the performance of unnecessary cesarean sections is an indicator that may serve as proxy for problems related to quality of care for indigenous women, including the right to respectful care. The present analysis demonstrates the existence of systematic exclusion and discrimination affecting indigenous women that influence their income, welfare, and basic health conditions, especially involving reproductive health. This study points to the urgent need to develop measures that contribute to improving income and decreasing poverty in the country’s indigenous regions, with a target population of indigenous women and youth.


Indigenous women Maternal health Poverty Maternal mortality ratio Mexico Nayarit Discrimination Indigenous pregnancy Reproductive health Infant mortality Maternal mortality Reproductive health Cesarean section Health services Tarahumara Guerrero Maternal morbidity 


  1. Campbell, O., & Graham, W. J. (2006). Strategies for reducing maternal mortality: Getting on with what works. The Lancet, 368(9543), 1284–1299. Retrieved April 27, 2016, from CrossRefGoogle Scholar
  2. INEGI. (2016). México en cifras. Información nacional, por entidad federativa y municipios. Aguascalientes: Instituto Nacional de Estadística y Geografía. Retrieved April 27, 2016, from Google Scholar
  3. OMS. (2015). Declaración de la OMS sobre tasas de cesáreas. Ginebra: Organización Mundial de la Salud. Retrieved April 27, 2016, from Google Scholar
  4. Pelcastre, B., Meneses, S., Ruelas, G., Reyes, H. (2009). Proyecto: Identificación de un modelo de atención a la salud para adultos mayores en zonas indígenas. México: Fondo Sectorial IMSS/ISSSTE/CONACyT-087123.Google Scholar
  5. Pintado Cortina, A.P. (2004). Tarahumaras. Pueblos Indígenas de México Contemporáneo. Comision Nacional para el Desarrollo de los Pueblos Indígenas, Programa de las Naciones Unidas para el Desarrollo. Mexico City: CDI, PNUD.Google Scholar
  6. SAGARPA. (2010). Síntesis del Diagnóstico prospectivo del sector rural del estado de Chihuahua. México: SAGARPA. Retrieved from
  7. Schwartz, D. A. (2015). Interface of epidemiology, anthropology and health care in maternal death prevention in resource-poor nations. In D. A. Schwartz (Ed.), Maternal mortality: Risk factors, anthropological perspectives, prevalence in developing countries and preventive strategies for pregnancy-related death. New York: Nova Science Publishers.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Sergio Meneses Navarro
    • 1
  • Blanca Pelcastre Villafuerte
    • 2
  • Marisol Vega Macedo
    • 3
  1. 1.CIESAS Sureste-CONACYTCarretera a Chamula Km 3.5San Cristóbal de Las CasasMexico
  2. 2.National Institute of Public HealthCuernavacaMexico
  3. 3.Alliance for Health, Food, and Nutrition (ASAN)ChiapasMexico

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