Programa De Acción Específico Enfermedades Cardiometabólicas 2019-2024

Objectives

Improve equitable prevention, detection, diagnosis, treatment, control and follow-up of cardiometabolic diseases, particularly obesity, type 2 diabetes, hypertension and dyslipidaemia, among adults aged 20 years and over receiving first-level care. The programme seeks to reduce morbidity, complications, premature mortality, social and economic consequences, and inequalities in access to quality care.[1][2][3]It consolidates previously separate programmes on diabetes, obesity and cardiovascular risk into an integrated cardiometabolic disease approach.[4][5]

• Promote universal, free and non-discriminatory access to health services, social assistance and medicines, with cultural relevance, social participation and particular attention to people facing vulnerability, marginalisation or historical discrimination.[6][1][7]
• Strengthen primary health care and Integrated Health Service Networks to provide continuous, comprehensive and person-centred care across prevention, screening, diagnosis, treatment, rehabilitation and control.[2][8][9]
• Prevent cardiometabolic risk through healthy diets, physical activity, health education, improved food environments and life-course action on behavioural risk factors.[10][3][11]
• Improve early identification and referral of major complications, especially acute myocardial infarction and end-stage chronic kidney disease, including access to timely reperfusion, angioplasty and renal replacement treatment.[12][13]
• Align action with the National Development Plan 2019–2024, the Health Sector Programme 2020–2024, the National Strategy for the Prevention and Control of Overweight, Obesity and Diabetes, and Sustainable Development Goal 3.4 on reducing premature mortality from non-communicable diseases.[14][7][15]
• Strengthen national stewardship mechanisms, unified information systems, professional competencies and evidence-based monitoring to improve quality and continuity of care.[8][15][16]

Implementation

Deliver the programme through an integrated primary health-care model supported by Integrated Health Service Networks, coordinated across the Ministry of Health, state health services, specialised chronic-disease units and major public health institutions.[2][17][18]Implementation combines population prevention, standardised clinical care, multidisciplinary support, information systems, professional development, inter-institutional coordination and targeted referral pathways.[5][19][20]

• Implement the HEARTS strategy, with Pan American Health Organization technical support, using cardiovascular risk stratification, behavioural risk-factor action, simplified standardised pharmacological protocols, monitoring and evaluation.[5]
• Deploy multidisciplinary chronic-disease care through Specialised Medical Units for Chronic Diseases and Diabetes Centres of Excellence Networks, linking specialised units with primary-care facilities and teams comprising doctors, nurses, nutritionists, psychologists and social workers.[21][22][19]
• Provide clinical prevention, treatment support, patient education, family-centred care and self-management through interdisciplinary teams and Mutual Support Groups for Chronic Diseases.[19]
• Develop standardised hypertension and diabetes care algorithms, strengthen medicines, diagnostics and laboratory supplies, and support referral and counter-referral between first-, second- and third-level services.[17][20][13]
• Implement public communication, health promotion and community participation with health promoters, organised civil society and public health policy bodies to encourage healthy lifestyles, symptom recognition, timely care-seeking and adherence.[23][24]
• Train first-level health professionals through a master training plan and institutional agreements, covering prevention, detection, follow-up and control of cardiometabolic diseases.[16]
• Coordinate implementation across the 32 federative entities, the cardiometabolic diseases programme, the National Centre for Preventive Programmes and Disease Control, the Mexican Social Security Institute, the Institute for Social Security and Services for State Workers, and other National Health System bodies.[24][20][18]
• Use information and communication technologies, including telemedicine, mobile tools and electronic clinical guidance, to support self-management, training, clinical decision-making and continuity of care.[25]
• Monitor service delivery and outcomes through unified information systems, chronic-disease registries, electronic records and surveillance platforms.[8][25]Key indicators include detection coverage for diabetes, hypertension, obesity and dyslipidaemia; diabetes, hypertension and obesity control; staff training; mortality from diabetes, cardiovascular disease and acute myocardial infarction; and premature mortality.[26][27][28][29][30][31][32]
• Report detection and control indicators quarterly where specified, using the Health Information System for Basic Statistics and the National Population Council projections as relevant data sources; use periodic mortality measurement to assess longer-term progress.[26][33][31][32]
• Finance actions from authorised budgets of participating spending executors while the programme remains in force.[7]No total budget, activity-level allocation, unit cost, funding gap or economic assumption is specified in the supplied material.[7][18]

Monitoring & Evaluation

The programme establishes a monitoring and evaluation framework for cardiometabolic diseases that combines unified information systems, epidemiological and nutrition surveillance, standardised indicators, routine reporting, clinical quality measurement and institutional follow-up.[14][8][15][25]It also links accountability to stewardship within the National Health System, transparent tracking of institutional targets and inter-institutional monitoring of implementation.[12][34]

• Maintain permanent epidemiological nutrition surveillance; undertake timely detection, risk assessment, epidemiological studies and monitoring of compliance with prevention measures.[14]
• Strengthen data capture, linkage and harmonisation across information systems, including electronic clinical records, to generate timely, reliable information and credible indicators.[21][35]
• Use the Chronic Disease Information System across the 32 State Health Services for nominal electronic registration and follow-up of type 2 diabetes, obesity, hypertension and dyslipidaemia.[22]
• Monitor medicine and laboratory-test availability through the ABASTONET reporting system, and assess diabetes and hypertension care through the Diabetes Care Quality Index and Hypertension Care Quality Index.[22]
• Track treatment quality and complication prevention through glycated haemoglobin measurement, microalbuminuria testing and foot examinations, including accreditation and follow-up of Mutual Support Groups for Chronic Diseases.[19]
• Monitor diabetes, hypertension, obesity and dyslipidaemia detection quarterly, using completed detections as a proportion of scheduled detections, with results disaggregated by national and state level, sex, age group and test result where specified.[26][36][37][38]
• Publish quarterly detection information in May, August, November and March of the following year, using the National Health Information System and related systems for completed detections and National Population Council projections for programmed denominators.[26][33][37]
• Increase diabetes detection from a 2018 baseline of 27.7% to 45% by 2024, hypertension detection from 28.3% to 45%, and obesity detection from 27.4% to 45%.[39][27][40]
• Monitor diabetes control among treated patients using glycated haemoglobin below 7% and/or fasting plasma glucose of 70–130 mg/dl; the baseline was 31.8% in 2018 and the target is 45% in 2024.[28]
• Increase hypertension control below 140/90 mmHg from 62.8% in 2018 to 80% by 2024, and monitor obesity control as at least 5% loss of baseline body weight among treated patients.[29][41][42]
• Measure the proportion of first-level health professionals updated in cardiometabolic diseases semi-annually, from a 71.2% baseline in 2018 towards an 80% target in 2024.[30][43][44]
• Track overall and premature mortality from diabetes and cardiovascular diseases, as well as mortality from acute myocardial infarction, using population-based rates disaggregated by sex and federal entity where specified.[31][45][32]
• Use a six-year measurement cycle for mortality indicators, including premature mortality among people aged 30 to 59, with data collected from January 2019 to December 2024 and information available from March to May 2025.[45]
• Assign follow-up and progress reporting to named programme bodies, including PSAA/CENETRA, while using inter-institutional monitoring of HEARTS and IAM Mx implementation to identify improvement needs and support continuity of care.[24][12][26]
• Promote transparency and accountability for institutional targets and monitor achievement of the Action Programme for Cardiometabolic Diseases objectives.[12]

Several sections identify indicator, target, evaluation and monitoring processes, but do not provide complete indicator definitions, reporting formats, independent audit arrangements or a comprehensive accountability framework.[34][46][47][48]

Costing & Financing

Financing is principally expected to come from the authorised budgets of participating spending executors for the duration of the programme.[7]The programme also commits to supporting state health services and overseeing the transfer and distribution of financial resources for cardiometabolic disease care, with an emphasis on transparent, effective, efficient and equitable use.[21]

• Finance priority objectives, strategies, specific actions, inter-institutional coordination, follow-up and reporting through authorised budgets of participating spending executors while the programme remains in force.[7]
• Prioritise available resources for vulnerable populations, trained staff, complete multidisciplinary teams, infrastructure, equipment and sufficient medicines.[21]
• Support free medical care and medicines for people without social security, especially in highly and very highly marginalised areas, although no associated financing mechanism or monetary value is specified in the available extracts.[7][2]
• Recognise chronic disease care as a source of high expenditure and identify care costs as part of the cardiometabolic disease burden.[10][3]
• Require strengthened primary-care capacity, timely supplies of medicines and health inputs, and adequate local and national resources, without specifying their cost.[25][11]

No total programme budget, allocations by activity or institution, unit costs, financing shares, additional funding sources, quantified funding gap, resource-mobilisation plan or economic assumptions are specified in the supplied extracts.[21][7][17][25]