Estrategia nacional para la atención a la salud de personas en contexto de movilidad humana

Objectives

Mexico’s National Strategy for Health Care for People in the Context of Human Mobility, version 1.0, establishes a comprehensive, long-term route to meet the health needs of people in human mobility who are in national territory. It aims to guarantee comprehensive, equitable, timely, culturally appropriate, stigma-free and non-discriminatory health care regardless of migration status, grounded in human rights, gender responsiveness, health equity, intersectionality and the best interests of children and adolescents.[1][2][3]

• Ensure access to comprehensive health care for migrants, refugees, asylum seekers, returnees, internally displaced people, seasonal agricultural workers, people in transit and other mobile populations, recognising Mexico as a country of origin, transit, destination and return.[4][5][6]
• Remove legal, administrative, linguistic, cultural, geographical and economic barriers that impede access, continuity of treatment, information and protection against discrimination.[6][7][8]
• Develop individual and community health capabilities through communication, health education, healthy environments, self-care and intersectoral action.[3][9]
• Strengthen prevention, early detection, treatment and continuity of care for communicable and non-communicable diseases, including vaccination, tuberculosis, malaria, HIV, sexually transmitted infections, cardiometabolic conditions and zoonotic diseases.[3][10][11]
• Intensify sexual and reproductive health activities, particularly for women and adolescents, including pregnancy and newborn care, contraception, violence-related care, sexually transmitted infection prevention and referral.[3][12][13]
• Improve mental-health and addiction prevention, detection, first-contact care, referral and follow-up through person-centred, culturally relevant and non-discriminatory services.[14][15]
• Diversify health monitoring and information systems to generate a clearer epidemiological profile of people in mobility contexts and support public-health decision-making.[16][3][17]

Implementation

Implementation combines person-centred primary health care, flexible outreach delivery, intersectoral coordination and a federal, state and local governance structure. The Ministry of Health leads sectoral policy through the Undersecretariat for Health Policies and Population Wellbeing and the Directorate-General for Public Health Policies, while implementation is replicated through state health services and health jurisdictions or districts.[2][18]

• Coordinate participating health-sector bodies, other levels of government, civil-society organisations, international organisations and public, social and private providers through a Technical Group on Health and Human Mobility, state coordination arrangements and jurisdictional or district health-security committees.[19][18][20][21]
• Deliver first-level care through fixed services and itinerant health brigades in shelters, temporary refuges and accommodation centres, complemented by territorial outreach at shelters, bus terminals, receiving communities and migration routes.[8][22][23]
• Establish care networks, inter-institutional protocols and referral and counter-referral routes linking health services, shelters, support organisations and specialised facilities, particularly for children, adolescents, seriously ill repatriated nationals, chronic conditions, mental health and HIV.[24][25][26][15]
• Train health and shelter personnel in human rights, cultural relevance, non-discrimination, migrant-sensitive care, child and adolescent needs, mental health, violence, surveillance and reporting.[27][26][28][15]
• Provide health promotion through health fairs, workshops, culturally and linguistically appropriate risk communication, sanitation and hygiene activities, and validation of migrant shelters as health-promoting settings.[29][30][31]
• Deploy targeted public-health measures, including vaccination outreach, water and food-safety surveillance, active case-finding, epidemiological triage, laboratory diagnosis, vector control, rapid testing and health-risk communication at points of entry, shelters and other locations where mobile populations concentrate.[10][32][33][11]
• Monitor implementation through the National Basic Health Information Subsystem, Health Emergencies Information System, National Epidemiological Surveillance System and other information systems, including quarterly state reports, federal supervision, committee reviews and reporting to the Government Cabinet.[17][20][21]
• Track specific service and outcome indicators, including people reached through National Public Health Service actions, accommodation spaces with fixed or itinerant first-level care, validated health-promoting shelters, vaccine doses administered, repatriation flights attended, outbreaks closed, tuberculosis case detection and antiretroviral-treatment coverage.[34][23][31][35][36][37][38]
• Use available public resources across federal, state and local bodies, assess local requirements for personnel, materials and equipment, and manage requests for additional support while preserving routine service delivery. No monetary budget, cost estimate, financing source or quantified funding gap is specified.[18][21]

Monitoring & Evaluation

The strategy establishes a multi-level monitoring and accountability architecture combining routine health-information systems, epidemiological surveillance, operational reporting, supervision and committee review. It includes both broad commitments to strengthen data on people in situations of human mobility and defined indicators for selected service and disease-control activities.[2][17][20]

• Collect and integrate implementation, service and epidemiological data through the Directorate-General of Health Information, the National Basic Health Information Subsystem, the Health Information System, the Health Emergencies Information System and the National Epidemiological Surveillance System.[20]Health personnel are to record the identification variable accurately when service users are classified as migrants or as being in a human-mobility situation.[17]
• Produce quarterly reports from the National Basic Health Information Subsystem to track progress, analyse results and inform public-policy decisions.[17]State health authorities are also expected to prepare quarterly operational reports and submit information for review through State Committees for Health Security.[20][21]
• Establish timely reporting on implementation progress and activities to the Government Cabinet, conduct joint federal and state supervision, verify implementation, and redirect health actions where necessary.[20]State and jurisdictional or district committees are to document agreements, commitments, compliance, follow-up and outstanding support needs.[21]
• Maintain epidemiological surveillance at points of entry, in local health units and through active case-finding in established shelters and refuges.[32]Apply operational case definitions, notification criteria and recording forms consistent with the National Epidemiological Surveillance System and Mexican standard NOM-017-SSA2-2012.[32][39]
• Produce periodic epidemiological monitoring bulletins, support timely laboratory diagnosis, and train surveillance personnel and staff at points of entry.[33]International health activities are also intended to identify and refer public-health risks among mobile populations for an integrated epidemiological response.[2]

Several component-level indicators specify measurement methods, frequency, disaggregation and targets. The National Public Health Service indicator counts people in mobility situations receiving comprehensive care or guidance, disaggregated by federal entity and measured quarterly; its baseline is to be determined from standardised 2024 recording, and its 2030 target is health intervention, guidance or support at 100% of reception events.[34][40][41]

• Measure the annual percentage of temporary accommodation spaces with at least one fixed medical service or itinerant first-level health brigade, at national, state and district levels.[23]The stated hypothetical 2024 baseline is 35%, with an 85% national-coverage target for 2030.[42]
• Count annually the number of migrant shelters validated as health-promoting environments, by federal entity, with an expected upward trend.[31]The extracted historical series for 2018 to 2024 is unavailable, while the table entries for 2025 to 2030 are marked not applicable.[43][44]
• Count annual vaccine doses administered to people in mobility contexts by age group and federal entity through the Applied Doses Report managed by the National Centre for Child and Adolescent Health.[45][35]This newly created indicator has no baseline or 2030 target in the supplied extract.[46]
• Measure the proportion of repatriation flights attended by international health services, with monthly data collection and annual reporting.[36]Expected performance is at least 95%, although historical data for 2018 to 2024 are unavailable.[47][48][36]
• Measure the percentage of reported communicable-disease outbreaks among people in mobility situations that are closed, with a proposed 2030 target above 80%; no baseline has yet been measured.[37][49]
• Measure pulmonary tuberculosis detection among people in mobility situations semi-annually using bacteriological or rapid molecular-test positivity and a probable-case denominator based on prolonged cough with sputum production.[50][51][52]The mobility-status variable is not currently available in the relevant system, so states are expected to add it in observations.[52]
• Measure annually the proportion of people living with HIV in a mobility context who receive antiretroviral therapy, using the System for Logistics and Administration, Surveillance of Antiretrovirals.[53]The first calculation used second-quarter 2025 data as its baseline, recording 747 people receiving treatment among 799 people in the relevant mobility-context population; the 2030 target is 95%.[54][55]

Surveillance also draws on disease-specific and administrative datasets. The National Epidemiological Surveillance System and the National Public Health Laboratory Network support early warning, outbreak response and laboratory coverage for 31 conditions in the Basic Analytical Framework.[56]Malaria monitoring includes samples, confirmed cases, treatment completion, species, probable country of infection and detection location.[57]HIV monitoring through SALVAR disaggregates records by sex, gender identity, age and location, although the source notes fragmented prevalence data and an internal inconsistency in one age-group figure.[58][59]

Notwithstanding these mechanisms, the supplied material does not provide a single comprehensive indicator framework, universal baselines, fully specified reporting calendar, evaluation design or independent accountability mechanism for the whole strategy. Data gaps remain significant for internal forced displacement, mental health, substance use and several newly created mobility-specific indicators.[60][61][62][20]

Costing & Financing

The strategy assigns implementation responsibilities across federal, state and local public bodies, which are expected to plan and operate activities using their available human, financial and material resources.[18]It identifies a need to assess additional personnel, supply and equipment requirements, particularly at jurisdictional level and during extraordinary events such as migrant caravans.[21]

• Assess local requirements for human resources, supplies and equipment while maintaining routine service delivery.[21]
• Manage requests for additional support and agree resource-management measures through committee processes and interinstitutional coordination.[18][21]
• Support operational inputs including mobile and fixed first-level services, health brigades, laboratory diagnosis, surveillance, vaccination, rapid tests, protective equipment, first-aid kits, training and communication materials.[11][63][12]
• Maintain specialist capacity for identified service needs, including intravenous doxycycline for severe rickettsiosis, wound management for myiasis prevention, mental-health referral mechanisms, and continuity of treatment for chronic conditions and HIV.[64][65][15][38]

Health fairs are characterised as sustainable, economical and potentially high-impact when adapted to migrants’ sociocultural circumstances.[29]However, the source provides no monetary budget, cost estimate, unit cost, allocation, financing source, resource-mobilisation plan, quantified funding gap or economic assumption for the strategy or its components.[2][66][18]