Maternal Health Policy and the Politics of Scale in Mexico

Since 1987, international organizations have accorded greaterattention to the problem of maternal mortality, particularlywith the inclusion of its reduction in the Millennium DevelopmentGoals. This article examines maternal health policies in Mexico,focusing on interactions between the international, national,and local scales and considering the case of local projectsin two states, Chiapas and Guerrero. Although the discourseof maternal health expressed at the international level hasfacilitated the creation of networks dedicated to maternal health,the restructuring of health services in Mexico and the rescalingof their provision have often conflicted with the realizationof this goal. The impact of decentralizing health services hasdiffered according to (a) the timing and nature of decentralization;(b) the number and expertise of nongovernmental organizations(NGOs) working on maternal health issues, and the connectionsbetween these NGOs and international networks; and (c) the responsivenessof the state governments to maternal health issues.