The population of Oaxaca, in both rural and urban areas, suffers from lack of adequate medical care. Oaxaca has the highest maternal mortality (12 per 10,000 live births) and infant mortality (14.4 per 10,000 live births) in Mexico. It is estimated that at least 50% of the state's population has no access to primary health care. There is no comprehensive health care program clearly focused on older children and youth. The Department of Family Integration (DIF) and the National Indigenous Institute (INI) provide some assistance to preschool and primary school children to detect diseases and nutritional deficits.
Health services and infrastructure are clearly concentrated in the cities, yet even if they were to exist, they are insufficient. Rural areas have clinics in the municipal seats, but they are understaffed and lack drugs. The situation is even worse with respect to specialized services such as mental health, dentistry, rehabilitation, and care for the disabled. Finally, in recent years the federal public health services budget has been reduced.
The undersupply of primary health services combined with inadequate housing and the weak economic situation of families are reflected in the precarious health conditions of Oaxaca's children and youth.
The death rate by age group is 3% for 5 to 14 years and 5.7% for 15 to 24 years.13 The main causes of death between 5 and 14 years are infectious intestinal diseases (20%), accidents, malnutrition, respiratory infections, and heart disease. At 15 years, homicide becomes the leading cause of death, as 38% percent of deaths in males ages 15 to 24 are due to acts of violence, followed by accidents and intestinal diseases. For women a significant cause of death is complications in induced abortions, along with complications in pregnancy, childbirth, and the post-partum period.14
Caloric and protein deficits run at 20% and 24%, respectively, in the population under 5 years; these figures rise to 30% and 40% in regions marked by extreme poverty. This situation often has irreversible consequences for physical and intellectual growth, which are manifested later in childhood and in adolescence. The First National Census of Height (1993) for first grade children indicated that Oaxaca was among the states with the greatest prevalence of short children (more than 75% of the children reported in the census).15
No official data are available on the disabled population. Nonetheless, it is known that this sector does not receive enough attention. Only one medical center specializes in disabilities in the state, in the city of Oaxaca. Poliomyelitis is considered eradicated; even so, a significant number of youth over 15 have sequelae of varying degrees of seriousness. There is no reliable data on the mental or oral health conditions of Oaxaca's children and youth.
Oaxaca is one of the three states with the highest growth rate for number of persons infected with AIDS in all Mexico; the problem is spreading significantly in rural areas due to migration. Of the 312 cases detected from 1986 to 1994, most are in men over 25 years.16
Young people's access to information on sexuality is limited, and the cultural patterns constitute major barriers to obtaining the appropriate information. Although family planning campaigns are in place, there is a split between family planning and sex education. This likely contributes to the large numbers of induced abortions (there are no official data) among women, including adolescents. |
