Health, citizenship, and human rights advocacy initiative: improving access to health services in Mexico

In early 2009 Fundar, Centro de Análisis e Investigación initiated an advocacy project called Health, Citizenship, and Human Rights (Salud, Ciudadanía y Derechos Humanos, SCyDH), which aimed to improve access to and availability of health services for socially excluded groups in Mexico.

Three years into this initiative, Fundar’s approach has evolved considerably. Though the organization began with a rather general interest in health services for the poor, it has since focused its campaign strategy on addressing a series of specific budgetary issues affecting theSeguro Popular (SP), the agency tasked with providing healthcare to the country’s 52 million uninsured. For Fundar, the focus on the SP is merited because of the enormous financial scale of the program. How well the SP is managed has important implications for approximately half the country’s population — the half that consists mainly of impoverished or socially excluded groups without proper access to health services.

In three years, by reaching out to grassroots organizations as well as to policymakers, Fundar has had a real impact on public policy — but the work has also had a surprising impact on the organization itself. Fundar has evolved from an organization known primarily for its technical research and analysis on federal budgets into a policy advocacy network. Indeed, the way this project developed in its first three years (2009-2012) illustrates important organizational lessons. This case study tells the story of how the organization managed to acquire the skills and tools necessary to move toward health policy advocacy in the interest of vulnerable people.

This case study is part of an effort of the International Budget Partnership (IBP) to document how the work of civil society organizations in analyzing and monitoring public expenditure can help influence public decision making and bring about changes in government action. The central questions this case study seeks to answer include: How does an organization with a history of work centered mainly on research and analysis on federal budget policy, adapt to conduct sustained advocacy work on a large-scale policy involving different branches and levels of government? What are the main contextual factors that enable or impede federal budget advocacy work by civil society organizations in Mexico?