THEME: SEXUAL AND REPRODUCTIVE HEALTH IN CHANGING HEALTH SYSTEMS Commentary: Mexico: Moving from universal health coverage towards health care for all

Improving on previous social protection schemes, in 2000, policy-makers created the Mexican Social Protection System in Health (SPSS), an insurance scheme to expand financial coverage for health care, and especially to reduce and eliminate out-of-pocket health expenditures by the poorest households. Mexico has been widely applauded for achieving universal health coverage, meaning financial coverage, in 2012. However, such an achievement does not, by itself, result in adequate services for women’s sexual and reproductive health and rights (SRHR; see paper by Sen & Govender, 2014). Following the reform of the National Health Law in 2004, policy-makers began to work on harmonising health standards across all states in terms of selected aspects of service quality and efficiency. By 2012, more than 52 million people were enrolled in the SPSS, and the total health expenditure increased from 5.1 % to 6.3 % of GDP between 2001 and 2010 (Knaul et al., 2012); these are considerable accomplishments. None-theless, the per cent of GDP allocated to health is low compared to other countries in the region (World Bank, n.d.), and significant gaps remain in securing SRHR, particularly for rural, poor and indigenous women and adolescents