(IAP ’16) Ricardo Martinez Campos, G

Ricardo Martinez Campos (G, Urban Studies & Planning)

Ricardo will spend IAP in Mexico City where he will be working with the Mexican Social Security Institute in the Department of Medical Infrastructure. He will conduct research to find the different indicators that need to be considered to make decisions about the future medical infrastructure to be built in Mexico. Using Geographic Information Systems and statistical approaches, he plans to highlight vulnerability zones in the country in terms of demographic values, lack of infrastructure and presence of medical services. The final goal will be a series of recommendations and workflows (mapping) to identify these vulnerability zones, the statistical processes needed to describe and understand them, and the best way to represent this information and make it public.

Check back for his updates!

 

Part 3 – Construction of Indicators

 

While I was expecting to develop a great project during IAP (very ambitious project), my general ideas were reduced (or better said, landed to earth) to a baseline where the project can be launched and be continued. The main idea of this baseline is both to give a precedent for what needs to be done in the future in the Institution, if improvement in planning infrastructure wants to be achieved and, be the platform where future internships can built knowledge upon. Currently, there is interest both from MIT and Harvard students to continue what we began this January 2016.

The final indicators that will help deciding the future of medical infrastructure depend on a huge amount of variables that need not only an exhaustive collection of data but also a large statistical analysis that implies the knowledge of different fields that urban planning cannot cover. However, the definition of and description of indicators can be made with an integral vision of what the city is, its needs, the needs of its population and the impacts any kind of infrastructure can create.

The following table shows one of the 4 indicators, the “urban indicators” developed during this period of IAP. It will be the task of the people who will come after me, to define and detail the missing indicators and establish the process of planning. With the following table, you can also find attached the draft of the memorandum for the new planning process. (please do not share or print).

Part 2 – Medical Infrastructure Current State

 

In a very fast developing economy, where the inequity gap is constantly increasing, where the poor get poorer and the rich get richer, where 50% of the population lives in some kind of poverty, how can you decide who will get medical service and who won’t?. 

In a country with such huge disparities, it is hard to make decisions when you know that someone at the end will be affected; when you realize that social benefits or common benefits do not actually work the way theory established they will: for everyone. Assuming this problematic, it is the final goal of the coordination to decide who will receive service and eventually who won’t; and the strategy that is going to be implemented is through measuring urban systems in 4 different dimensions: the urban dimension, the demographic dimension, the environmental and propensity to risks dimension and the performance and service dimension. 

This different dimensions will result in 4 proposed indicators. And this is a huge moment not only for the coordination but for the Institution and for the future of Mexico. The capacity of the Institution to create big infrastructure in cities has a direct impact in its social and economic development. And as today, these impact are not being measured. Understanding that these are critical conditions that have to be considered when planning (and not only the performance condition which is the one used currently to assess future projects) will lead not only into a more integral planning, but also will create a fair process of service and resources allocation in Mexico. 

This is a challenge. The Coordination is basically divided in between the people who want a change in the process of planning infrastructure and those who are comfortable with doing what they’ve been historically doing. And this is of course not a single-coordination decision. The implementation of the project depends of the General Director of IMSS as well as the financial capacity of the SHP Mexico. However, the first steps were done this week and the process of elaborating the different indicators that will help to decide future medical sites began.

As any indicator, these have to be backed with information about the current state of the medical panorama. During this week we started mapping the current state of health services and infrastructure in Mexico. The draft results are shown in the following maps:

Part 1 – The Mexican Institute of Social Security and the challenge of planning for a Universal right for access to health.

 

Commonly known as IMSS, the Mexican Institute of Social Security is not only the second largest social oriented institution in Mexico -left behind only by INFONAVIT- but also the largest Social Security Institution in Latin America. Serving a 40% of the population, the service capacity of IMSS reaches all Mexican States and Regions.

However, it’s capacity is reaching to a point. While Mexican population is growing very fast and the population pyramid is shifting towards a larger amount of elderly and children, the infrastructure capacity (installed capacity as it is called – the amount of service they can provide) is reaching to a point where it can not longer cover the needs of the Mexican people. That’s why Daniel Broid, current Director of the Department of Medical Infrastructure Planning and MIT alumni, is undertaking an aggressive project to give a permanent answer to the lack of infrastructure in the country. Being true the fact that financially IMSS and the Mexican Financing Secretary are no longer capable to sustain the Institute, the time has come to start prioritizing which are going to be the next places in Mexico where there will be built new medical infrastructure.

My 2016 IAP took part of this project of analyzing which would be the planning strategy to decide where infrastructure was going to be built. Under a general panorama, my agenda for these time was distributed as follows:

1. First week: understangin IMSS; while I’m mexican and I was raised in Mexico, an even my parents where professionally affiliated to IMSS, it was overwhelming the amount of information I had to process during this week. such a big Institution naturally needs to be sectorized and, of course, I was only a part of that sectorization. This issue carried enormous difficulties throughout my project because having such descentralized organisms under the same Institution lead to diversification of information and eventually the problem of access to it.
2. Second week: drafting recommendations; as I was in charge of the project, my own-proposed task was to elaborate a series of recommendations in a memorandum on how to create a new strategy for a planning process for medical infrastructure. Since the project involved the manage of Big Data, the desired scope of research was through Spatial Analysis. Therefore, the elaboration of different maps showing the indicators I was proposing was crucial. In this part of the project I would be working with the different Coordinations that handled data inside IMSS as well as with a former UNAM goegrapher.
3. Third week: implementation and mapping; As mentioned before, the main intention of the project is to generate statistical analysis through geo-spatial analysis. This is just the beginning of a broader plan that implies the construction of a geo-spatial database for IMSS.

This is and was my desirable agenda; through this first week, I’ve understood that the collection of data may represent a hard obstacle on the process of this project. It will also be an obstacle the sensation of lack of cooperation inside my Department. It feels like there is a sense of lack of confidence and unwillingness on sharing information. Having said that, people tend to be very aggressive when changes are presented or recommendations are made on how to improve things. No wonder, these people have been working here under the same working scheme for more than 20 years.

 

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