What is the Sexual and Reproductive Health Need in Oaxaca?
Kelly Castagnaro, Senior Communications Officer
As the fifth largest state of Mexico, Oaxaca is characterized by extreme geographic fragmentation. Located where the Eastern Sierra Madre and the Southern Sierra Madre come together, Oaxaca shares a common border with the states of Veracruz and Puebla (on the north), Chiapas (on the east), and Guerrero (on the west). Oaxaca's rugged topography has played a significant role in giving rise to its amazing cultural diversity. Because individual towns and tribal groups lived in isolation from each other for long periods of time, there are sixteen groups that maintained individual languages, customs, and ancestral traditions well into the colonial era, and - to some extent - to the present day. According to many, Oaxaca is - by and large - the most ethnically complex of Mexico's thirty-one states, and it is believed that, even today, at least half of the population of Oaxaca still speaks an indigenous dialect.
According to Conapo (Mexico’s National Population Council), Oaxaca is the third most economically marginalized state in Mexico. The state has 3.3% of the population, but produces only 1.5% of the GNP. Eighty percent of the state’s municipalities do not meet federal minimums for housing and education. While the majority of Oaxaca’s population lives in rural areas, most development projects are planned for the capital and surrounding area. About 31% of the population is employed in agriculture, about 50% in commerce and services, and 22% in industry.
In Mexico, as in many countries throughout the region, the health and well-bring of women and youth vary greatly according to the region and state in which they live. Those living in the relatively less developed, less urbanized, and poorer southern states like Oaxaca have more limited access to sexual and reproductive health services and information than those living in the more developed, more urbanized areas, such as Mexico City and the northern states.
The marital, sexual, and reproductive behavior of young women also varies greatly depending on where they live. In 2006, 29% of women aged 20–24 in rural areas reported having been married before age 18, compared with 17% in urban areas. Fewer urban than rural women had had a birth before age 18 (14% vs. 22%). Meanwhile, the proportion of married women who have an unmet need for contraception—that is, who are able to become pregnant, but are not using any contraceptive method, even though they do not want to have a child soon or at all—increased among this age-group, from 23% to 31%. The situation is more critical among sexually active, unmarried young women aged 15–24: Only 35% were using a contraceptive method in 2006.
While maternal mortality has decreased steadily in Mexico since the 1950s, the national numbers mask glaring inequalities, which continue to divide Mexico along lines of class, ethnicity, and geography. In Oaxaca, where 53% of the population lives in rural areas, indigenous women and rural communities face acute health challenges on many fronts because of abject poverty, poor education, and a dire shortage of medical staff.
In 2008, there were 57 maternal deaths per 100,000 live births in Mexico, a ratio that is five times that found in industrialized countries. Moreover, the maternal mortality ratio in the least developed region of the country (comprised of the states of Guerrero, Oaxaca, and Chiapas) is 97 maternal deaths per 100,000 live births—almost double the national average. Such regional disparities are partly due to the uneven distribution of health care resources and providers, which favors urban areas, such as Mexico City.