Right to health for undocumented migrants in Mexico: from theory to practice in the context of the health system reform

Purpose: Undocumented Central American migrants in Mexico are legally eligible for free access to the public health system through the new Instituto para la Salud y el Bienestar (INSABI) health program, but many experience structural vulnerability and stigmatization that prevent them from accessing health-care facilities. The purpose of this study is to investigate the discrepancy between the migrants’ Human Right to health, proclaimed by the Mexican Government and supposedly guaranteed by law, and the reality of the migration process. Design/methodology/approach: This study reviewed relevant literature on the health risk factors, social and structural vulnerability, stigmatization and structural violence experienced by undocumented migrants as obstacles to their Human Right to health. It also reviews the current legal framework in Mexico and internationally. Findings: This review demonstrates the lack of implementation of the current legal framework in Mexico and identifies a set of complex obstacles to effective access to health for undocumented migrants. Although the migration process itself was not found to be directly associated with major health issues, the social conditions of the migratory journey expose the migrants to serious threats, especially sexually transmitted diseases and tuberculosis. Practical implications: This paper makes 10 practical recommendations for interventions collectively involving the state, international and civil organizations and the migrant community. These are especially relevant since the implementation of the INSABI health program in 2020. Social implications: The paper lays the basis for influencing Mexican health system stakeholders to improve the health of migrants. Originality/value: The sociological barriers to health access for undocumented populations in Mexico have not been fully explored. In addition, this paper provides a unique reflection on opportunities and challenges linked to the 2020 health system reform.