In 1996, palliative care was available in several Mexican cities, such as Mexico City, Guadalajara, Nuevo Leon, Guerrero, Chiapas, Baja California, Chihuahua, Sonora, Sinaloa, Tamaulipas and Yucatan.²¹ However, officially recognized palliative care services only existed in Mexico City at the National Cancer Institute and at the National Institute of Nutrition, and in Guadalajara at the Nuevo Hospital Civil ( New Civil Hospital).

In 2004, although several physicians provide palliative care in Mexico, only a few of them form part of consolidated and functionally organized palliative care teams. The majority of palliative care services are available in public hospitals as part of pain clinics. Two hospices operate outside the national health care system.

Palliative care coverage across the country is mixed. For instance, the most recognized palliative care services exist in Mexico DF and in Guadalajara. In other areas, palliative care is unavailable.

In Mexico DF, palliative care teams exist at the following public hospitals:

• the National Cancer Institute
• the National Institute of Nutrition
• the Veinte de Noviembre (November Twentieth ) Hospital
• the Siglo Veintiuno (Twenty First Century) Hospital (which is a hospital of the Mexican Institute of Social Security)
• the ‘General’ Hospital

There are also some private initiatives, such as a palliative care unit created by Dr. Silvia Allende; a private palliative care team directed by Dr. Francisco Mayer in partnership with ‘Cristina’ Hospice and a hospital palliative care team operating at the ‘Ángeles del Pedregal’ private Hospital.²² ‘Isabel Mexico’ Hospice also exists as a non-profit, private organization in Mexico DF.

In Guadalajara, palliative care is provided at the New Civil Hospital, at the Palia Institute and at the Centro Universitario para el Estudio y Tratamiento del Dolor y Cuidados Paliativos (University Centre for the Study and Treatment of Pain and Palliative Care) at the Universidad Autónoma de Guadalajara. Hospice care is provided by ‘Cristina’ Hospice.

In the city of Monterrey, palliative care is provided at a palliative care unit.

While most palliative care teams offer hospital outpatient and inpatient care, home care is scarcely provided, mostly by hospices and by the palliative care teams at the National Cancer Institute and at the National Institute of Nutrition, in Mexico DF and at the New Civil Hospital and at the University Centre for the Study and Treatment of Pain and Palliative Care, in Guadalajara.

Table 2 shows the ratio palliative care services per million population in Mexican cities in which the more consolidated palliative care services exist.

Table 2: Ratio palliative care services per million population