Background information

The principal traditional medical specialists are traditional birth attendants, herbalists, bonesetters, curanderos, snake culebreros, shamans, spiritualists, and sobadores (83, 135).

Statistics

Traditional birth attendants preside over more than two-thirds of childbirths in Mexico. There are 55 to 60 chiropractors practising in Mexico (45). There are about 3000 homeopathic physicians (53).

Regulatory situation

In 1980, the Mexican Institute of Social Security created a unit to study traditional medicine and medicinal plants. Later, a programme was introduced to foster the integration of traditional and allopathic systems of medicine. The programme was designed to involve traditional practitioners in the health activities of 3500 rural medical units within the Social Security System (135). The Mexican Institute of Social Security is also working with the national plan for depressed zones and marginalized groups (Coplamar) to integrate allopathic and traditional medicine (83).

Mexico's registry of traditional medicine practitioners is kept by the National Indigenous Institute and the Mexican Institute of Social Security.

Traditional medicine forms an integral part of the health care delivery system. Although there is no official licence for the practice of traditional medicine, other than for traditional birth attendants, the authorities are currently working on creating such a licence. Proposals for a bill to regulate traditional medical practice, aside from that of traditional birth attendants, have been made since 1989 (83).

The Regulations of 20 October 1976 (136) established a distinct sector of the health field for qualified traditional birth attendants. Section 2 of the Regulations define qualified traditional birth attendants as persons who have been attending deliveries without training and are licensed and qualified under the Regulations. Licences are issued by health centres following the completion of a training course. Section 9 states that entry to the course is restricted to persons who have attained majority, are literate, and are recognized by the communities in which they work as carrying out obstetric activities. Section 13 specifies that traditional birth attendants may attend women in their community during normal pregnancy, delivery, and the puerperium provided that they notify a health centre. They may also prescribe appropriate medications in accordance with the instructions of the Secretariat for Health and Welfare.

There is a proposal to add provisions to the General Health Law that would regulate the quality control of medical activities, establishments, products, and services. Chapter 4 of these proposed changes covers herbal medicines.

Homeopathy has been accepted and integrated into the national health system in Mexico. In 1895, a presidential decree was issued to establish a national homeopathic school; to regulate training requirements for homeopathic doctors, including title protection; and to establish a national homeopathic hospital. In 1996, the Government recognized homeopathy as a medical speciality (86). Licensing legislation regulates chiropractic educational standards and practice (81). Chiropractors have been licensed since 1988. Credentials must be periodically revalidated (65).

Education and training

The National Indigenous Institute has a unit dedicated to the organization, coordination, and instruction of traditional medicine. In some states, the Institute coordinates with associations of traditional medicine practitioners to provide workshops, courses, and other activities where practitioners can gather and share their knowledge. Traditional medicine is taught through apprentice programmes, including practice, observation, and workshops. In some cases, families are known for a particular speciality.

The Mexican Institute of Social Security offers informal presentations and workshops on traditional medicine, medical anthropology, and community work techniques to personnel working in the official health services (83).

There are several schools and hospitals teaching homeopathy. Homeopatia de Mexico, an association for homeopathic practitioners, obtained official recognition for its postgraduate school in 1996 (53). A chiropractic college is presently being established (81).