Unveiling the elephant in the room: the lack of professionalism in Mexico’s civil service and policy outcomes

Overall, high levels of poverty and inequality have remained prevalent in Mexico, despite its economic growth over the last three decades. This can be linked to the inefficiencies created at a bureaucratic level and its subsequent policy outcomes. 

Mexico’s lack of professionalism in the civil service can be widely understood through Prospera, its most important social protection programme to date. Prospera was a conditional cash transfer programme (CCT) aimed at eradicating extreme poverty and developing the country’s human capital. With more than 20 years of implementation, in 2019, the current administration decided to eliminate it. Since then many studies have questioned its internationally promoted success. 

]omen were provided bi-monthly cash benefits that were conditional on things such as attending doctor’s appointments and ensuring their children attend school. Of course, if they did not comply with these conditionalities they were removed from the programme and lost the benefits. The international pressures, to transform Mexico’s poor and uneducated population in a short period of time, had an important influence on the street-level bureaucracy of the programme.  Supervisors and promoters were entitled to exert more rigidity around the compliance of such conditionalities due to the economic and political results expected from the programme.

In 2000, Mexico ratified its commitment towards achieving the Millennium Development Goals (MDG) at the UN. The MDG 5 aimed to improve maternal health and achieve universal access to reproductive health”, which Mexico ensured by introducing women’s reproductive health policies in public clinics and hospitals inside Prospera, named Oportunidades at the time (United Nations, 2015).

Promoters of Prospera exercised abusive discretion in determining sanctions provided by the programme (Ramirez and Velázquez, 2023). 

The perceived benefit was low and the relationship between beneficiaries and street-level bureaucrats was weak given the lack of professionalism from the promoters/latter.  Health, education and  nutrition are human rights;  the government's main objective should be to ensure them instead of utilising them to achieve economic and political objectives.

This was reflected in the interviews made by Ramirez and Velázquez (2023) to a 12 year beneficiary of the programme:

“We were forced to go to health appointments, to vaccinations, to take dogs to be vaccinated. And if we didn’t have a dog, doctors made us get one from the neighbour, from wherever, but we had to bring at least three dogs. And if you didn’t comply, the doctors wouldn’t sign your report card and you would get an absence, so you ended up not getting your support the next month. Also for pap smears and mammograms: as I wasn’t old enough, I had to get a woman to go. That was ugly, we were forced”(p.519).

Smith-Oka (2009) also conducted a study on women’s medical appointments after these policies had already been implemented for over nine years.  The study  found that culturally embedded abusive practices were being exercised by medical practitioners and nurses, thus reinforcing gender and social stereotypes. More than 30% of the women she spoke to “stated that they - and their acquaintances - felt forced in their personal interactions with the medical staff”(p. 2071). 

Women often felt coerced, persuaded and manipulated by medical staff to comply with family planning methods.  These included, but were not limited to, sterilisations and the insertion of intrauterine devices. Nurses and doctors’ relation to women have a direct impact on their reproductive health, hence are responsible for informing patients about procedures and facilitating informed choices. According to Lipsky, “the poorer the person, the more he or she is likely to be a nonvoluntary client of not one but several street-level bureaucracies” (1980, p.54). 

Prospera’s beneficiaries were the poorest in the country; indigenous women who lived in rural regions with no access to education. Nurses, doctors and promoters control access to the programme, have a higher position in society and exercised a patronising attitude over these women. These conditions generated gender inequality, abusive behaviour from medical staff and the reinforcement of discriminatory practices.

In both studies, street-level bureaucrats lack one essential quality: professionalism. Policies change constantly as policy makers and politicians add things to programmes frequently, but most of them fail to include the training and development of skills for those that are ought to be the most prepared. They are left solely with their judgement and sometimes poor capacity to solve complex problems with scarce resources.

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