Join PAI’s #HERVoice campaign to uplift inspiring women who are making a difference around the world. Learn more

Just the Math

With financial and technical support from PAI, Observatorio de Mortalidad Materna en México empowers indigenous youth to work with health clinics to ensure providers are giving quality, nondiscriminatory and culturally relevant sexual and reproductive health care.

How indigenous youth are driving change in Mexico's poorest region

In 2015, in response to the country’s high teenage pregnancy rate, Mexico established a national strategy designed to strengthen young people’s access to sexual and reproductive health care. However, due to widespread discrimination, indigenous adolescents and youth continue to face significant obstacles accessing birth control and youth-friendly sexual and reproductive health care.

This is certainly the case in Chiapas, the country’s poorest state and home to one of its largest indigenous populations. Compared to young women nationally, adolescent girls in Chiapas have more children on average and have a higher unmet need for birth control. Deep discrimination and inequality among indigenous adolescents and youth undermine their right to access sexual and reproductive health care and drive high teenage pregnancy rates.

Observatorio de Mortalidad Materna en México (OMM) is working to change that. With financial and technical support from PAI, OMM created a program that trains indigenous youth to work alongside health clinic staff in Chiapas to ensure that they are providing quality, nondiscriminatory and culturally relevant care. This includes offering sex education materials in indigenous languages and banning the denial of care to young women in traditional dress.

As a citizen monitor, Cecilia Hernández, 16, travels to public health facilities across Chiapas to record how staff treats patients. In one instance, she saw that multiple contraceptive options were unavailable at a clinic. Cecilia knew this inventory was critical and when she asked staff members about it, they told her that the contraceptive methods requested from the Ministry of Health were overdue to arrive.

“This is harder for young people,” she explains, “because they don’t have money, they have a hard time asking for what is [available] and not that many pharmacies sell birth control.”

Social accountability, specifically citizen monitoring, is an important step in providing oversight to Mexico’s relatively decentralized public health system. The evidence OMM’s citizen monitors gather is used to educate the government of Chiapas on how to improve the quality and accessibility of care at the 45 public health facilities serving thousands of indigenous youth and women in the region.

In a region where indigenous people, especially youth, are left out of conversations about their well-being, the work of citizen monitors is helping to broaden those discussions and make sure that health clinics are meeting the pressing needs of the communities they serve. Cecilia and OMM are driving real change in their communities, and PAI is proud to support them in this essential work.

Meeting people in the health centers, getting to learn more about sexual and reproductive health and having the opportunity to travel to other communities — this job is a blessing.
Cecilia Hernández, citizen monitor, OMM

Join Us

Get Updates

Stay informed about the issues impacting sexual and reproductive health and rights.

Sign Up


Be a champion for women and girls around the world.

Support Our Work


Join the movement to advance the rights of women and girls.

Take Action