Overview and Key Findings
The Index of Transparency in Health Spending (ITGSEF) 2025, conducted by Aregional, reveals a concerning trend in the transparency of health spending across Mexico’s 32 states. The average transparency score has dropped to 44.93 points, with only five entities—Guanajuato, Sinaloa, Jalisco, Querétaro, and Aguascalientes—achieving high transparency levels.
Data Analysis and Methodology
The ITGSEF evaluates the availability, quality, and accessibility of fiscal and management information in public health through six blocks: Normative Framework, Budget Planning, Financial Reports, Acquisitions, Inventory Control, and Quality Certifications. Each block analyzes public documents, digital formats, and reporting systems, assigning scores based on updates, detail, and format.
Block Analysis
- Block 1: This block, which assesses the publication of laws and regulations, has sufficient transparency with 68.83% compliance and a 2.2% annual variation. However, most states only upload minimal documents like health laws without updating or linking them to specific programs.
- Block 4: With 59.37% compliance, this block shows a positive variation of 3.6%. However, Block 3, which evaluates operational costs, has an average of 45.56%. This indicates that 75% of state governments are deficient in transparency across four out of six blocks.
Decline in Transparency: Case Studies
Sonora, Tlaxcala, and Veracruz have experienced significant drops in transparency scores, losing 25, 24, and 23 points respectively. These states had shown improvements in 2024 but fell back into opacity in 2025, primarily due to neglecting the updating of their portals and information systems. This regression is particularly concerning as it demonstrates that without monitoring mechanisms and penalties, transparency gains can be fragile and reversible.
High Transparency States
Guanajuato led the list for the sixth consecutive year with 91.79 points, followed by Sinaloa (84.08 points), Jalisco (83.64 points), Querétaro (77.10 points), and Aguascalientes (76.10 points). Yucatán was the only state with sufficient transparency, scoring 66.85 points.
Centralization of Resources: A Risk
In August 2023, a decree transferred resources from the Fondo de Aportaciones para los Servicios de Salud (FASSA) to the Fondo de Salud para el Bienestar, managed by IMSS-Bienestar. Nine entities refused to sign the agreement and continue contributing state resources for the system’s proper functioning, remaining among the most transparent.
The IMSS-Bienestar model presents new challenges, as health spending is now reported as a single block in Mexico City without state-by-state breakdowns. This could hinder the tracking of resources for medicines or equipment by state, although full impact assessment is expected only by 2026. Yucatán, recently joining the agreement, is of particular interest.
Experts from Aregional emphasize that the federal government has an opportunity to establish incentives and penalties for transparent resource allocation, stating that “when you lose resources, you investigate why and demand their return; this is how transparency should function.”
Key Questions and Answers
- Q: What is the ITGSEF 2025? A: The Index of Transparency in Health Spending (ITGSEF) 2025 is a study conducted by Aregional that evaluates the availability, quality, and accessibility of fiscal and management information in public health across Mexico’s 32 states.
- Q: How many states have high transparency levels? A: Only five states—Guanajuato, Sinaloa, Jalisco, Querétaro, and Aguascalientes—achieved high transparency levels according to the ITGSEF 2025.
- Q: What are the main challenges in health spending transparency? A: The main challenges include incomplete, disorganized, or inaccessible data publication by state governments, as well as the centralization of health resources under the IMSS-Bienestar model.
