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Introduction: Maternal and child malnutrition is a worldwide public health problem with short, medium, and long-term adverse consequences for both mother and child. In Mexico, maternal and child malnutrition represents a serious public health problem that must be urgently addressed. In this context, Primary Health Care (PHC) plays an important role in the prevention, detection, monitoring, and treatment of the different forms of maternal and child malnutrition. Assessing the quality of nutritional care offered at this level of care is necessary in order to improve it; however, there are no indicators for the evaluation of this quality. Therefore, this study aimed at developing a set of indicators to assess the quality of maternal and child nutritional care at PHC., Methods: We developed indicators for different stages of life: preconception, pregnancy, infancy, and preschool age. A systematic review of the literature on clinical guidelines for the prevention, diagnosis, and treatment of the different forms of malnutrition was carried out; the recommendations of the guidelines evaluated with good quality were extracted., Results: Based on these recommendations, 22 indicators were constructed. A pilot study was carried out to validate the indicators and 16 indicators were selected to assess the maternal and child nutritional care at PHC., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Ancira-Moreno, Omaña-Guzmán, Bautista-Morales, Acosta-Ruiz, Hernández Cordero, Burrola-Méndez, Vilar-Compte, Monterrubio Flores, Kaufer-Horwitz, Pérez Navarro, Muñoz-Manrique, Mazariegos, Trejo-Domínguez, Sánchez Muzquiz, Cajero, Brero, Sachse and Cobo Armijo.)

Background: There is little evidence of the association between digital marketing of formula and baby food and infant and young child feeding (IYCF) practices., Objective: Assess parents' exposure to digital marketing of formula and baby food for children <2 years and its association with the purchase and IYCF practices in Mexico., Methods: Parents ≥18 years recruited from a market research panel completed an online survey (n=1074) and capture-on-screen (n=95) between December 2020 and January 2021. Logistic regressions were used to estimate the association between exposure to digital marketing of formula and baby foods with its purchase, motivation, consumption and IYCF practices., Results: Digital marketing of formula and baby food was self-reported by 93.9% of parents in the online survey and observed by 93.7% in the capture-on-screen. Recorded ads did not comply with the International Code of Marketing of Breast-milk Substitutes. Parents who self-reported seeing a higher versus lower number of ads were less likely to exclusive breast feed (OR=0.38; 95% CI: 0.19 to 0.78), and more likely to give mixed feeding (OR=2.59; 95% CI: 1.28 to 5.21), formula (OR=1.84; 95% CI: 1.34 to 2.53), processed foods (OR=2.31; 95% CI: 1.59 to 3.32) and sugary drinks (OR=1.66; 95% CI: 1.09 to 2.54). Higher exposure to ads was associated with a higher chance of purchasing products motivated by nutritional (OR=2.1; 95% CI: 1.32 to 3.28) and organic claims (OR=2.1; 95% CI: 1.21 to 3.72)., Conclusions: Digital marketing of formula and baby food may negatively influence IYCF and should be regulated to ensure children's nutrition and health., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Return to work is one of the most significant barriers to breastfeeding (BF). Family-friendly policies are critical to ensure that BF and maternal work are not mutually exclusive. This study aims to determine contextual factors and underlying mechanisms influencing the implementation of workplace policies in Mexico. Following a qualitative approach, the study was conducted in the following four cities in Mexico: Mérida, Chihuahua, Guadalajara, and Monterrey. Interviews were conducted in 14 workplaces, and included 49 (potential) beneficiaries, 41 male employees, and 21 managers and human resources personnel. The information collected was analyzed through a deductive thematic analysis and mapped against the Context-Mechanism-Outcome framework of Breastfeeding Interventions at the Workplace. Contextual factors influencing a BF-friendly environment in the workplace were as follows: work-schedule flexibility, provision of lactation services (i.e., BF counseling) other than a lactation room, women's previous experience with BF and family-friendly environments in the workplace. The underlying mechanisms enabling/impeding a BF-friendly environment at the workplace were as follows: awareness of Mexican maternity protection legislation, usage of BF interventions in the workplace, culture, supervisor/co-worker support and BF-friendly physical space. To achieve a BF-friendly environment in the workplace, actions at the level of public policy and workplaces must accompany adherence to Mexican legislation.

Objetivo. Conocer la opinión de actores clave respecto del proceso de judicialización del derecho a la protección de la salud en México. Material y métodos. Se realizaron 30 entrevistas semiestructuradas a representantes de los pode-res Judicial (PJ), Legislativo (PL), Sector Salud (SS), industria farmacéutica, academia y organizaciones de la sociedad civil (OSC) durante mayo de 2017 a agosto de 2018, en distintos lugares de la Ciudad de México. Se transcribieron las graba-ciones y se analizó el contenido con base en categorías de interés. Resultados. Las posturas respecto al fenómeno de la judicialización del derecho a la salud son disímiles. Hay tensiones entre quienes ven su potencial efecto como agente de cambio del sector y quienes la perciben como una interferencia ilegítima del PJ. No existe una estrategia coordinada entre los sectores para promover un cambio en el SS. Conclusiones. Las posturas respecto al fenómeno de la judicialización en México son disímiles. Hay tensiones entre quienes ven su potencial efecto como agente de cam-bio del sector y quienes la perciben como una interferencia ilegítima del PJ en el SS. Otros argumentan que no existe una estrategia coordinada entre los sectores para promover un cambio en el SS.

Objective: To analyze the coverage of lung cancer in Mexico and offer recommendations in this regard., Materials and Methods: By means of the conformation of a multidisciplinary group, we analyze the burden of the disease relative to the lung cancer and the access to the medical treatment offered by the different public health subsystems in Mexico., Results: Important inequalities in lung cancer care are documented among the different public health subsystems. Our data suggest differential access and coverage to both traditional treatments and existing therapeutic innovations and differences in the capacity of health service providers to guarantee the right to health protection without distinction., Conclusions: Recommendations are made on the need to improve actions for tobacco control, early diagnosis for lung cancer and inclusion of innovative therapies and homologation among different public health service providers through financing via tobacco taxes., Competing Interests: Declaration of conflict of interests. The authors declare that they have no conflict of interests.

The decreasing breastfeeding rate in México is of public health concern. In this paper we discus an innovative regulatory approach -Performance Based Regulation- and its application to improve breastfeeding rates. This approach, forces industry to take responsibility for the lack of breastfeeding and its consequences. Failure to comply with this targets results in financial penalties. Applying performance based regulation as a strategy to improve breastfeeding is feasible because: the breastmilk substitutes market is an oligopoly, hence it is easy to identify the contribution of each market participant; the regulation's target population is clearly defined; it has a clear regulatory standard which can be easily evaluated, and sanctions to infringement can be defined under objective parameters., Recommendations: modify public policy, celebrate concertation agreements with the industry, create persuasive sanctions, strengthen enforcement activities and coordinate every action with the International Code of Marketing of Breast-milk Substitutes.