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A new budget structure soon made budget monitoring of some health initiatives impossible and so the coalition turned its attentions to improving the design of reproductive health programmes. 2005 saw another shift in emphasis when it became clear that the Federal government did not have power to influence state level decisions on health funding. A new focus developed around service delivery and the use of state funds in the marginalised states of Oaxaca, Guerrero and Chiapas. The success of the coalition clearly rests on the ability of the coalition to adapt to varying political circumstances, and shifting their emphasis between different levels of government. The increasing level of civil society is clearly a positive development. However, political reform in Mexico has also brought a series of challenges for civil society groups. These challenges relate to the states evolving governance structure. The evidence suggests that response to these challenges has so far been good, with groups adapting to governing systems with a good level of flexibility .

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