UNDP helps to boost health services for vulnerable populations in Buenos Aires

30 Jun 2010

By María Martha Ambrosoni

UNDP Argentina worked with the district of La Matanza to strengthen public health service management.

Buenos Aires, Argentina, 22 June — In 2002, La Matanza, home to Argentina’s poorest 1.3 million people in the outskirts of Buenos Aires, faced the worst economic and social crisis in the country’s recent history.  

As the most populated district — 3,800 persons per km2, while the provincial average is 45 — La Matanza suffered from deeply-rooted poverty even before the crisis.  Its unemployment rate hovered at 25 per cent.  The district’s health services offered one public hospital bed to every 1,500 persons (the national average was one for every 460 or so people).  About half of the population had no health insurance and needed public coverage.  

In the aftermath of the crisis, the demands for social services — especially health care — soared.  And many of the public system in districts simply could not handle the unprecedented demands.  This put greater pressure on poor districts such as La Matanza.  

“The crisis made private health services abandon the poorest areas”, said Juan Manzur, a medical doctor who was then in charge of public health in the district.  “We needed to develop capacity for more efficient internal processes, like logistics and inventories”.  

The crisis, in fact, provided an opportunity to overhaul the existing system.  The district authorities requested UNDP’s assistance with the reforms.  Subsequently, UNDP designed and helped to implement the reform plans.  

During a needs assessment phase, it became clear that the public health services suffered from frequent breakdowns in the supply chain, preventing people from receiving care.  Basically, administrative and human resources constraints prevented the efficient procurement of medicine, equipment and other healthcare inputs.  The reforms created a district government unit in charge of all health procurement activities, as well as an advisory committee for medical planning and management.  New management protocols and tools for more effective procurement — such as corporate procurement guidelines and performance indicators — were created.

Thanks to the health reforms, cases of medical treatment in the district rose from 2.8 million in 2001 to 4.6 million in 2008.
“Before the intervention, we bought medical equipment based on how much money we had”, said Paula Campana, a health procurement agent.  Many items were purchased either randomly or urgently.  The reforms focused on management of medical equipments and investing in human resources.  “We received training to provide timely health services and also concentrated on efficient and transparent way to provide care”, she explained.  

The programme guaranteed the most vulnerable population’s access to health care, by improving efficiency and enhancing health services management.  Medical treatment cases rose from 2.8 million in 2001 to 4.6 million in 2008 in the district.  

At the end of 2009, access to municipal medical care increased about 60 per cent in La Matanza, according provincial data.

“Now my daughter, Ayelén, has a complete vaccination calendar and receives treatment for asthma, and I don’t need to get up at five o’clock in the morning to have an appointment at the health centre or ask for special leave at work to take her to the hospital”, said Soledad, one of the beneficiaries.  

The intervention facilitated the implementation of preventative strategies that was then translated into health gains, especially for children.

“This project allowed us to improve our relationship with the suppliers, because we were able to organise ourselves to follow the national or provincial practice”, added Manzur, who later became the health minister in the province of Tucumán and eventually for the whole country.  

“The commitment and leadership of the local government were essential for success”, he added.  “And the health workers were willing to adopt the project to make improvements”.