The Auditor General of the City of Buenos Aires (AGCBA, for its acronym in Spanish) found that health centers and Community Action (CESAC) in the southern area of the City were not distributed according to the demand of the population. So there were more concentration centers and other resources which came to assign administrative health promoters tasks.
It is the patient care rooms of primary care, working particularly in "all actions and services for prevention and health promotion." The report, which was approved this year on 2007 data, was based on the Health Regions I and II covering the southern part of the City of Buenos Aires.
The report notes that "four out of ten people in the city live in the south," which in the Health Region I live 639,619 inhabitants and in Region II 1,119,829 million. Faced with this scenario, the agency adds that in these jurisdictions "the distribution of CESAC was not done in response to demand."
In turn, the work of the Audit notes that although "southern communes are concentrate the largest population and poor households," exposed to high social vulnerability, the cafeteria rooms of these regions have "serious infrastructure deficits that determine the effectiveness and efficiency of actions."
At the same time, and from a sample of 12 South CESAC Centers, the AGCBA found that the distribution of professional resources does not meet the needs of its population.
It even noted that "the health promoters trained to strengthen self-care activities" which are indispensable for primary health care strategy, had to be "reassigned to the fulfillment of administrative duties in the absence of staff for this purpose."
The report adds that "83% (of centers) do not have educational materials and 67% have no audiovisual equipment or technology for advocacy," and in the prevention of drug addiction, "33% of centers do not perform any type of activity."
This analysis also shows that most CESAC has shared offices and even in almost every center the registered population is female and under-five years old, "no actions to meet the demand for professionals in family medicine are evident or pediatrics."
In addition, "75% of patient care rooms are not involved in computer network referral hospital." Even, according to the report, "an expected action is that the center be linked to the hospital where the patient is derived, particularly when residing in other jurisdictions," but "only CESAC has links with effectors outside of the city."
Finally, the audit verified that there was a 43% cut in funding for patient care rooms pertaining to subparagraph consumer goods, own primary care due to "lack of adequate budgetary planning" in 2007.
The Case of CESAC 7
In a housing complex in the district of Lugano, there is a center that is located under a bridge built for a walkway. According to the AGCBA, "in most of the audited centers space is scarce; they lack offices, multipurpose rooms for workshops and waiting room for patients." The CESAC 7 is one of those cases.
The report explains that the parlor has "several glasses missing or broken, which, besides the cold water inlet and allows visualization of the offices of the central space (gynecology, nursing and guard) and have no ceiling."
Also, the Watchdog said "they do not have an office for each specialty, so they must share. The gynecology room dos not have a bathroom and pediatrics does not have a sink "and there are no" materials used in sink practices."
"In the pharmacy there are leaks that compromise the conservation of elements deposited there," says the report, adding that "space is very small and its height (1.20 meters at the lowest place) does not allow for the movement of personnel."
The report also states that "there are places where a person with a height greater than 1.70m cannot enter," and there are dependencies that "have no windows, no air conditioning, in the summer situation worsens, forcing them to leave the door open."
The same happens in the administrative sector and files that lack proper ventilation and lighting.
As for the security, electrical installations are close to gas services, and there are "leaks that coincide (with electrical appliances), through which flows water when it rains."
Moreover, the report adds: "there is no specific area for storage of medical waste and even the collection containers are at the entrance of the Center."
However, the AGCBA acknowledged in its report that despite "serious structural deficits, plants and other local programs are implemented, courses, workshops, home visits and other group activities are done to strengthen community participation and responsibility in self-care health."