Health System: $5 million dollars are invested in training, but no one knows if they are carried out
<p><span style="line-height: 1.6em;">Since most records have gone missing, there is no way of knowing if the activities that were done with those funds were carried out, even though they play a ‘strategic role’ in the Health Essential Functions project. There are four basic programs that do not have performance indicators (PI). Among the few that do have PI, there was a case in which a subject was replaced because it would not achieve the necessary goal.</span></p> <div> </div>
Training activities have a strategic role in the Draft Essential Public Health Functions (DEPH) project that was funded by the International Bank for Reconstruction and Development (IBRD). As a matter a fact, most of the $5.5 million dollars were spent on these initiatives. However, the General Auditor's Office (AGN) found that "there is no record of the actions taken with those funds."
Under these plans there are three main courses, the first one is about everything related to the National Tuberculosis Program, the second course has to do with the Expanded Immunization program, and the last course explains everything related to blood topics. However, despite its importance, the Coordination Unit (CU) doesn’t have complete details as to costs, expenses, or the topics explained.
The auditors stated that according to their research of the money invested on the training seminars at the DEPH, of the $5.5 million dollars and the 299 seminars completed between 2007 and 2010, the CU could only provide data on $3.1 million and 198 seminars. However, the AGN indicates that for 2010 showed an improvement in the execution of development funds and shares.
AGN stated that they "could not measure the impact that the investment had on the programs it was meant to strengthen" because of a lack of reliable information.
Let us recall that, as was published by The Auditor a few weeks ago, the DEPH is funded by IBRD and is under the aegis of the Ministry of Health. It aims to "contribute to the principle of equal opportunities for access to health services for the entire population, eliminating social differences".
Monitoring and Control
Other important actions that DEPH carries out is monitoring and evaluation. Evaluation indicators are generated in order to make a command board that will be the same used by the Department of Health. However, AGN indicators were branded "inappropriate" for various reasons.
Before detailing these issues, it is important to note that there are three programs prioritized by the DEPH that "don’t have an indicator assigned to them." These are: Dengue Fever, Emergencies and Disasters, Regulation, and Prevention of Addictions. The auditors evaluated them through the documentation the CU had of them, and found that they carried less than expected.
When the overall analysis of the situation had to be measured, especially taking into consideration the project’s final results, the audit team believed the results were "partial, because they concerned the eradication of only two diseases: measles and congenital rubella." The case involving the Global Chagas Indicator was startling because, "the scope of the program according to the target set was not reached, therefore, they decided to replace it by another that would be achievable."
In relation to medium term indicators, which record the results and implementation at the provincial level and the degree of compliance with the goals, the audit said that while "the loan contributes to the measurement of cases, there is no follow-up notification.” That means that cases of measles, rubella, and hemolytic uremic syndrome are detected, but nothing else is, as far the records go.
Finally, the federal watchdog also noted the indicators that analyze the evolution of the project and include early warnings of future problems. With regards to those called "monitoring", they concluded that "they are not useful for assessing the contribution of DEPH".