Congress ignores poorer cities in Health amendments – 10/30/2023 – Health

Parliamentary amendments for Health fail to prioritize the poorest municipalities and those with the worst primary care indicators.

The conclusion is from an unprecedented study by Gife (Group of Institutes, Foundations and Companies), to which the Sheet had exclusive access. Based on these conclusions, the survey proposes an index to direct amendments to the cities that need them most.

“When directing an amendment to health, looking at the index is super interesting. In terms of thinking about public policies, you provide more objectivity. We are proposing this”, summarized the general secretary of Gife, Cassio França. When contacted, the Ministry of Health did not respond.

The study analyzed the preferences of parliamentarians in indicating amendments between 2018 and 2022 and how these resources are distributed and applied in all municipalities in Brazil.

In total, R$47 billion went to Health in the period, with R$27.2 billion from individual amendments, R$7 billion from bench amendments and R$12.8 billion from the rapporteur’s amendments.

The amendments’ resources have not prioritized municipalities with the worst health indicators, the study points out.

“Municipalities with the lowest rates of premature deaths due to chronic non-communicable diseases, for example, received on average 62% more resources per capita than municipalities with greater difficulties in this indicator”, calculates the survey.

Amendment resources have also not prioritized poorer municipalities, with fewer resources for health.

“Municipalities with the lowest per capita budget values ​​are those that have received the least amendments for basic care since 2018, obtaining, on average, 59% less resources than those with greater availability of municipal resources for health”, says the study .

For Gife, parliamentarians “should prioritize investments in primary care when allocating their share of amendments to health.”

“The municipalities with the worst levels of basic care coverage are those that have received the least resources from parliamentary amendments,” the survey showed.

“Despite concentrating almost 46% of the Brazilian population, municipalities with Basic Care coverage from the Family Health Program at a very low level [menos de 70% de cobertura] received four times less in per capita values ​​than municipalities with complete coverage”, indicated the study.

When choosing the municipality that will receive the resources, they should “consider equity criteria, taking into account the need for resources, the universalization of basic care and the improvement of the population’s health conditions, prioritizing municipalities with indicators that suggest a greater need for additional funding.”

Another problem revealed by the study is that, of the total, around 96.6% went to the municipalities and almost all in the fund-to-fund modality — which has less transparency and allows less control over the application of resources.

Furthermore, there is a high concentration of funding expenses in the total resources allocated. Only R$8.9 billion (18.6% of the total) was invested in works, acquisition of permanent material and other forms of investment.

This ends up causing the municipality to depend on this type of resource to maintain the payment of contracted expenses in subsequent years.

To help resolve the issue, Gife created the Potential Need for Amendments Index for Primary Care, based on indicators of premature mortality from chronic non-communicable diseases, infant mortality, maternal mortality and vaccination coverage

In the breakdown by municipality, Santo Antonio do Descoberto (GO) has the worst situation, with an index of 0.954. The indicator ranges from 1 to 0, with 1 being the greatest need for resources.

Next come two cities in Roraima: São Luiz, with 0.953, and Cantá, with 0.951.

The study will be released this Monday (30) at a public hearing of the Mixed Parliamentary Front for Health, in the Chamber of Deputies.