By Mario Sánchez.
Congenital heart disease leads to serious disabilities and greatly reduces the life expectancy of the girls and boys who are born with it. In 2008, nearly a quarter of deaths of children under age one in Argentina were due to this “hard to treat” pathology. However, surgical treatments could have prevented many of these deaths, if the children had received them early on.
It is within this context that I’d like to tell you about the federal health services network that Argentina created to improve congenital heart disease care. I think the coordination mechanism that was developed in Argentina clearly showcases the benefits that can be reaped from better coordination across healthcare providers and sets an example for other early childhood services.
In 2008, the Ministry of Health launched the “National Congenital Heart Disease Program” with two goals: improving disease care in public hospitals, and resolving the issue of under-utilized capacity, which was stemming from a lack of coordination among the care providers at various levels (most of which are funded and operated by the provinces). The program created a national network to coordinate healthcare—from diagnosis to treatment, monitoring and follow-up—for children with congenital heart disease. This centrally coordinated network takes into consideration the complexity and urgency of each case when determining where and how each child should be treated.
In 2010, the Ministry of Health began administering the program health through Plan Nacer, a maternity and child health insurance program for the uninsured. When an uninsured child is born with congenital heart disease, Plan Nacer pays the public or private healthcare providers for the cost of his or her diagnostic, treatment or follow-up care services. The amount of the coverage varies, depending on the complexity of the disease. In addition, children may need to be transferred to a hospital away from home, if the hospital in his or her home province doesn’t have adequate resources to provide the necessary level of care.
To date, the initiative has had a number of notable achievements, both in terms of successful surgeries as well as administratively, in the form of shorter waiting lists. For example, Garrahan hospital, one of the largest public hospitals in the country, reduced the scheduled wait time for surgery by 75% between 2009 and 2011. Other public hospitals have achieved a reduction in mortality due to congenital heart disease of more than 70%.
The need to improve coordination among agencies providing social services is a challenge worth undertaking in the region. Although the situation in each country is unique, services tend to be decentralized, to a greater or lesser degree, in terms of their regulation, financing and provision. I’d love to hear experiences in other countries similar to that of Argentina, to see how they are improving coordination among their various agencies and levels of government, increasing the impact of early childhood interventions, and most importantly, saving children’s lives.
Mario Sánchez has been a Lead Social Protection Economist at the IDB’s office in Argentina since 2011. With over 6 years experience at the Bank, he has led projects in the areas of social protection, education, health and social policy. He has broad experience in project and process evaluation.