2023-12-22 16:10:58
The Comptroller General of the Republic has issued a serious warning about the inefficiency and mismanagement of resources in the implementation of the “SISPI” Indigenous Health System. Throughout three National Development Plans, significant government resources were allocated, reaching $20,193 million during the period 2010-2022; However, only 47% of these funds were executed. This exhaustive analysis reveals the lack of compliance with proposed goals and deficiencies in the articulation of the SISPI with the General Social Security Health System, raising questions about the future of the system and attention to the health needs of indigenous communities in Colombia. The Comptroller’s Office makes an urgent call to review and improve the regulation and implementation process of the SISPI to guarantee a positive impact on the well-being of these populations.
The Comptroller General of the Republic has issued a detailed report that highlights the ineffectiveness and deficiencies in the implementation of the Indigenous Health System “SISPI” in Colombia. Throughout three National Development Plans (2010-2014, 2014-2018 and 2018-2022), goals were proposed to structure and operate the SISPI, but the results have been unsatisfactory.
During the period 2010-2022, the National Government allocated resources of $20,193 million for this purpose. However, the execution of these funds was only 47%, equivalent to $9,467 million, indicating an inefficient use of the resources allocated to the implementation of the system. At the same time, between 2012 and 2022, $50,043 million were transferred to territorial entities and indigenous organizations for the development of 77 health models, without clear technical criteria and without adequate monitoring of their progress.
The allocated resources were not distributed in a manner consistent with the largest gaps in health of the indigenous population, which could result in an inadequate and inequitable distribution of public resources. Of these funds, 48% was delivered to the Cauca Regional Indigenous Council (CRIC) model, followed by the Huila Regional Indigenous Council (CRIHU) with 10%. These five models concentrated the remaining 28% of the resources.
The Comptroller’s Office identified significant shortcomings in the articulation of the SISPI and the health models with the General Social Security Health System (SGSSS). Furthermore, it was evident that the Ministry of Health and Social Protection does not keep a clear record of the funded models, the benefited population, the resources allocated by model and the continuity of results.
The evaluation revealed that the SISPI, created in 2014 through Decree Law 1953, lacks regulation for its operation to date. The Comptroller’s Office warns about the absence of a system of indicators on the health conditions of indigenous peoples, limiting the ability to objectively measure the impact of SISPI on improving the health of this population.
Likewise, the lack of criteria and mechanisms for verifying results, the lack of exhaustive studies of costs and financial sustainability, and the dismantling with the indigenous differential Capitation Payment Unit (UPC), which should cover spending on care, were noted. differentials for indigenous peoples.
The recurrent problems identified in five specific health models include weaknesses in the articulation and coordination of health services, lack of policies and training programs in a differential approach for health personnel, lack of knowledge of SISPI guidelines, and regulatory barriers that do not They adapt to the characteristics and worldview of indigenous peoples.
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