The work is expected to be completed in February; head of the 4th Health Region takes stock of actions during the year/Karin Franco, with reporting by Paulo Sava and Rose Harmuch
Summary: – There is still no confirmed date for the inauguration of the building and the start of services;
- Structure will have the capacity to handle up to 15 thousand consultations per month;
- The State Government committed to paying for the operation of the AME.
The work on the Specialty Medical Outpatient Clinic (AME) in Irati is already 80% complete. The space will provide specialized consultations and other services in the region, linked to the Intermunicipal Health Consortium (CIS/Amcespar).
The work had an investment of more than R$20 million, through the State Government. “In addition to 80% of the work completed, we have the bidding process underway for all the furniture. So, all of this work will have new furniture, there is a new air conditioning system and all of this is in the bidding process. When the work is finished, the structural part, there will be the whole issue of furniture as well”, explains the head of the 4th Health Regional, Cristiana Maria Schvaidak.
The work is expected to be completed at the end of February. There is still no date for the inauguration of the building and the start of services.
The structure being built can handle up to 15,000 specialized consultations per month. In addition to consultations, the structure will have the Dental Specialties Center (CEO). “It is one of the only ones in Paraná where there is a CEO, so there is a building just for the Dental Specialties Center. CAPS [Centro de Atenção Psicossocial] he will stay where the CEO is today. So, the CEO is also a part of the consortium. Municipalities will no longer incur costs in relation to property rental”, he says.
Municipalities are able to offer specialized consultations to the population through CIS/Amcespar, where the nine members share the costs of consultations. With the installation of AME, the State Government committed to paying for the operation of the building, with the payment of bills such as electricity and water, which were previously divided between the municipalities. The municipalities’ counterpart will be an increase in the number of specialized consultations in the region.
Balance
Cristiana took stock of the State Government’s investments in the region, which were around R$110 million. Among the highlights are resources for hospitals. In Irati, one of the investments was announced during the 90th anniversary celebrations of Santa Casa de Irati, with a resource of R$2.4 million to purchase equipment. “Santa Casa is in progress with this protocol. It is the replacement of beds, ultrasound, endoscopy equipment, equipment for the ICU, to use cardiac monitors. It is a replacement of several essential equipment for the continuity of care at Santa Casa”, he said.
In the region, other municipalities received investments in their hospitals. “We are with the Hospital de Teixeira Soares, which is already reaching 80% of the work completed. It is a practically new hospital for the municipality of Teixeira Soares. We recently had the announcement of the opening of the tender for the construction of the hospital in Imbituva. It will be a hospital that will even have a maternity ward there. It is R$ 25 million. Of these, R$ 14 million are resources and counterpart from the State Government. We also have an ongoing protocol for renovation and expansion of R$6 million for the Rebouças Hospital. Also, recently, the Rio Azul Hospital was awarded R$6 million for renovation and expansion.
The head of the 4th Regional highlights that works in hospitals go through bureaucratic procedures. “It’s not just the resource coming, but all this bureaucratic process of approving the projects by the health surveillance. These things take a little time, but with all this commitment and with all this dedication, both from these hospitals that received these resources and from our Regional Health team, these processes are moving very quickly. We see hospitals that created a project in less than two months already being approved by the health surveillance. We sent the appeal, but for the resource to reach the end, in the population, there is a whole process so that this happens”, he explains.
Another State Government project is the physiotherapy clinics. “We saw, after Covid, that people needed rehabilitation. All municipalities have a space that provides care for their population. But this is a new project from the State Government, it is a space intended for rehabilitation. These are clinics from which our region and almost all municipalities benefited. First it was in Imbituva, Rebouças, but we have guaranteed it for Irati, for Mallet, for Rio Azul. We will have physiocenters in almost all municipalities of our 4th Health Region”, said.
Another work carried out by the 4th Health Region is the construction of emergency services in the region. “We have in our 4th Health Region resources destined for two municipal emergency services (PAM). One is in the municipality of Irati and one in the municipality of Inácio Martins. It is also a specific resource, it is a specific building, which comes with all the necessary environments to serve the population with quality. The PAM of Irati and Inácio Martins have already gone through that phase of the bureaucratic process, of the project. There is a whole issue of design, implementation, in short, which the engineers know very well about They have already won this stage and I believe that they will be put out to tender soon, both in Irati and Inácio Martins”, he explains.
One of the objectives in the region last year was to improve 24-hour service in the region, highlights the head of the 4th Regional. “We have a mixed unit in Fernandes Pinheiro that is also being built. We also have a renovation in Guamiranga. The emergency service in Guamiranga is now 24 hours a day, so the health context in our 4th Region has also changed a lot. All municipalities have a door open 24 hours a day to serve the population”, he says.
This action is the result of a restructuring of emergency and urgent care in the region, due to SAMU. “There is a reference grid to where I am going to refer that patient when I get the trauma, when you call the SAMU. Where is the SAMU going to take that patient? There was a regulation grid, which was created when the SAMU was implemented, and we needed to update it. It was hard work because we needed to talk to all the entry points again, but we did this in the 90 days that I took over as director of the Regional Health. We updated this regulation grid. People are thinking: ‘Oh my God, yeah just a piece of paper that they updated.’ No. It’s the entire access point from which the emergency and emergency patient will be referred. Organizing these services guarantees faster care for the population,” he explains.
The head of the 4th Health Region also highlighted the work done with vaccination in the region, which has managed to achieve its goals, even with anti-vaccine campaigns. “In our context of our region, we managed to reach our vaccination goals. There is a national immunization calendar, so it must be followed. Thanks to God and for the support and tireless work of all the basic health units of the 4th Health Region, we have managed to reach the goals, both for the influenza vaccine, for the flu, now we have the vaccine for pregnant women, to prevent bronchiolitis in children under six months”, he says.
According to Cristiana, those who join anti-vaccine campaigns have not known what it was like before immunizations. “Vaccines are always a priority. Vaccines save lives. There is, unfortunately, an anti-vaccine campaign and, I say, those who carry out this anti-vaccine campaign are people from younger generations who have not seen people dying from infantile paralysis, from measles, from preventable diseases. I say that we are fine, we are healthy because our parents made us take the vaccine. Now it is our turn, as parents, to take our children and encourage them to take the vaccine”, he said.
In the region, the head of the 4th Regional Health Region highlighted the work done in the municipalities to attract the population to vaccination. The work placed the 4th Region in sixth place, among 22 Regions, which managed to vaccinate more people. “The people are very supportive of the vaccination campaign. The municipal health secretaries form a task force to create extended opening hours. I will mention the municipality of Fernandes Pinheiro, which holds a dance on the day of the vaccination campaign. People go, dance, have fun, play bingo and, at the end, receive the vaccine. Just like other municipalities also have extended opening hours, it opens on the weekend, on Saturday, in short, so that people can benefit from the vaccine. From eight to five, the staff works, but we will carry out the vaccine during extended hours, outside of working hours. It is important that we guarantee the population’s access to the vaccine”, he says.
The work done with pregnant women in the region was also highlighted by the head of the 4th Health Region. “We still have rates that need to be improved, reducing maternal and child mortality. Back in April, when I took over as director of the Health Region, we were in 15th, with an indicator of 15th in maternal and child mortality. Now at the end of the year, we closed in 12th, but we need to reduce this to less than single digits”, he explains.
To achieve a good result in working with pregnant women, the 4th Health Region has carried out several actions. “The first step is to strengthen prenatal care where the pregnant woman is monitored. We strengthened it, we made a pact hand in hand for life with the nine municipalities. It was even on the agenda of the Amcespar meeting [Associação dos Municípios Centro do Sul do Paraná] with the mayors. You need to ensure that this woman receives quality prenatal care, that she has access to exams, consultations, ultrasounds, and that she completes the minimum required number of consultations. We did very hard work in all municipalities”, he says.
One of the challenges is in relation to the places where pregnant women have their children. “Within our 4th Region, we only have two hospitals where they deliver babies. We have the São Francisco de Assis hospital, in the municipality of Rio Azul, which meets the usual risk for the municipality of Rio Azul. It guarantees labor and birth for the residents of Rio Azul. Only usual risk. In all the rest of the municipalities, pregnant women deliver the baby at Santa Casa de Irati, which is a usual risk for the eight municipalities, including Irati, and is medium and high risk for the nine municipalities in the region. It’s a lot of work in which we need to increasingly improve and ensure that this pregnant woman has quality care”, he highlights.
A future project of the 4th Health Region is for pregnant women in the region to visit Santa Casa de Irati before their due date, so that they are familiar with the environment. “See where they are going to give birth, who will be the team that will be attending at Santa Casa de Irati. To improve the rate, everyone must do their part. Both the basic health units in their prenatal care, the reference hospitals that will deliver this baby and there is also a counterpart for the pregnant woman”, he explains.
The head of the 4th Health Region emphasizes that it is important for pregnant women to undergo all prenatal care, including consultations, exams and vaccines. “I know that, sometimes, she is working. There are n factors, but that she, during this period of pregnancy, dedicates herself to prenatal care. If she is a medium and high risk pregnant woman, she is monitored in the city of origin and she is monitored at the PASA outpatient clinic [Ponto de Atenção Secundária Ambulatorial]which is the specialty outpatient clinic in the consortium. She needs a consultation at the consortium, a consultation at the municipality and she thinks it’s too much. It’s not too much. All care is necessary to ensure that your baby is born safely,” he said.