Joint Report on the Results of the International Coordinated Audit on the Prevention and Consequences Elimination of Floods

Report ID: 356

The International Coordinated Audit on the Prevention and Consequences Elimination of Floods was carried out in the framework of the EUROSAI Working Group on the Audit of Funds Allocated to Disasters and Catastrophes. The SAIs of of Belarus, Georgia, Poland, Serbia, Turkey, Ukraine (audit coordinator) and the European Court of Auditors participated in the audit.

The purpose of the audit was the assessment of the establishment by national bodies of the response mechanisms in case of floods and the timeliness of such actions, the effectiveness of the flood risk management system and the reduction of the harmful impact of floods, the economy and legality of using the allocated budget funds for the above purpose.

Participants of the international coordinated audit unanimously state that in the process of managing natural disasters, the amount of money invested in reducing the risk of a catastrophe is the most cost-effective, as proper prevention and preparedness measures can significantly reduce the adverse impact of natural disasters.

The international coordinated audit highlighted, that in the countries of participating SAIs and at EU level (according to the findings of the European Court of Auditors):

✓ legal and organizational frameworks for flood protection planning and management have been established, however there is a need to further finalizing the programming documents, specification of the developed policies, strengthening coordination between the competent authorities, as well as strict adherence to the requirements of European and national legislation;

 ✓ a system of flood risk management based on the basin principle was introduced and regional bodies of river basin management were established, but integrated flood risk management was not provided in national and cross-border river basins;

✓ measures aimed at flood protection have not been implemented effectively, in particular due to late decision-making;

 ✓ approaches to financing flood measures are imperfect, do not provide the need for funds as most of SAIs-participants noted, and flood risk management plans sent to the European Commission do not always identify the source of funds, as ECA reported;

 ✓ there is a need to improve forecasting of future flood risk.

The study of this problem resulted in elaboration of key recommendations to the governments and responsible bodies of the countries.

Participants of the international coordinated audit share the provisions of the INTOSAI Guidance GUID 9000 “Cooperative Audits between SAIs” and identify a decisive factor in cooperative efforts to find a common solution for a specific audit topic, as their countries have similar interests in sphere of flood prevention and its consequences elimination.

Source: EUROSAI Database of Audits - https://www.eurosai.org/en/databases/audits/Joint-Report-on-the-Results-of-the-International-Coordinated-Audit-on-the-Prevention-and-Consequences-Elimination-of-Floods/

PRIMARY HEALTH CARE MANAGEMENT IN BRAZIL – Coordinated Audit (Executive Summary)

Report ID: 357

With a large population, Brazil has as one of its most difficult and complex missions to ensure universal, equal and free access to health care services, a right enshrined in the Federal Constitution itself. In this regard, the implementation of such public policy is faced with many challenges, as in the case of decentralization of actions, funding sources, the human resources required, and the management of the available financial resources.

Primary health care is the main point of entry into, and the communication hub for the entire health care network; and it should be the preferred contact of the users of the Unified Health System (SUS). At this level of care, the main needs of the population are identified, and that has a bearing on the planning and management of the other tiers.

Primary health care was the subject of this coordinated performance audit conducted by the Federal Court of Accounts (TCU) and by 29 Courts of Accounts (TC), signatories to the Technical Cooperation Agreement entered into on March 25, 2014. The object of this audit was to assess, through a coordinated audit, aspects related to the delivery of services, access, infrastructure and problem-solving capacity of primary health care to citizen-users. More specifically, to define that scope to assess whether primary health care management (at the federal, state and municipal levels) provides quality when delivering services. Therefore, it was considered that quality derives − among other variables − from managerial actions (management processes) implemented for primary health care.

Such auditing encompassed fieldwork − in a spontaneous manner − in 23 states and 317 cities, whose results were added with an electronic survey replied by 14 State Health Departments, 2,577 Municipal Health Departments and 175 Regional Health Management Offices. The audit questions were developed around three big subjects: planning, people management, and monitoring and assessment.

The Executive Summary  presents the main results from the audit that was carried out; and constitutes a strategic tool for improving the management of those services, as it offers an excellent diagnosis of the infrastructure, access, delivery of services, and the problem solving capacity of primary health care. The report contains reference to good practices.

Source: https://portal.tcu.gov.br/biblioteca-digital/auditoria-coordenada-na-atencao-basica-a-saude.htm

GESTIÓN DE LA ASISTENCIA SANITARIA EN BRASIL - Auditoría Coordinada (Resumen Ejecutivo)

Report ID: 364

Con una gran población, Brasil tiene como una de sus misiones más difíciles y complejas garantizar el acceso universal, equitativo y gratuito a los servicios de salud, un derecho consagrado en la propia Constitución Federal. En este sentido, la implementación de esa política pública se enfrenta a muchos desafíos, como en el caso de la descentralización de las acciones, las fuentes de financiación, los recursos humanos necesarios y la gestión de los recursos financieros disponibles.

La atención primaria de salud es el principal punto de entrada y el eje de comunicación de toda la red de atención de salud; y debe ser el contacto preferido de los usuarios del Sistema Único de Salud (SUS). En este nivel de atención se identifican las principales necesidades de la población, lo que influye en la planificación y gestión de los demás niveles.

La atención primaria de salud fue objeto de esta auditoría de gestión coordinada realizada por el Tribunal Federal de Cuentas (TCU) y por 29 Tribunales de Cuentas (TC), firmantes del Acuerdo de Cooperación Técnica suscrito el 25 de marzo de 2014. El objeto de esta fiscalización era evaluar, mediante una auditoría coordinada, los aspectos relacionados con la prestación de servicios, el acceso, la infraestructura y la capacidad de resolución de problemas de la atención primaria de salud a los ciudadanos-usuarios. Más concretamente, definir ese ámbito para evaluar si la gestión de la atención primaria de salud (a nivel federal, estatal y municipal) ofrece calidad en la prestación de los servicios. Por lo tanto, se consideró que la calidad deriva -entre otras variables- de las acciones gerenciales (procesos de gestión) implementadas para la atención primaria de salud.

Dicha auditoría abarcó un trabajo de campo -de manera espontánea- en 23 estados y 317 ciudades, cuyos resultados se sumaron con una encuesta electrónica respondida por 14 Direcciones Estatales de Salud, 2.577 Direcciones Municipales de Salud y 175 Gerencias Regionales de Salud. Las preguntas de la auditoría se desarrollaron en torno a tres grandes temas: planificación, gestión de personas y seguimiento y evaluación.

El Resumen Ejecutivo presenta los principales resultados de la auditoría realizada; y constituye una herramienta estratégica para mejorar la gestión de dichos servicios, ya que ofrece un excelente diagnóstico de la infraestructura, el acceso, la prestación de servicios y la capacidad de resolución de problemas de la atención primaria de salud. El informe contiene referencias a las buenas prácticas.

Fuente: https://portal.tcu.gov.br/biblioteca-digital/auditoria-coordenada-na-atencao-basica-a-saude.htm

GESTÃO DA SAÚDE NO BRASIL - Auditoria Coordenada (Resumo Executivo)

Report ID: 365

Com uma grande população, o Brasil tem como uma de suas missões mais difíceis e complexas assegurar o acesso universal, igual e gratuito aos serviços de saúde, direito consagrado na própria Constituição Federal. Neste sentido, a implementação de tais políticas públicas enfrenta muitos desafios, como no caso da descentralização das ações, das fontes de financiamento, dos recursos humanos necessários e da gestão dos recursos financeiros disponíveis.

A atenção primária à saúde é o principal ponto de entrada e o eixo de comunicação de toda a rede de saúde; e deve ser o contato preferencial dos usuários do Sistema Único de Saúde (SUS). Neste nível de atendimento, são identificadas as principais necessidades da população, e isso tem influência no planejamento e gestão das outras camadas.

A atenção primária à saúde foi objeto desta auditoria de desempenho coordenada conduzida pelo Tribunal Federal de Contas (TCU) e por 29 Tribunais de Contas (TC), signatários do Acordo de Cooperação Técnica celebrado em 25 de março de 2014. O objetivo desta auditoria foi avaliar, através de uma auditoria coordenada, aspectos relacionados à prestação de serviços, acesso, infra-estrutura e capacidade de solução de problemas da atenção primária à saúde dos cidadãos-usuários. Mais especificamente, definir esse escopo para avaliar se a gestão da atenção primária à saúde (nos níveis federal, estadual e municipal) proporciona qualidade na prestação de serviços. Portanto, foi considerado que a qualidade deriva - entre outras variáveis - de ações gerenciais (processos de gestão) implementadas para a atenção primária à saúde.

Tal auditoria envolveu trabalho de campo - de forma espontânea - em 23 estados e 317 cidades, cujos resultados foram adicionados com uma pesquisa eletrônica respondida por 14 Departamentos Estaduais de Saúde, 2.577 Departamentos Municipais de Saúde e 175 Delegacias Regionais de Gestão de Saúde. As questões de auditoria foram desenvolvidas em torno de três grandes temas: planejamento, gestão de pessoas, e monitoramento e avaliação.

O Resumo Executivo apresenta os principais resultados da auditoria que foi realizada; e constitui uma ferramenta estratégica para melhorar a gestão desses serviços, pois oferece um excelente diagnóstico da infra-estrutura, acesso, prestação de serviços e a capacidade de resolução de problemas da atenção primária de saúde. O relatório contém referências a boas práticas.

Fonte: https://portal.tcu.gov.br/biblioteca-digital/auditoria-coordenada-na-atencao-basica-a-saude.htm

Joint Report on the Results of the International Audit on Waste Management and Utilization

Report ID: 366

The International Coordinated Audit on Waste Management and Utilization was conducted in the framework of the EUROSAI Working Group on the Audit of Funds Allocated to Disasters and Catastrophes. The purposes of the national audits – were to assess the state and efficiency of the waste management system in the countries participants of the audit.

The Supreme Audit Institutions (SAIs) of Moldova, Serbia and Ukraine participated in the audit. The SAI of Ukraine was the audit coordinator, The aim of national audits was to assess the state and effectiveness of the waste management system in countries of SAIs– participants of the international audit. The scope of the audit comprised from 2015-2018.

The results of the national audits conducted in the field of household, industrial and other hazardous waste, which can pose a serious threat to human health and the environment, as well as lead to environmental and man-made disasters, showed: for those countries, whose SAIs participated in the audit, common inconsistencies/gaps and problems within existing waste management systems

The results of the cooperative audit indicate the need to strengthen the governments’ efforts to move from the existing linear economy to a circular economy based on the maximum processing of waste generated in the territories of countries as well as the creation of an integrated waste management system in accordance with the EU “waste management hierarchy” in order to reduce the negative impact on the environment, public health and prevent the occurrence of environmental and man-made disasters.

Fuente:  EUROSAI Database of Audits -  https://www.eurosai.org/en/databases/audits/Joint-Report-on-the-Results-of-the-International-Audit-on-Waste-Management-and-Utilization/