Can Tuna Cans Inspire Healthcare Innovation? Insights from Argentina’s CAPS

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By Francesca Monteiro

 

Pairing old tuna cans and unused contraceptive coil wire is not something I would have previously imagined. Yet, in the neighbourhood of José León Suárez, health promoters salvage these materials, helping locals transform them into ornamental storage tins during the health centre’s weekly crafts workshop.

This seemingly small act reflects the creativity and resilience driving the initiatives at these centres, where limited resources are repurposed into tools to connect with the community.  

As a public health volunteer with Voluntario Global, I’ve had the opportunity to work in primary health centres, or Centros de Atención Primaria de la Salud (CAPS), in the province of Buenos Aires. Through participating in community-focused activities, I’ve gained a deeper understanding of Argentina’s healthcare system and how CAPS provide more than just medical care.

In this post, I’ll explore the critical role CAPS play in the healthcare system, the obstacles they face, and the lessons they offer for fostering a healthier, empowered community.

 

 

What Are the Three Pillars of Argentina’s Healthcare System?1

The healthcare system in the province of Buenos Aires reflects the broader structure of Argentina’s healthcare model, which is divided into three sectors: public, social security (known as Obras Sociales), and private.

The public sector provides free care, a lifeline for those without the social security tied to formal employment or the means to pay for private healthcare. Primary healthcare centres, or CAPS, serve as a key part of this system.

The social security sector is organised around Obras Sociales, union-managed health insurance plans financed by employers and employee payroll contributions. This sector primarily serves formally contracted workers and their families, providing access to both public and private healthcare services.

Meanwhile, the private sector includes private insurance agencies (Empresas de Medicina Prepaga) and independent private providers, which cater to those who can afford out-of-pocket costs or premium insurance plans.

How Are CAPS Shaping Healthier Communities?

CAPS are a cornerstone of Argentina’s public healthcare system, particularly for underserved and vulnerable populations. They serve as the first point of contact for patients—covering specialities such as general medicine, social work, psychology, odontology, gynaecology and nutrition—focusing on primary care rather than the emergency and complex treatments handled by hospitals.

In the centres I’ve worked with, health prevention and promotion are truly at the heart of their mission. What sets them apart is their commitment to ensuring patients see centres not just as a place for treatment, but as resources that empowers them to take control of their health and adopt preventive measures in their daily lives. Dedicated health promoters lead workshops and campaigns, providing accessible, community-tailored education. They also address the socioeconomic drivers of health, recognising its deep ties to factors like poverty and education. By actively involving residents in initiatives, they aim to build trust and encourage participation, a connection clearly reflected in the locals’ appreciation for their healthcare team.

Day-to-day, this takes shape through weekly exercise classes, where older adults are encouraged to stay active and maintain their independence. Nutrition sessions also offer practical tips on food hygiene while tackling local misconceptions—like the ever-important question of when it’s safe for children to start drinking mate. Disease awareness campaigns go beyond traditional posters or social media posts accessible only to the more tech-savvy, but extend directly into the community. During one such dengue prevention initiative, prompted by last year’s outbreak of 583,000 cases,2 I joined a team going door-to-door in the neighbourhood. We shared practical tips, such as how to reduce mosquito breeding, and addressed residents’ questions, ending the day with much-appreciated tortas fritas to keep spirits high.

Efforts also reach into schools, where clinicians and teachers come together to tackle pressing challenges. For instance, I supported a team during a school session on understanding emotions, aimed at addressing the growing anxiety seen in children. To further support families, vaccination drives at school pick-up points help busy parents keep their children’s immunisations up to date. And where schools aren’t suitable venues, mobile health clinics offer services from vaccinations to cancer screenings in the town plaza, bringing healthcare to the heart of the community.

However, while CAPS play a vital role in fostering community health, they operate within a system facing significant challenges.

The Harsh Realities Facing Argentina’s Health Centres

Argentina’s healthcare system is fragmented, with limited coordination across its public, social security, and private sectors. Recent austerity measures under President Milei, whose proposed health reforms have sparked significant controversy, have placed additional strain on the public sector, exacerbating longstanding resource shortages and inequalities.

Severe funding cuts, coupled with soaring inflation—193% year-on-year as of October 20243—have left many centres struggling to provide even the most basic supplies, with essential medications and equipment often in short supply. Efforts to collaborate with external organisations, like schools, are similarly hampered by stretched budgets and staff shortages.

For staff, the pressures can be immense. Many clinicians I’ve spoken to are juggling two or even three jobs to cope with stagnant wages and rising living costs, leading to burnout driven by financial uncertainty, relentless workloads, and the emotional toll of working in high-stress environments. One healthcare worker quipped that their typical diet includes asado—"or at least it did"—a reflection of how inflation has made even staple foods unaffordable. In fact, Argentines are now consuming less beef per capita than ever before on record.4 Reduced purchasing power also means that for some, the idea of a holiday outside the province feels increasingly out of reach.

Neighbourhood conditions add further complexity, with Argentina’s poverty rate soaring from 42% in late 2023 to 53% by mid-2024.5 Now more than ever, patients are focused on surviving week to week, prioritising immediate needs like food, housing, and work. Prevention becomes an uphill battle in these circumstances, as little time or energy is left for engaging with health advice. Additionally, even the best education efforts are constrained when resources are in short supply. As an example, while guidance on safe sex is vital in reducing unwanted and teenage pregnancies, limited access to contraceptives prevents individuals from applying what they have learnt—there is a disconnect between knowledge and practice. These challenges are compounded by accessibility barriers. In some areas, seeking care requires long, costly journeys on public transport due to the lack of specialists close to home. Some patients have even voiced fears about attending appointments, citing the risk of violent robberies at specific times. Moreover, many endure lengthy waits for appointments and face inconsistent care as resources are continually stretched thin.

While these challenges showcase the resilience of CAPS, they also underscore the urgent need for systemic reform to sustain their efforts.

What Lessons Can Be Learnt from CAPS?

One of the most striking lessons I’ve learned from working with CAPS is that health education, while vital, must be grounded in the realities of the patients they serve. This became clear when advice on eating fresh produce sometimes had to be adjusted for those without access to a working fridge or steady income. Effective health promotion isn’t just about delivering information—it’s about making it achievable within the context of people’s lives. Equally inspiring is the camaraderie among healthcare workers—despite the daily challenges faced, their dedication and team spirit are evident. Whether brainstorming ideas for the next campaign or sharing a laugh about the morning’s chaos, it’s clear they find joy in their work and the impact they make.

CAPS showcase the potential of a healthcare model rooted in collaboration between medical teams and patients, where health prevention is prioritised even amid resource constraints. They highlight that while resources are essential, truly impactful healthcare also relies on connection, creativity, and a deep understanding of patients' realities. However, resilience, ingenuity and repurposed tuna cans can only go so far—systemic reform, driven by robust government support, is crucial to ensuring efforts like those of CAPS are properly sustained and can achieve their full potential. These lessons are not only vital for Argentina but offer valuable insights for building fairer and more sustainable healthcare systems worldwide.

 

 

References

  1. Belló M, Becerril-Montekio VM. Sistema de salud de Argentina. Salud Pública de México. [online]. 2011;53(Suppl 2):S96–S109. [Accessed 6 November 2024]. Available from: https://www.scielosp.org/pdf/spm/2011.v53suppl2/s96-s109
  2. Ministerio de Salud de la República Argentina. Salud actualiza la situación epidemiológica de dengue y presenta los datos de cierre de la temporada 2023-2024. [online]. MSAL: Argentina; 2024 August. [Accessed 6 November 2024]. Available from: https://www.argentina.gob.ar/noticias/salud-actualiza-la-situacion-epidemiologica-de-dengue-y-presenta-los-datos-de-cierre-de-la
  3. Ministerio de Economía de la República de Argentina. Índice de precios al consumidor (IPC). Instituto Nacional de Estadística y Censos (INDEC). [online]. 2024;8(35):3. [Accessed 6 November 2024]. Available from: https://www.indec.gob.ar/uploads/informesdeprensa/ipc_11_246E0BFFA2AC.pdf
  4. Grimberg C. Inflation, recession force Argentines to eat less beef. [online]. Reuters: 2024 June. [Accessed 6 November 2024]. Available from: https://www.reuters.com/markets/commodities/meat-loving-argentines-eat-less-beef-inflation-bites-2024-06-22/
  5. Soria H, Corbalán J, Sigal L. Argentina poverty rate soars over 50% as Milei austerity bites. [online]. Reuters: 2024 September. [Accessed 6 November 2024]. Available from: https://www.reuters.com/world/americas/mileis-austerity-seen-pushing-half-argentina-into-poverty-2024-09-26/

 

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