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Gobernación del Magdalena reduce $329 millones del Fondo Departamental de Salud
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La Gobernación del Magdalena expidió el Decreto 204, mediante el cual se reducen $329.020.918 del Fondo Departamental de Salud. La modificación presupuestal se produce en un momento donde el departamento enfrenta desafíos significativos en cobertura, mortalidad materna y atención primaria, según indicadores oficiales.
Decreto 204 de 2025: ajuste presupuestal en salud
El Decreto No. 204 de 2025, publicado hoy por la Gobernación del Magdalena, autoriza una modificación del presupuesto general vigente, dentro de la cual se reduce un total de $329.020.918 del Fondo Departamental de Salud. La partida afectada corresponde a recursos de inversión para aseguramiento, con cargo a la Secretaría Seccional de Salud.
El documento no especifica las razones técnicas que motivan la reducción ni las áreas operativas directamente impactadas. Sin embargo, puede consultarse públicamente en el sitio oficial de la Gobernación.
Contexto sanitario del Magdalena en 2024–2025
De acuerdo con cifras del Ministerio de Salud y el Instituto Nacional de Salud, el departamento del Magdalena presenta indicadores de salud que reflejan necesidades estructurales de inversión y fortalecimiento institucional.
Mortalidad materna
Según el boletín técnico del Instituto Nacional de Salud, la razón de mortalidad materna en Magdalena en 2024 fue de 45 por cada 100.000 nacidos vivos, superando la media nacional. Esta cifra representa eventos mayoritariamente prevenibles, asociados a dificultades en el acceso a servicios obstétricos, control prenatal y atención oportuna en zonas rurales.
Cobertura de aseguramiento
La cobertura en salud en el Magdalena, medida por afiliación efectiva al régimen contributivo y subsidiado, fue del 88% al cierre del tercer trimestre de 2024, frente a un promedio nacional de 93%. Esto implica una brecha poblacional no asegurada de más de 130.000 personas.
Mortalidad en menores de cinco años
Así mismo, en 2024, la tasa de mortalidad en menores de cinco años por Infección Respiratoria Aguda (IRA), Enfermedad Diarreica Aguda (EDA) y Desnutrición Aguda (DNT) fue de 12,8 por cada 100.000 niños menores de cinco años. Estas causas se consideran altamente prevenibles mediante atención primaria, programas de nutrición y vacunación oportuna.
¿Qué función cumple el Fondo Departamental de Salud?
El Fondo Departamental de Salud es un instrumento presupuestal que permite a los departamentos ejecutar recursos propios y cofinanciados para:
- Aseguramiento de población no afiliada o en transición.
- Ejecución de acciones de salud pública no cubiertas por el Plan de Intervenciones Colectivas.
- Transferencias a hospitales públicos de baja complejidad.
- Implementación de planes de acción ante brotes epidémicos y emergencias sanitarias.
Reducciones en este fondo pueden limitar la capacidad del ente territorial para cumplir con compromisos en salud pública, especialmente en programas que requieren sostenibilidad operativa como vacunación extramural, vigilancia epidemiológica o transporte asistencial.
Marco normativo
Desde el punto de vista legal, los departamentos pueden modificar su presupuesto mediante decreto, conforme al Estatuto Orgánico de Presupuesto y a lo aprobado por las Asambleas Departamentales. Sin embargo, los principios de progresividad y no regresividad del derecho a la salud, definidos por la Ley 1751 de 2015, requieren que cualquier ajuste en el gasto público en salud esté sustentado técnicamente, y que no implique deterioro en el acceso a servicios esenciales.
Asimismo, la Sentencia T-760 de 2008 de la Corte Constitucional reitera que el Estado, en todos sus niveles, tiene el deber de garantizar disponibilidad y calidad en los servicios de salud, sin retrocesos.
Importancia del seguimiento y transparencia
A la fecha, la Gobernación del Magdalena no ha emitido un comunicado técnico ni una evaluación de impacto de la medida presupuestal adoptada. En ese sentido, resulta clave que las autoridades departamentales:
- Expliquen técnicamente los criterios que sustentaron la reducción.
- Detallen cómo se protegerán los programas esenciales en salud pública.
- Publiquen un seguimiento del gasto ejecutado y su impacto sanitario.
La transparencia en la gestión presupuestal permite identificar riesgos anticipados, corregir desviaciones y garantizar continuidad en los servicios que afectan directamente a la población.
¿Qué implicaciones tiene recortar recursos en medio de brechas sanitarias persistentes?
La reducción de $329 millones en el presupuesto del Fondo Departamental de Salud del Magdalena, aunque legalmente autorizada, debe ser monitoreada con atención por los actores del sistema de salud, las autoridades de control y las veedurías ciudadanas. El contexto sanitario del departamento evidencia la necesidad de inversiones estables, particularmente en aseguramiento, atención materna, y salud infantil.
El seguimiento a este tipo de decisiones permitirá fortalecer la planeación financiera territorial y garantizar que los recursos disponibles sean utilizados eficientemente para mejorar los resultados en salud pública.
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