Using Systems Dynamics for Capturing the Multicausality of Factors Affecting Health System Capacity in Latin America while Responding to the COVID-19 Pandemic

• Published in: International journal of environmental research and public health Vol. 18; no. 19; p. 10002
• Main Authors: Cordova-Pozo, Kathya Lorena, Korzilius, Hubert P. L. M., Rouwette, Etiënne A. J. A., Píriz, Gabriela, Herrera-Gutierrez, Rolando, Cordova-Pozo, Graciela, Orozco, Miguel
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 23.09.2021; MDPI
• Subjects: Coronaviruses; COVID-19; Disease transmission; Explicit knowledge; Impact analysis; Infections; Informal economy; Pandemics; Population; Public administration; Restrictions; Severe acute respiratory syndrome coronavirus 2; Social factors; Statistical analysis; Nicaragua; Bolivia; Uruguay; Latin America
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph181910002

Similar interventions to stop the spread of COVID-19 led to different outcomes in Latin American countries. This study aimed to capture the multicausality of factors affecting HS-capacity that could help plan a more effective response, considering health as well as social aspects. A facilitated GMB was constructed by experts and validated with a survey from a wider population. Statistical analyses estimated the impact of the main factors to the HS-capacity and revealed the differences in its mechanisms. The results show a similar four-factor structure in all countries that includes public administration, preparedness, information, and collective self-efficacy. The factors are correlated and have mediating effects with HS-capacity; this is the base for differences among countries. HS-capacity has a strong relation with public administration in Bolivia, while in Nicaragua and Uruguay it is related through preparedness. Nicaragua lacks information as a mediation effect with HS-capacity whereas Bolivia and Uruguay have, respectively, small and large mediation effects with it. These outcomes increase the understanding of the pandemic based on country-specific context and can aid policymaking in low-and middle-income countries by including these factors in future pandemic response models.