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

Abstract

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.

Using group model building to frame the commercial determinants of dietary behaviour in adolescence – proposed methods for online system mapping workshops

“…Therefore, we believe that our methodological evaluation supports our study’s findings. However, we recognise that validation methods for GMB models, such as meditation analysis, structural-equation-modelling, exploratory factor analysis could help quantitatively test the relationships among the elements and underlying factors, and account for their non-linear relationships in the model and produce more robust models to support policymaking efforts [ 15 ].…”

“…Conducting GMB workshops online may have several advantages, such as reduced costs and time required to run the workshops, inclusion of a broader range of stakeholders regardless of their physical location and breaking down GMB activities into several short online sessions rather than whole day workshops, which would allow for reflective processes between sessions. Despite the aforementioned advantages, we only found two examples of fully online GMB workshops in the literature [ 14 , 15 ], which were held online due to COVID-19 restrictions.…”