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

Kathya Lorena Cordova-Pozo, Hubert P. L. M. Korzilius, Etiënne A. J. A. Rouwette, Gabriela Píriz, Rolando Herrera-Gutierrez, Graciela Cordova-Pozo and Miguel Orozco
Additional contact information
Kathya Lorena Cordova-Pozo: Institute for Management Research, Radboud University, P.O. Box 9108, 6500 HK Nijmegen, The Netherlands
Hubert P. L. M. Korzilius: Institute for Management Research, Radboud University, P.O. Box 9108, 6500 HK Nijmegen, The Netherlands
Etiënne A. J. A. Rouwette: Institute for Management Research, Radboud University, P.O. Box 9108, 6500 HK Nijmegen, The Netherlands
Gabriela Píriz: Dirección Técnica de Servicio Médico Integral, Luis Alberto de Herrera 2275, Montevideo 11600, Uruguay
Rolando Herrera-Gutierrez: Centro Integral de Medicina Familiar CIMFA, Caja Nacional de Salud, Villa Galindo, Calle La Merced s/n., Cochabamba, Bolivia
Graciela Cordova-Pozo: Unit of anaesthesiology, Hospital Seton Caja Petrolera de Salud, Km 5 Av. Blanco Galindo, Cochabamba, Bolivia
Miguel Orozco: Freelance Consultant in Health and Development, Managua, Nicaragua

IJERPH, 2021, vol. 18, issue 19, 1-19

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.

Keywords: group model building; system dynamics; COVID-19; Latin America; multicausality; exploratory factor analysis; mediating effects (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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