Comparative health governance in Latin America: the case of national
policy decisions during pandemic response in five countries
Abstract
Context: Little is known about pandemic response in Latin
America. The aim of this study was to compare key COVID-19 response
measures taken by five Latin American countries to understand what
elements of public governance are needed for more effective policy
strategies, and to inform future pandemic preparedness.
Methods: Using a qualitative, iterative approach guided by a
governance framework, we analyzed the most salient characteristics of
each country’s response (restriction, sanitary, and social protection
measures). Findings: A focus on transparency and inclusion,
together with attention to the primary level of care, appeared to be
more prominent in countries with less Covid-19 incidence and mortality
such as Argentina and Costa Rica. In contrast, Brazil, Chile, and
Ecuador, with more fragmented and segmented health systems, coupled with
less transparency and participatory decision making, were more severely
impacted. Conclusions: Pandemic preparedness may benefit from
emphasizing organizational, institutional, and informational elements of
governance. Since data is essential to decision making in an evolving
pandemic, the flow of information interacts with different elements of
governance; therefore, more attention should be placed on the relation
of the informational dimension with the organizational and institutional
dimensions.