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One managerial narrative describes COVID-19 as a trigger for innovation in health system planning and delivery. Analysing 33 interviews with national stakeholders in Colombia´s health system, this paper argues that an 'innovation' narrative provides a partial account of managerial responses to COVID-19. COVID-19 triggered positive and negative effects on adaptive resilience: as mirror for recognizing problems predating the pandemic; as accelerator of service changes; as source of solidarity among professional groups; as workforce trauma; and as disruptor of adjacent improvement activity. The paper concludes that multi-level effects of adaptive resilience, and costs of its practice, need to be recognized. [ABSTRACT FROM AUTHOR]

Researchers and practitioners recognise the importance of context when implementing healthcare interventions, but the influence of wider environment is rarely mapped. This paper identifies the country and policy-related factors potentially explaining the country differences in outcomes of an intervention focused on improving detection and management of heavy alcohol use in primary care in Colombia, Mexico and Peru. Qualitative data obtained through interviews, logbooks and document analysis are used to explain quantitative data on number of alcohol screenings and screening providers in each of the countries. Existing alcohol screening standards in Mexico, and policy prioritisation of primary care and consideration of alcohol as a public health issue in Colombia and Mexico positively contributed to the outcome, while the COVID-19 pandemic had a negative impact. In Peru, the context was unsupportive due to a combination of: political instability amongst regional health authorities; lack of focus on strengthening primary care due to the expansion of community mental health centres; alcohol considered as an addiction rather than a public health issue; and the impact of COVID-19 on healthcare. We found that wider environment-related factors interacted with the intervention implemented and can help explain country differences in outcomes. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to identify and analyze how prison systems in Argentina, Chile, Colombia, and Mexico respond to the coronavirus disease (COVID-19). It explores the challenges these institutions face, the actions taken, the beneficiaries from such measures, and their immediate effect. We argue that governments and prison authorities struggle to put in place comprehensive measures to prevent and control the spread of COVID-19 within these institutions and that more concrete and swift actions are needed to address the magnitude and the consequences of the pandemic. This paper uses both primary and secondary data to describe the current prison situation and analyze institutional responses to the COVID-19 pandemic in these countries. [ABSTRACT FROM AUTHOR]

This paper describes some indicators of the Colombian educational system considering the effect of the pandemic and assesses the causal effect of an alternation plan between face-to-face and remote education, conducted in 2020, on the results of an achievement test. Indicators reveal that the pandemic caused a greater demand for education services in public schools, increased dropout, and repetition rates, and widened the gaps in academic performance. The causal empirical exercise indicates that the students who participated in the experiment obtained, on average, better results in the achievement test compared to students who remained in the non-face-to-face scheme. [ABSTRACT FROM AUTHOR]

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This study attempted to identify the overall impact of COVID-19 on the restaurant industry in Colombia through the interviews with ten restaurant owners or chefs (e.g., fine-dining, family-dining, casual dining, and quick-service restaurants). Adopting the three phase post-pandemic planning framework, this study examined how the restaurants responded, recovered, and renewed their businesses and what survival strategies they have been implementing to respond to the new normal after the COVID-19 outbreaks. Findings of the study indicated the restaurants in Colombia focused on and developed four operational survival strategies: operational transformation and challenges, government support, social responsibility, and precautionary measurement practices, focusing on their core value and assets such as employees and menus. [ABSTRACT FROM AUTHOR]

Political leaders rely on narratives to make sense of crises, but the extent to which such narratives are used to (de)mobilize scientific evidence in policy responses has not been fully explored. Based on the analysis of public messages and communications of the presidents of Brazil, Colombia, and Mexico, we discuss how they have narratively approached the Covid-19 crisis, particularly with respect to the degree of their reliance on scientific expertise. Building on debates on policy narratives, crisis management, and evidence-based policymaking, we argue that the narratives presidents devised had significant (and mostly negative) effects on the design of policy responses. Their narratives sidelined (Bolsonaro), leveraged (Duque), or limited (López-Obrador) the role of scientific expertise in policy responses. Thus, in contrast to previous literature, these narratives aligned more with the president's agendas and personal biases, than with the need to explain the crisis for their societies or to design appropriate policies. [ABSTRACT FROM AUTHOR]

COVID-19 vaccination is a global priority. Latin American countries have some of the highest COVID-19 death rates worldwide with vaccination hampered by a variety of reasons, including mis- and disinformation, vaccine hesitancy, and vaccine supply constraints. Addressing vaccine hesitancy through effective messages has been found to help increase vaccine uptake. Participatory processes could be used to co-design health messages for this purpose. This article describes the methodology used to co-design evidence-based audio messages to be deployed in a cohort of individuals through an interactive voice response (IVR) mobile phone survey intervention, aimed towards increasing vaccination uptake in an adult population in Colombia. Participants of the COVID-19 vaccination message co-design process included a sample of the general population of the country, representatives of the funder organisation, and research team members. The co-design process consisted of four phases: (1) formative quantitative and qualitative research, (2) message drafting based on the results of the formative research, (3) message content evaluation, and (4) evaluation of the voices to deliver the audio messages; and was informed by reflexive meetings. Three categories of evidence-based audio messages were co-designed, each corresponding to an arm of the mHealth intervention: (1) factual messages, (2) narrative messages, and (3) mixed messages. An additional fourth arm with no message was proposed for control. The iterative co-design process ended with a total of 14 audio messages recorded to be deployed via the intervention. Co-developing health messages in response to health emergencies is possible. Adopting more context-relevant, participatory, people-centred, and reflexive multidisciplinary approaches could help develop solutions that are more responsive to the needs of populations and public health priorities. Investing resources in message co-design is deemed to have a greater potential for influencing behaviours and improving health outcomes. [ABSTRACT FROM AUTHOR]

The study aimed to adapt and explore the psychometric performance of the Fear of COVID-19 Scale (FCV-19S) in the general Colombian population. The original FCV-19S is a 7-item scale that underwent an adaptation (Item 1 and 5 were deleted). From an online sample of 1,687 adults (59% female), exploratory and confirmatory factor analyses were performed for versions of the scale with 6 and 5 items. Cronbach's alpha and McDonald's omega were calculated. The confirmatory factor analysis showed that the 5-item scale (Fear of COVID-5) presented better indicators. In conclusion, the Fear of COVID-5 has acceptable performance in the Colombian population. [ABSTRACT FROM AUTHOR]

The SARS-Cov-2 infection has multiple neurologic manifestations including encephalitis in multiple cases reported, however the psychosis as principal manifestation of this condition is infrequently. We report the case of a 48-year-old woman with a confirmed diagnosis of SARS-CoV-2 who developed paranoid and self-referential ideas with behavioural alteration and multiple findings on mental examination. Encephalitis associated with Covid-19 was suspected due to the neurological clinical presentation (persistent despite resolve hypoxaemia and systemic symptoms) and brain magnetic resonance image (MRI) that showed asymmetric hippocampal hyperintensities, although cerebrospinal fluid and electroencephalogram (EEG) were normal. The patient received medical treatment with methylprednisolone for 5 days with complete resolution of her symptoms. The current SARS-CoV-2 pandemic has neurological complications either by direct involvement or by para-infectious or post-infectious phenomena. Encephalitis occurs in a small proportion of the cases, while psychiatric symptoms have been described in a variable percentage of the events. However, a psychotic picture such as the one reported in our case is unusual. MRI, cerebrospinal fluid and EEG are important for the diagnostic evaluation of these patients but not obligatory to the diagnosis. The treatment of this condition with corticosteroids has been successful even in cases associated with Anti-NMDA. Our case is the second reported in Colombia, the first to be associated with psychosis. [ABSTRACT FROM AUTHOR]

Colombia provides a unique setting to understand the complicated interaction between health systems, health insurance, migrant populations, and COVID-19 due to its system of Universal Health Coverage and its hosting of the second-largest population of displaced persons globally, including approximately 1.8 million Venezuelan migrants. We surveyed 8,130 Venezuelan migrants and Colombian nationals across 60 municipalities using a telephone survey during the first wave of the pandemic (September through November 2020). Using self-reported enrollment in one of the several Colombian health insurance schemes, we analyzed the access to and disparities in the use of health-care services for both Colombians and Venezuelan migrants by insurance status, including access to formal health services, virtual visits, and COVID-19 testing for both groups. We found that compared with 3.6% of Colombians, 73.6% of Venezuelan telephone survey respondents remain uninsured, despite existing policies that allow legally present migrants to enroll in national health insurance schemes. Enrolling migrants in either the subsidized or contributory regime increases their access to health-care services, and equality between Colombians and Venezuelans within the same insurance schemes can be achieved for some services. Colombia's experience integrating Venezuelan migrants into their current health system through various insurance schemes during the first wave of their COVID-19 pandemic shows that access and equality can be achieved, although there continue to be challenges. [ABSTRACT FROM AUTHOR]

To identify potential protective mechanisms that might buffer the effects of the COVID-19 pandemic on well-being, the current set of studies (NStudy 1 = 1172, NStudy 2 = 451) examined the roles of hope and religious coping (positive and negative) in promoting well-being during periods when stringent stay-at-home orders were implemented in Colombia and South Africa to control the spread of SARS-CoV-2. After controlling for relevant sociodemographic characteristics (Studies 1 and 2), subjective health complaints, and sleep quality (Study 2), hope was positively associated with well-being and the relation between hope and well-being was moderated by religious coping. Whilst well-being was highest when levels of hope were high (irrespective of positive or negative religious coping levels), when reported hope was low, well-being tended to be higher when positive religious coping was high (Study 1) and negative religious coping was low (Study 2). Implications of the findings for maintaining well-being during a public health crisis are discussed. [ABSTRACT FROM AUTHOR]