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The COVID-19 pandemic led to declines in in-person consultations and substantial increases in telemedicine use in many countries. This paper investigates whether this pattern occurred in Colombia using data for people with particular health conditions prior to the pandemic (rheumatoid arthritis, hemophilia, chronic kidney disease, HIV, and cancer). The study shows that healthcare utilization by people in Colombia with these conditions dropped significantly during the first months of the pandemic relative to the average of the previous two years. However, by the end of 2020, the rate of healthcare utilization had almost reached pre-pandemic levels. While the number of services fell for people in both the contributive and subsidized scheme, the share of people who had any contacts with healthcare providers each month declined substantially for those in the subsidized scheme and by a statistically insignificant amount for those in the contributive scheme. Declines in utilization and contacts for in-person consultations were partially offset by the increased use of telemedicine services which accounted for almost one-fifth of healthcare contacts by December 2020. Of the main explanations for healthcare disruptions, the diversion of healthcare resources to treat COVID-19 patients does not seem to have been as significant as changes in social mobility and government lockdown policies. These findings have a variety of implications for public policy, including: the need to address the causes of healthcare utilization declines among individuals in the subsidized scheme; the importance of incorporating better social communication and adjustments to lockdown policies when planning for future health emergencies; the value of expanding telemedicine, not only during emergencies but also during normal times; and the potential benefits from improving the quality and availability of administrative data so that future research can contribute more effectively to policies that promote greater equity and effectiveness in Colombian healthcare services.

El cambio climático amenaza el bienestar de millones de personas en América Latina y el Caribe. Los eventos climáticos extremos y los desastres están aumentando en frecuencia e intensidad, lo que está afectando desproporcionadamente a los grupos más pobres y vulnerables en toda la región. Además, la degradación acelerada de los ecosistemas terrestres, marinos y costeros pone en peligro los medios de vida de millones de personas. Finalmente, las políticas de mitigación necesarias para contener el avance del cambio climático, como, por ejemplo, la eliminación de subsidios energéticos y la reconversión de industrias contaminantes, pueden afectar los niveles de ingreso y de consumo de los hogares. En este documento, se analizan las principales contribuciones que los sistemas de protección social pueden tener en la agenda climática, y las principales brechas y desafíos que deberán superar para responder adecuadamente a estas nuevas amenazas.

This study describes the perception, adoption, and acceptance factors involved in the deployment of digital technologies for public health in Latin America and considers the implications for future digital health interventions. We conducted a descriptive analysis using nationally representative data from a phone survey conducted in 2020 in 10 countries in Latin America. We found that early in the pandemic, in countries with existing applications, 74% of the population used a smartphone, 47% had knowledge of the government app to report symptoms, but only 2% reported using it. Those interviewed reported that they are willing to share their personal data during a pandemic (61%) 50 percentage points higher than in non-pandemic times, although understanding how their personal data was used by the government and private companies was extremely low. More than 70% reported that they would use an application to report symptoms and would use an app that accesses their location or that uses contact tracing technology to alert them about possible exposure. Also, at least half of the users agree with preventive measures against COVID-19 such as daily follow-up calls, tracking via GPS for quarantine enforcement, and daily visits. In all countries, adoption of digital technologies increases if individuals or their relatives report they are infected; it decreases when end-users do not trust the anonymity policies or are concerned about government surveillance. Yet, encouraging greater adoption of digital technologies strongly depends on who designed the technology. Results show that 73% of users would prefer an app designed by an international organization such as the WHO to an app designed by the local government (64%) or a telephone company (56%). The study concludes with a reflection on the promising results of digital technologies and discusses the importance of considering users perceptions, factors for acceptance, and trust when pursuing adoption of digital technologies.

This dataset contains the data and figures associated with the publication “Aging in Latin America and the Caribbean: Social Protection and Quality of Life of Older Person”.

Esta nota resume la evidencia sobre el impacto directo e indirecto del COVID-19 en los niños menores de 18 años. En primer lugar, se proveen cifras actualizadas para América Latina y el Caribe sobre la tasa de contagio y su severidad en esta población. Luego, se muestran las tasas de vacunación pediátrica actuales, así cómo y con qué vacunas se recomienda vacunar. Por último, se analiza el impacto de la pandemia en la salud, desarrollo físico, mental, socioemocional y el aprendizaje. A nivel global, el contagio en niños y adolescentes ha sido menor que en adultos, incluso para las nuevas variantes más transmisibles del virus. Lo mismo ha ocurrido con las tasas de morbilidad, incluso de largo plazo, hospitalización y mortalidad. Si bien la evidencia a la fecha no es concluyente en torno al rol de niños y adolescentes como vectores de transmisión, existe cada vez mayor consenso sobre la eficacia de las vacunas limitar su sintomatología, con niveles de efectividad similares a los de los adultos. La vacunación pediátrica recién se lanza en algunos países de la región, pero otros ya han vacunado una buena proporción de esta población. Esto tiene implicancias importantes para la operación de centros de desarrollo infantil, prescolares y escuelas. Su cierre fue una de las primeras medidas de control que muchos países tomaron para evitar la propagación del virus. En buena parte de la región, estos cierres han sido los más largos del planeta. La evidencia compilada sugiere que estos cierres prolongados no han sido una medida particularmente eficaz para controlar la transmisión del virus. Esto, combinado con sus nefastos impactos en el desarrollo, el aprendizaje y la salud socioemocional de los niños urgen a la pronta remediación de las pérdidas de aprendizaje y de salud mental.

In this report, we analyze older persons quality of life in Latin America and the Caribbean, its relationship with social protection policies, and how these policies must adapt to respond to population aging. We create a measure of quality of life of older persons which combines healthy life expectancy and income security. For the purposes of this report, we define older persons social protection as the combination of pensions, healthcare, and long-term care. These policies have a direct relationship with older persons quality of life. Pensions reduce old-age poverty. Healthcare improves older persons health status and reduces the risk of poverty due to catastrophic medical expenses. Long-term care improves the wellbeing of care dependent persons and their family caregivers. These positive impacts of older persons social protection are documented in a wide body of literature. For each type of policy, we assess the level of coverage, the quality of the benefits they provide, as well as their current and future sustainability, both from a fiscal and from a social perspective.

This technical note describes how the COVID-19 pandemic has affected Latin America and the Caribbean, and analyzes the implications for the health of the population, health spending, and reforms and investments in health services, in order to to understand how we should prepare for future health emergencies. This note summarizes the few empirical studies and analyzes administrative data from hospitals and civil registration systems in four countries. The results show substantial declines in health and health care provision during the first year of the pandemic, particularly in preventive and elective care. Furthermore, while some countries in 2021 returned to pre-pandemic care levels, others still remain below average. This study concludes with lessons learned on how the pandemic has altered health policy recommendations for the region, generating a greater sense of urgency to move forward with permanent long-term agendas such as eliminating fragmentation, integrating care, and seeking digital transformation while Priorities are reordered towards investments in emergency preparedness, health surveillance, resilience, and self-sufficiency. In other words, go beyond the normal.

Las pruebas y el rastreo de contactos son la columna vertebral de una respuesta eficaz del sistema de salud ante una epidemia. Sin embargo, en el caso del COVID-19, aunque la comunidad científica desarrolló pruebas de diagnóstico tan pronto se reconoció la amenaza pandémica, su producción se retrasó y la mayoría de los países no implementaron pruebas en cantidades suficientes o dentro de una estrategia nacional coherente. El objetivo del presente documento es identificar las estrategias exitosas en el uso de pruebas y el rastreo de contactos para informar a las políticas que puedan implementar los países de América Latina y el Caribe para desacelerar y controlar la pandemia. Se dan énfasis en las políticas de menor costo y las que toman en cuenta restricciones de recursos o en la oferta de insumos diagnósticos.