Strengthening Health Systems To Face Pandemics: Subnational Policy Responses To COVID-19 In Latin America

Felicia Marie Knaul, Michael M. Touchton, Hector Arreola-Ornelas, Renzo Calderon-Anyosa, Silvia Otero-Bahamón, Calla Hummel, Pedro Pérez-Cruz, Thalia Porteny, Fausto Patino, Rifat Atun, Patricia J. Garcia, Jorge Insua, Oscar Mendez, Eduardo Undurraga, Carew Boulding, Jami Nelson-Nuñez, V. Ximena Velasco Guachalla, Mariano Sanchez-Talanquer

Research output: Contribution to journalArticlepeer-review

Abstract

Nonpharmaceutical interventions such as stay-at-home orders continue to be the main policy response to the COVID-19 pandemic in countries with limited or slow vaccine rollout. Often, nonpharmaceutical interventions are managed or implemented at the subnational level, yet little information exists on within-country variation in nonpharmaceutical intervention policies. We focused on Latin America, a COVID-19 epicenter, and collected and analyzed daily subnational data on public health measures in Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Mexico, and Peru to compare within- and across-country nonpharmaceutical interventions. We showed high heterogeneity in the adoption of these interventions at the subnational level in Brazil and Mexico; consistent national guidelines with subnational heterogeneity in Argentina and Colombia; and homogeneous policies guided by centralized national policies in Bolivia, Chile, and Peru. Our results point to the role of subnational policies and governments in responding to health crises. We found that subnational responses cannot replace coordinated national policy. Our findings imply that governments should focus on evidence-based national policies while coordinating with subnational governments to tailor local responses to changing local conditions.

Original languageEnglish (US)
Pages (from-to)454-462
Number of pages9
JournalHealth Affairs
Volume41
Issue number3
DOIs
StatePublished - Mar 1 2022

ASJC Scopus subject areas

  • Medicine(all)

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