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Gobernanza en crisis: un análisis de métodos mixtos de la gobernanza de la salud mundial durante el COVID-19
Kadria Ali Abdel-Motaal1, Sungsoo Chun1
1Institute of Global Health and Human Ecology, American University, New Cairo 11835, Egypt.
Resumen
La gobernanza sólida mejoró significativamente los resultados de COVID-19, incluidas las intervenciones anteriores y una mejor equidad de vacunas, independientemente de la riqueza de una nación. Esto pone de relieve el papel fundamental del desempeño efectivo del gobierno en la seguridad de la salud mundial.
Área de la Ciencia:
- Gobernanza de la salud mundial
- Política de salud pública
- Impacto socioeconómico de las pandemias
Sus antecedentes:
- La pandemia de COVID-19 reveló importantes debilidades e inequidades en la gobernanza de la salud mundial.
- Los recursos económicos influyeron en la respuesta a la pandemia, pero el papel del desempeño de la gobernanza fue sub-examinado.
- La investigación existente a menudo utiliza el rastreador de respuesta del gobierno de Oxford COVID-19 (OxCGRT), pero carece de integración con las métricas de gobierno.
Objetivo del estudio:
- Evaluar cómo la calidad de la gobernanza, independientemente de los ingresos, afectó la respuesta y los resultados de la pandemia nacional.
- Integrar las métricas de gobernanza con los datos de respuesta a la pandemia para un análisis exhaustivo.
- Evaluar el efecto conjunto de las intervenciones políticas y el desempeño de la gobernanza en los resultados sanitarios y la equidad de las vacunas.
Principales métodos:
- Enfoque de métodos mixtos que combina conjuntos de datos globales cuantitativos y revisión cualitativa de la literatura.
- Utilizó el rastreador de respuesta del gobierno de Oxford COVID-19 (OxCGRT), los indicadores de gobierno mundial (WGI) y los datos del Banco Mundial / OMS.
- Construyó un índice de rendimiento de la gobernanza utilizando la eficacia del gobierno y la calidad de la regulación; empleó ANOVA, Kaplan Meier y regresión OLS.
Principales resultados:
- El alto rendimiento de la gobernanza se correlacionó con las intervenciones anteriores, una menor mortalidad y una mayor cobertura de vacunas, independientemente de los ingresos.
- El análisis de Kaplan Meier mostró que los cierres de escuelas eran significativamente más rápidos en los países de alta gobernanza (p < 0,01).
- La regresión multivariable confirmó la gobernanza como un predictor significativo, incluso después de controlar el ingreso y el gasto en salud.
Conclusiones:
- El desempeño de la gobernanza fue un factor decisivo en los resultados de la pandemia.
- La crisis de COVID-19 subraya la necesidad de sistemas de gobernanza sólidos para gestionar emergencias complejas.
- La gobernanza efectiva es crucial para la resiliencia institucional, económica y social más allá del sector de la salud.
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