Using Systems Dynamics for Capturing the Multicausality of Factors Affecting Health System Capacity in Latin America while Responding to the COVID-19 Pandemic.

Similar interventions to stop the spread of COVID-19 led to different outcomes in Latin American countries. This study aimed to capture the multicausality of factors affecting HS-capacity that could help plan a more effective response, considering health as well as social aspects. A facilitated GMB was constructed by experts and validated with a survey from a wider population. Statistical analyses estimated the impact of the main factors to the HS-capacity and revealed the differences in its mechanisms. The results show a similar four-factor structure in all countries that includes public administration, preparedness, information, and collective self-efficacy. The factors are correlated and have mediating effects with HS-capacity; this is the base for differences among countries. HS-capacity has a strong relation with public administration in Bolivia, while in Nicaragua and Uruguay it is related through preparedness. Nicaragua lacks information as a mediation effect with HS-capacity whereas Bolivia and Uruguay have, respectively, small and large mediation effects with it. These outcomes increase the understanding of the pandemic based on country-specific context and can aid policymaking in low-and middle-income countries by including these factors in future pandemic response models.

Violencia en la pareja, las caras del fenómeno / Intimate partner violence, the faces of the phenomenon

Este trabajo pretende mostrar las diversas caras o facetas del fenómeno de la violencia en la pareja, el mismo que en la literatura es conocido como violencia conyugal, violencia doméstica, violencia por parte del companero íntimo, etc. Se identifica como un problema de salud pública debido a los altos costos que genera y la manera como lesiona la vida cotidiana de quienes lo padecen. Se manifiesta en el seno de las relaciones de pareja e irradia hacia los diversos âmbitos de interacción de los actores, llámese mujer, varón, nino, nina. Involucra a todo el grupo o los grupos familiares de quienes lo viven, y puede lesionar de forma severa a los mismos. Se revisan aspectos del fenómeno como el hecho de que no sólo se presenta en las relaciones en las que la pareja tenga una unión de hecho, sino también en parejas de novios. No solo afecta a las mujeres o a las ninas; también afecta a los hombres. Tampoco es exclusivo de las parejas heterosexuales; los estudios muestran que entre parejas del mismo sexo también está presente. Se trata entonces de un fenómeno universal, multicausal, multidimensional, de salud y de tipo legal, que genera consecuencias que incluyen desde un problema de autoestima, de ansiedad, de depresión, de estrés hasta la muerte misma.

This paper aims to show the various faces or facets of the phenomenon of violence in couples, this is known in the literature, such as conjugal violence, domestic violence, or intimate partner violence. Is identified as a public health problem given the high costs and how it hurts daily life of sufferers. It manifests itself within intimate relationships and radiates to the various fields of interaction among actors, be it woman, man, boy, girl. This phenomenon affects not only the individual but also the whole group or family groups of the couple, severely injuring them. We review aspects of the phenomenon such as the fact that it not only occurs in relationships where the couple has a legal union, but also in dating couples. It Is not directed to women or girls, since men are also victims of violence in couples. Besides is not exclusive of heterosexual couples, studies show that is also present samesex couples. Intimate partner violence is a universal, multicausal, multidimensional, health and legal phenomenon, which generate consequences that can range from a low self-esteem, anxiety problems, depression, and stress to even death.