Salud en las Américas

Visión prospectiva de la salud

Woman being examined by nurse

La Región tiene como imperativo construir sistemas de salud resilientes y sostenibles para asegurar la salud universal y como herramienta para hacer frente a actuales y futuras emergencias de salud pública. Es necesario fortalecer la gobernanza en el ámbito de la salud para que los países formulen políticas encaminadas a promover la salud y el bienestar, reducir las inequidades en torno a la salud y alcanzar el ODS 3. Esta publicación muestra que, si bien la mayoría de los países de la Región buscaron una respuesta integral a la pandemia, uno de los desafíos más importantes fue coordinar esa respuesta en un contexto de alta fragmentación estatal y de falta de recursos críticos del sistema de salud. Dicha coordinación dependió de las capacidades políticas e institucionales de las autoridades de salud para dirigir un ejercicio eficaz de las funciones esenciales de la salud pública.

Es necesario promover estrategias prosociales que favorezcan acciones encaminadas a ayudar a las personas y las comunidades, durante la actual pandemia y en las futuras, desde un enfoque de salud mental y física, con el fin de abordar los efectos negativos en la salud mental. Es importante que durante las fases de preparación y respuesta a cualquier evento que amenace la salud, la salud mental forme parte de los planes como uno de los pilares fundamentales que contribuya a salvar vidas y a salvaguardar la salud mental de las personas, haciendo hincapié en los grupos en situación de vulnerabilidad.

La rectoría de las autoridades de salud es una dimensión política e institucional fundamental de una agenda intersectorial para promover sistemas de salud resilientes. La pandemia ha evidenciado que es prioritario que los países dispongan de sistemas de salud con capacidad para reaccionar a futuras emergencias sanitarias, pero también la urgencia de reforzar la respuesta a las condiciones de salud prevalentes. Para hacer frente a nuevas emergencias, los países deben contar con planes actualizados, y mantener operativas las medidas de respuesta para contención y mitigación. Progresar en la Agenda 2030 (3) y retomar el camino hacia el logro de los ODS para "[g]arantizar una vida sana y promover el bienestar para todos en todas las edades" implica avanzar hacia la salud universal.

Uno de los resultados positivos de liderazgo y gobernanza en la Región ha sido la cooperación entre países de las Américas —incluidas experiencias de cooperación horizontal en América Latina y el Caribe— para tener un acceso más equitativo a tecnologías sanitarias como vacunas, equipos médicos, EPP y terapias contra la COVID-19, así como la cooperación desde Canadá y Estados Unidos y para acelerar el acceso a vacunas y otras tecnologías. Se requiere contar con mecanismos multidimensionales de coordinación intersectorial que considere las diferentes condiciones sociales para alcanzar una respuesta de salud efectiva, desde una perspectiva de toda la sociedad y el Estado.

En la Región de las Américas —como en el mundo— las personas en situación de vulnerabilidad han concentrado una mayor carga de la pandemia. Los países necesitan explicitar estrategias de acción para reducir de forma significativa las brechas en salud. Se requieren políticas intersectoriales que promuevan una sinergia entre la salud, la economía, y las dimensiones social y ambiental bajo el concepto de equidad. Atender los determinantes sociales de la salud implica contar con sistemas de protección social universales, integrales y sostenibles para impulsar acciones de salud, más allá de lo asistencial y curativo.

Por otro lado, la pandemia ha revelado el papel central de las comunidades y sus organizaciones sociales, que fueron esenciales tanto para la implementación de la respuesta como para la adherencia a las recomendaciones. Su conocimientos y experiencias permitieron adecuar y adaptar las acciones a la realidad y contextos locales. Los sistemas de salud resilientes y sostenibles deben incorporar a comunidades y sus organizaciones en la formulación e implementación de policías de salud.

Es necesario promover la acción multisectorial desde el enfoque de “Una sola salud” para mejorar la prevención y preparación para la COVID-19 y los desafíos futuros en la interfaz entre los seres humanos, los animales y el medio ambiente. La complejidad del origen de la pandemia de COVID-19 ha evidenciado la necesidad de abordar la prevención de futuros patógenos emergentes, dado que más de 70% de estos agentes patógenos son zoonóticos. Para prepararse mejor ante una próxima epidemia de una enfermedad zoonótica emergente, se deben mejorar los sistemas de análisis de riesgos mediante la incorporación de datos de microorganismos, animales y cadenas de alimentos de origen animal, seres humanos y el medio ambiente.

En cuanto a la dimensión tecnológica, para fortalecer los sistemas de salud es necesario acelerar la transformación digital y fortalecer los sistemas de información para la salud. Durante la pandemia se han planteado retos para llevar a cabo un monitoreo oportuno, debido a la escasez de datos abiertos, de calidad y disponibles en tiempo real que permitan tomar decisiones. Los sistemas de información deben estar interconectados y en línea, ser interoperables y acordes con los estándares internacionales, y disponer de la desagregación necesaria para asegurar resultados con equidad y una toma de decisiones rápida y lo más fundamentada posible, con vistas a no dejar a nadie atrás. La agenda de transformación digital del sector de la salud implica contar con acciones de visión holística que considere los ocho principios rectores acordados por los Estados Miembros de la OPS (, ).

Es necesario robustecer los sistemas de vigilancia epidemiológica para controlar la pandemia actual y anticipar las futuras. Las herramientas de inteligencia epidemiológica deben proporcionar análisis en tiempo real para la toma de decisiones en los diferentes ámbitos (local, nacional, regional, mundial) de forma que sea posible orientar las acciones en lugares y momentos considerando la magnitud de la respuesta necesaria, y la identificación de los grupos de población en situación de mayor vulnerabilidad. Asimismo, el acceso a datos "no convencionales" y "no estructurados", como los de movilidad de la población, alfabetización digital, uso de dispositivos móviles o capacidad de ancho de banda para el uso de telecomunicaciones deben considerarse factores críticos para el éxito en la toma de decisiones informadas del sector de la salud. La creación de mecanismos como la Red Regional de Vigilancia Genómica de COVID-19 han contribuido no solo a la capacidad para la secuenciación del virus, sino a estimular a los países a poner en marcha la vigilancia genómica regular, como estrategia para incrementar la cantidad de datos disponibles a nivel mundial.

La Región debe enfocarse en el aumento de las capacidades regionales de desarrollo y producción de medicamentos y otras tecnologías sanitarias. La pandemia de COVID-19 creó situaciones de desabastecimiento e inequidades en el acceso a productos farmacéuticos, vacunas y otras tecnologías sanitarias esenciales que condicionaron las capacidades de respuesta de los sistemas de salud y limitaron o pusieron en riesgo la provisión de servicios de salud esenciales. El aumento de las capacidades regionales de desarrollo y producción de medicamentos y otras tecnologías sanitarias puede contribuir a mejorar el acceso a ellos y responder mejor a las prioridades y necesidades de salud de la Región, además de aportar a la protección de la seguridad nacional y a la recuperación económica en la Región.

Se deben fortalecer la gobernanza, los liderazgos, las condiciones y las capacidades de los recursos humanos en salud de la Región, que deben ser elementos clave en el fortalecimiento de los sistemas de salud. El fortalecimiento de los recursos humanos requiere de alianzas con actores clave, incluido el sector académico y el sector privado, entre otros. Se debe contemplar el desarrollo de políticas de formación, contratación, y retención del recurso humano para responder a los requerimientos de los sistemas nacionales con miras a alcanzar la salud universal.

La pandemia ha afectado drásticamente a la población mundial y de las Américas, con graves consecuencias económicas, sociales y de salud, y ha revelado una elevada desigualdad social, que se suma a las persistentes debilidades estructurales de los sistemas de salud en la Región. A pesar de esto, la Región ha sabido fortalecer las acciones de cooperación, basándose en la solidaridad y panamericanismo que la caracterizan. Se ha demostrado el valor de la inversión en la preparación para emergencias, el papel central de las comunidades y los procesos participativos, el eje articulador del trabajo intersectorial, los sistemas de información y en la capacidad de desarrollo de tecnologías sanitarias. La OPS continuará, de la mano de sus Estados Miembros, impulsando la salud universal y la equidad en la salud como elemento central para el desarrollo.

1. World Health Organization. WHO Coronavirus (COVID-19) Dashboard Geneva2021 [Available from: https://covid19.who.int/.

2. Pan American Health Organization. COVID-19: Dashboard Washington, D.C.: PAHO; 2022 [Available from: https://shiny.pahobra.org/covid19/.

3. Castro MC, Gurzenda S, Turra CM, Kim S, Andrasfay T, Goldman N. Reduction in life expectancy in Brazil after COVID-19. Nat Med. 2021;27(9):1629-35.

4. García-Guerrero VM, Beltrán-Sánchez H. Heterogeneity in Excess Mortality and Its Impact on Loss of Life Expectancy due to COVID-19: Evidence from Mexico. Can Stud Popul. 2021:1-36.

5. Rosero-Bixby L, Jiménez-Fontana P. Crónica de la pandemia de Covid-19 en Costa Rica. San José: Programa Estado de la Nación (PEN). 2021.

6. International Monetary Fund. World Economic Outlook: Managing Divergent Recoveries. Washington, D.C.: IMF; 2021.

7. Comisión Económica para América Latina y el Caribe. Panorama Social de América Latina, 2020. Santiago; 2021.

8. Comisión Económica para América Latina y el Caribe-Organizacion Panamericana de la Salud. The prolongation of the health crisis and its impact on health, the economy and social development,. CEPAL-OPS; 2021.

9. Economic Commission for Latin America and the Caribbean/PanAmerican Health Organization. The prolongation of the health crisis and its impact on health, the economy and social development. Washington, D.C.: The Economic Commission for Latin America and the Caribbean (ECLAC) and the Pan American Health Organization (PAHO); 2021.

10. Vélez CM. COVID19 Vaccination in Latin America and the Caribbean: Challenges, needs and opportunities. Montevideo: United Nations Educational, Scientific and Cultural Organization; 2021.

11. Comisión Económica para América Latina y el Caribe. Estudio económico de América Latina y el Caribe. Santiago: CEPAL; 2021. Contract No.: Rev. 1.

12. International Labor Organization. Working from home: from Invisibility to Decent Work. Geneva: ILO; 2021.

13. Economic Commission for Latin America and the Caribbean. Balance Preliminar de las Economías de América Latina y el Caribe, 2021. Santiago: ECLAC; 2022.

14. Maurizio R. Transitando la crisis laboral por la pandemia: hacia una recuperación del empleo centrada en las personas. Organización Internacional del Trabajo; 2021.

15. Organisation for Economic Co-operation and Development. Informalidad e inclusión social en tiempos de Covid-19, Cumbre ministerial virtual sobre inclusión social en América Latina y el Caribe.: OECD; 2020.

16. Gibbons R, Waldman M. Enriching a Theory of Wage and Promotion Dynamics inside Firms. Journal of Labor Economics. 2006;24(1):59 - 107.

17. Vélez R, Gómez-Franco L. Movilidad social en México: hallazgos y pendientes,. Centro de Estudios Espinosa Yglesia, Mexico; 2018.

18. Llamosas I, Rangel E. Efectos del primer empleo sobre las perspectivas laborales de los trabajadores en las regiones de México. Un enfoque de movilidad social, México. 2019.

19. International Monetary Fund. Fiscal Monitor; A Fair Shot. Washington, D.C.: IMF; 2021.

20. Comisión Económica para América Latina y el Caribe. Una década de acción para un cambio de época. Quinto informe sobre el progreso y los desafíos regionales de la Agenda 2030 para el Desarrollo Sostenible en América Latina y el Caribe. Santiago: CEPAL; 2022.

21. Krubiner CB, Faden RR, Karron RA, Little MO, Lyerly AD, Abramson JS, et al. Pregnant women & vaccines against emerging epidemic threats: Ethics guidance for preparedness, research, and response. Vaccine. 2021;39(1):85-120.

22. Ellington S, Strid P, Tong VT, Woodworth K, Galang RR, Zambrano LD, et al. Characteristics of Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-June 7, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(25):769-75.

23. Zambrano LD, Ellington S, Strid P, Galang RR, Oduyebo T, Tong VT, et al. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-October 3, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(44):1641-7.

24. López-Rodríguez G, Galván M, Galván Valencia O. Comorbilidades asociadas a mortalidad materna por COVID-19 en México. Gaceta médica de México. 2021;157:618-22.

25. Villar J, Ariff S, Gunier RB, Thiruvengadam R, Rauch S, Kholin A, et al. Maternal and Neonatal Morbidity and Mortality Among Pregnant Women With and Without COVID-19 Infection: The INTERCOVID Multinational Cohort Study. JAMA Pediatrics. 2021;175(8):817-26.

26. United Nations. Policy Brief: The Impact of COVID-19 on children. New York: UN; 2020 15 April 2020.

27. Doran CM, Kinchin I. A review of the economic impact of mental illness. Australian Health Review. 2019;43(1):43-8.

28. Layard R. Mental health: the new frontier for labour economics. IZA Journal of Labor Policy. 2013;2(1):2.

29. Kola L, Kohrt BA, Hanlon C, Naslund JA, Sikander S, Balaji M, et al. COVID-19 mental health impact and responses in low-income and middle-income countries: reimagining global mental health. The Lancet Psychiatry. 2021;8(6):535-50.

30. Zielinsk C. Infodemics and infodemiology: a short history, a long future. Rev Panam Salud Publica. 2021;45(e40).

31. GBD 2019 Mental Disorders Collaborators. Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019. The Lancet Psychiatry. 2021;In press.

32. Pan American Health Organization. The burden of mental disorders in the region of the Americas, 2018. Washington, D.C.: PAHO; 2018.

33. Kohn R, Ali A, Puac-Polanco V, Figueroa C, López-Soto V, Morgan K, et al. Mental health in the Americas: an overview of the treatment gap. Rev Panam Salud Publica. 2018;42:e165.

34. Tausch A, e Souza RO, Viciana CM, Cayetano C, Barbosa J, Hennis AJM. Strengthening mental health responses to COVID-19 in the Americas: A health policy analysis and recommendations. The Lancet Regional Health - Americas. 2022;5:100118.

35. Mascayano F, Alvarado R, Martínez-Viciana C, Irarázaval M, Durand-Arias S, Freytes M, et al. 30 years from the Caracas Declaration: the situation of psychiatric hospitals in Latin America and the Caribbean prior, during and after the COVID-19 pandemic. Social Psychiatry and Psychiatric Epidemiology. 2021;56(8):1325-7.

36. Campion J, Javed A, Sartorius N, Marmot M. Addressing the public mental health challenge of COVID-19. The Lancet Psychiatry. 2020;7(8):657-9.

37. Kumar A, Nayar KR. COVID 19 and its mental health consequences. Journal of Mental Health. 2021;30(1):1-2.

38. Pfefferbaum B, North CS. Mental Health and the Covid-19 Pandemic. New England Journal of Medicine. 2020;383(6):510-2.

39. Vigo D, Patten S, Pajer K, Krausz M, Taylor S, Rush B, et al. Mental Health of Communities during the COVID-19 Pandemic. The Canadian Journal of Psychiatry. 2020;65(10):681-7.

40. Parlapani E, Holeva V, Nikopoulou VA, Sereslis K, Athanasiadou M, Godosidis A, et al. Intolerance of Uncertainty and Loneliness in Older Adults During the COVID-19 Pandemic. Frontiers in Psychiatry. 2020;11(842).

41. Scholten H, Quezada-Scholz VE, Salas G, Barria-Asenjo NA, Molina R, García JE, et al. Psychological Approach to COVID-19: A Narrative Review of the Latin American Experience. Revista Interamericana de Psicología/Interamerican Journal of Psychology. 2020;54(1):e1287.

42. Taylor S, Landry CA, Paluszek MM, Fergus TA, McKay D, Asmundson GJG. COVID stress syndrome: Concept, structure, and correlates. Depression and Anxiety. 2020;37(8):706-14.

43. Santomauro DF, Mantilla Herrera AM, Shadid J, Zheng P, Ashbaugh C, Pigott DM, et al. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. The Lancet. 2021;398(10312):1700-12.

44. Racine N, McArthur BA, Cooke JE, Eirich R, Zhu J, Madigan S. Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19: A Meta-analysis. JAMA Pediatrics. 2021;175(11):1142-50.

45. Hossain MM, Tasnim S, Sultana A, Faizah F, Mazumder H, Zou L, et al. Epidemiology of mental health problems in COVID-19: a review. F1000Res. 2020;9:636-.

46. Ma Z, Zhao J, Li Y, Chen D, Wang T, Zhang Z, et al. Mental health problems and correlates among 746 217 college students during the coronavirus disease 2019 outbreak in China. Epidemiol Psychiatr Sci. 2020;29:e181.

47. Wathelet M, Duhem S, Vaiva G, Baubet T, Habran E, Veerapa E, et al. Factors Associated With Mental Health Disorders Among University Students in France Confined During the COVID-19 Pandemic. JAMA Netw Open. 2020;3(10):e2025591.

48. O'Connor RC, Wetherall K, Cleare S, McClelland H, Melson AJ, Niedzwiedz CL, et al. Mental health and well-being during the COVID-19 pandemic: longitudinal analyses of adults in the UK COVID-19 Mental Health & Wellbeing study. The British Journal of Psychiatry. 2021;218(6):326-33.

49. Creswell C, Shum A, Pearcey S, Skripkauskaite S, Patalay P, Waite P. Young people's mental health during the COVID-19 pandemic. The Lancet Child & Adolescent Health. 2021;5(8):535-7.

50. Panchal U, Salazar de Pablo G, Franco M, Moreno C, Parellada M, Arango C, et al. The impact of COVID-19 lockdown on child and adolescent mental health: systematic review. European Child & Adolescent Psychiatry. 2021.

51. Näslund-Hadley E, Hernandez-Agramonte JM, Montaño K, Namen O, Alpizar G, Luna U, et al. Educación inicial remota y salud mental durante la pandemia COVID-19. Washington, D.C.: División de Educación, Sector Social, Banco Interamericano de Desarrollo; 2020.

52. UNICEF. La reapertura y continuidad de los servicios de cuidado infantil y aprendizaje temprano son una prioridad en la región 2021 [Available from: https://www.unicef.org/lac/media/22861/file.

53. Li Y, Wang A, Wu Y, Han N, Huang H. Impact of the COVID-19 Pandemic on the Mental Health of College Students: A Systematic Review and Meta-Analysis. Front Psychol. 2021;12:669119.

54. Panchal U, Salazar de Pablo G, Franco M, Moreno C, Parellada M, Arango C, et al. The impact of COVID-19 lockdown on child and adolescent mental health: systematic review. Eur Child Adolesc Psychiatry. 2021:1-27.

55. Jones EAK, Mitra AK, Bhuiyan AR. Impact of COVID-19 on Mental Health in Adolescents: A Systematic Review. Int J Environ Res Public Health. 2021;18(5).

56. Samji H, Wu J, Ladak A, Vossen C, Stewart E, Dove N, et al. Review: Mental health impacts of the COVID-19 pandemic on children and youth - a systematic review. Child Adolesc Ment Health. 2021.

57. National Scientific Council on the Developing Child. Excessive Stress Disrupts the Architecture of the Developing Brain. Harvard: Center on the Developing Child, Havard University; 2014.

58. Castaldelli-Maia JM, Segura LE, Martins SS. The concerning increasing trend of alcohol beverage sales in the U.S. during the COVID-19 pandemic. Alcohol. 2021;96:37-42.

59. Lee BP, Dodge JL, Leventhal A, Terrault NA. Retail Alcohol and Tobacco Sales During COVID-19. Annals of Internal Medicine. 2021;174(7):1027-9.

60. MacKillop J, Cooper A, Costello J. National Retail Sales of Alcohol and Cannabis During the COVID-19 Pandemic in Canada. JAMA Network Open. 2021;4(11):e2133076-e.

61. Myran DT, Smith BT, Cantor N, Li L, Saha S, Paradis C, et al. Changes in the dollar value of per capita alcohol, essential, and non-essential retail sales in Canada during COVID-19. BMC Public Health. 2021;21(1):2162.

62. Roberts A, Rogers J, Mason R, Siriwardena AN, Hogue T, Whitley GA, et al. Alcohol and other substance use during the COVID-19 pandemic: A systematic review. Drug and Alcohol Dependence. 2021;229:109150.

63. Taylor S, Paluszek MM, Rachor GS, McKay D, Asmundson GJG. Substance use and abuse, COVID-19-related distress, and disregard for social distancing: A network analysis. Addictive Behaviors. 2021;114:106754.

64. McKnight-Eily LR, Okoro CA, Strine TW, Verlenden J, Hollis ND, Njai R, et al. Racial and Ethnic Disparities in the Prevalence of Stress and Worry, Mental Health Conditions, and Increased Substance Use Among Adults During the COVID-19 Pandemic - United States, April and May 2020. MMWR Morb Mortal Wkly Rep. 2021;70(5):162-6.

65. Ward RM, Riordan BC, Merrill JE, Raubenheimer J. Describing the impact of the COVID-19 pandemic on alcohol-induced blackout tweets. Drug and Alcohol Review. 2021;40(2):192-5.

66. Garcia-Cerde R, Valente JY, Sohi I, Falade R, Sancehz ZM, Monteiro MG. Alcohol use during the COVID-19 pandemic in Latin America and the Caribbean. Rev Panam Salud Publica. 2021;45:e52.

67. Jalili M, Niroomand M, Hadavand F, Zeinali K, Fotouhi A. Burnout among healthcare professionals during COVID-19 pandemic: a cross-sectional study. International Archives of Occupational and Environmental Health. 2021;94(6):1345-52.

68. Kannampallil TG, Goss CW, Evanoff BA, Strickland JR, McAlister RP, Duncan J. Exposure to COVID-19 patients increases physician trainee stress and burnout. PLoS One. 2020;15(8):e0237301.

69. Ghahramani S, Lankarani KB, Yousefi M, Heydari K, Shahabi S, Azmand S. A Systematic Review and Meta-Analysis of Burnout Among Healthcare Workers During COVID-19. Front Psychiatry. 2021;12:758849.

70. Morgantini LA, Naha U, Wang H, Francavilla S, Acar Ö, Flores JM, et al. Factors contributing to healthcare professional burnout during the COVID-19 pandemic: A rapid turnaround global survey. PLoS One. 2020;15(9):e0238217.

71. Juárez-García A, Camacho-Ávila A, García-Rivas J, Gutiérrez-Ramos O. Psychosocial factors and mental health in Mexican healthcare workers during the COVID-19 pandemic. Salud Mental. 2021;44(5):229-40.

72. Wu T, Jia X, Shi H, Niu J, Yin X, Xie J, et al. Prevalence of mental health problems during the COVID-19 pandemic: A systematic review and meta-analysis. Journal of Affective Disorders. 2021;281:91-8.

73. Abeldaño Zuñiga RA, Juanillo-Maluenda H, Sánchez-Bandala MA, Burgos GV, Müller SA, Rodríguez López JR. Mental Health Burden of the COVID-19 Pandemic in Healthcare Workers in Four Latin American Countries. INQUIRY: The Journal of Health Care Organization, Provision, and Financing. 2021;58:00469580211061059.

74. Uutela A. Economic crisis and mental health. Current Opinion in Psychiatry. 2010;23(2).

75. Giovanella L VR, Tejerina-Silva H, Acosta-Ramírez N, Parada-Lezcano M, Ríos G, et al. ¿A atenção primária à saúde integral é parte da resposta à pandemia de Covid-19 na América Latina?? . Trabalho, Educação e Saúde. 2021;19(e00310142).

76. Pan American Health Organization. Nota Técnica. La adaptación del Primer Nivel de Artención en el contexto de la pandemia COVID-19: intervenciones, modalidades y ámbitos. Washington, D.C.: PAHO; 2020.

77. Organisation for Economic Co-operation and Development. Strengthening the frontline: How primary health care helpshealth systems adapt during the COVID-19 pandemic. Paris: OECD; 2021.

78. Pan American Health Organization. Respuesta de la Organización Panamericana de la Salud a la COVID-19 en la región de las Américas 17 de enero a 31 de mayo de 2020. Washington, D.C.: PAHO; 2020.

79. Pan American Health Organization. Informe de la evaluación rápida de la prestación de servicios para enfermedades no transmisibles durante la pandemia de COVID-19 en las Américas. Washington, D.C.: PAHO; 2020.

80. World Health Organization. Tracking Continuity of Essential Health Services during the COVID-19 Pandemic. An interactive dashboard Geneva: WHO; 2022 [Available from: https://www.who.int/teams/integrated-health-services/monitoring-health-services/national-pulse-survey-on-continuity-of-essential-health-services-during-the-covid-19-pandemic/dashboard.

81. Pan American Health Organization. Análisis de género y salud: COVID-19 en las Américas (OPS/EGC/COVID-19/21-0006). Washington, D.C.: PAHO; 2021.

82. United Nations Population Fund. Impact of COVID-19 on access to contraceptives in the LAC region. UNFPA; 2020.

83. World Health Organization. Governments push for Universal Health Coverage as COVID-19 continues to devastate communities and economies. 2021 [Available from: https://www.who.int/news-room/feature-stories/detail/governments-push-for-universal-health-coverage-as-covid-19-continues-to-devastate-communities-and-economies.

84. Lal A, Erondu N, Heymann D, Gitahi G, Yates R. Fragmented health systems in COVID-19: rectifying the misalignment between global health security and universal health coverage. The Lancet. 2021;397(10268):61-7.

85. Sen-Crowe B, Sutherland M, McKenney M, Elkbuli A. A Closer Look Into Global Hospital Beds Capacity and Resource Shortages During the COVID-19 Pandemic. Journal of Surgical Research. 2021;260:56-63.

86. Organisation for Economic Co-operation and Development. Intensive care beds capacity Paris: OECD; 2022

87. Organisation for Economic Co-operation and Development. Development Co-operation Report 2020: Learning from Crises, Building Resilience. Paris: OECD; 2020.

88. Pan American Health Organization. COVID-19 has impacted the operation of health services for noncommunicable diseases in the Americas Washington, D.C.: PAHO; 2020 [Available from: https://www.paho.org/en/news/17-6-2020-covid-19-has-impacted-operation-health-services-noncommunicable-diseases-americas.

89. Shet A, Carr K, Danovaro-Holliday MC, Sodha SV, Prosperi C, Wunderlich J, et al. Impact of the SARS-CoV-2 pandemic on routine immunisation services: evidence of disruption and recovery from 170 countries and territories. Lancet Glob Health. 2022;10(2):e186-e94.

90. Pan American Health Organization. Annual Report of the Director of the Pan American Sanitary Bureau 2021. Working through the COVID-19 Pandemic. (Official Document: 364). Washington, D.C.: PAHO; 2021.

91. Economic Commission for Latin America and the Caribbean. Latin America and the Caribbean and the COVID-19 pandemic Economic and social effects. 2020 [Available from: https://repositorio.cepal.org/bitstream/handle/11362/45351/S2000263_en.pdf?sequence=6&isAllowed=y.

92. Organisation for Economic Co-operation and Development. Policy Responses to Coronavirus (COVID-19) COVID-19 in Latin America and the Caribbean: An overview of government responses to the crisis. Paris: OECD; 2020 [Available from: https://www.oecd.org/coronavirus/policy-responses/covid-19-in-latin-america-and-the-caribbean-an-overview-of-government-responses-to-the-crisis-0a2dee41/.

93. The World Bank. Governance & Institutions COVID-19 Response Resources. . Banco Mundial; 2021 25/11/2021.

94. Barello S, Caruso R, Palamenghi L, Nania T, Dellafiore F, Boneti L, et al. Factors associated with emotional exhaustion in healthcare professionals involved in the COVID-19 pandemic: an application of the job demands-resources model. International Archives of Occupational and Environmental Health. 2021;94:1751–61.

95. Tullo J, Lerea M, López P, Alonso L. Impacto de la COVID-19 en la prestación de los servicios de salud esenciales en Paraguay. Rev Panam Salud Publica. 2020;44(e161).

96. Pan American Health Organization. Segunda ronda de la encuesta nacional sobre la continuidad de los servicios esenciales de salud durante la pandemia de COVID-19 de febrero a marzo del 2021 Washington, D.C.: PAHO; 2021 [Available from: https://iris.paho.org/bitstream/handle/10665.2/55059/OPSHSSHSCOVID-19210012_spa.pdf?sequence=1&isAllowed=y.

97. Haakenstad A, Irvine CMS, Knight M, Bintz C, Aravkin AY, Zheng P, et al. Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet.

98. Core Indicators [Internet]. PAHO. 2022 [cited May 15, 2022].

99. Pan American Health Organization. Actualización epidemiológica: Enfermedad por Coronavirus (COVID-19). Washington, D.C.: PAHO; 2021 2 de diciembre de 2021,.

100. Rueda de prensa semanal sobre COVID-19: Palabras de apertura de la directora, 12 de mayo de 2021 [press release]. Washington, D.C.: PAHO2021.

101. World Health Organization. The impact of COVID-19 on health and care workers: a closer look at deaths. In: WHO, editor. Health Workforce Department – Working Paper 1. Geneva2021.

102. Comisión Económica para América Latina y el Caribe. "El impacto del COVID-19 en los pueblos indígenas de América Latina-Abya Yala: entre la invisibilización y la resistencia colectiva". Santiago: Comisión Económica para América Latina y el Caribe (CEPAL); 2020.

103. International Monetary Fund. Fiscal Affairs D. Chapter 2 A Fair Shot - Fiscal Monitor, April 2021. USA: International Monetary Fund. p. ch002.

104. Bourdrel T, Annesi-Maesano I, Alahmad B, Maesano CN, Bind MA. The impact of outdoor air pollution on COVID-19: a review of evidence from in vitro, animal, and human studies. Eur Respir Rev. 2021;30(159).

105. Pozzer A, Dominici F, Haines A, Witt C, Münzel T, Lelieveld J. Regional and global contributions of air pollution to risk of death from COVID-19. Cardiovasc Res. 2020;116(14):2247-53.

106. Singer M. A dose of drugs, a touch of violence, a case of AIDS: conceptualizing the SAVA syndemic. Free Inquiry in Creative Sociology. 2000;28(1):13-24.

107. Weaver LJ, Kaiser BN. Syndemics theory must take local context seriously: An example of measures for poverty, mental health, and food insecurity. Soc Sci Med. 2020:113304.

108. Homer J, Milstein B, Hirsch GB. System Dynamics Modeling to Rethink Health System Reform. In: Apostolopoulos Y, Lemke MK, Hassmiller L, editors. Complex Systems and Population Health. Oxford: Oxford University Press; 2020.

109. World Health Organization. Responding to non-communicable diseases during and beyond the COVID-19 pandemic: state of the evidence on COVID-19 and non-communicable diseases: a rapid review. Geneva: World Health Organization; 2020.

110. Pan American Health Organization. Las ENT de un vistazo: Mortalidad de las enfermedades no transmisibles y prevalencia de sus factores de riesgo en la Región de las Américas. Washington, D.C.: PAHO; 2019.

111. Pan American Health Organization. ENLACE: Data Portal on Noncommunicable Diseases, Mental Health, and External Causes Washington, D.C.: PAHO; 2022 [Available from: https://www.paho.org/en/enlace.

112. Pan American Health Organization. COVID-19 and comorbidities in the Americas: Hands-on tool to estimate the population at increased and high risk of severe COVID-19 due to underlying health conditions for the Americas. Washington, D.C.: PAHO; 2021.

113. Pan American Health Organization. Sixth ad hoc Meeting of PAHO's Technical Advisory Group (TAG) on Vaccine-preventable Diseases. United States of America (virtual meeting). 16 November 2020. Washington, D.C.: PAHO; 2021.

114. World Health Organization. Preventing noncommunicable diseases (?NCDs)? by reducing environmental risk factors. Geneva: World Health Organization; 2017.

115. Di Ciaula A, Krawczyk M, Filipiak KJ, Geier A, Bonfrate L, Portincasa P. Noncommunicable diseases, climate change and iniquities: What COVID-19 has taught us about syndemic. Eur J Clin Invest. 2021;51(12):e13682.

116. Horton R. Offline: COVID-19 is not a pandemic. Lancet. 2020;396(10255):874.

117. Non-Communicable Disease (NCD) Alliance. . Briefing note: Impacts of COVID-19 on people living with NCDs. Geneva: Non-Communicable Disease (NCD) Alliance; 2020.

118. Al-Oraibi A, Nellums LB, Chattopadhyay K. COVID-19, conflict, and non-communicable diseases among refugees. EClinicalMedicine. 2021;34:100813.

119. Azadnajafabad S, Ghasemi E, Saeedi Moghaddam S, Rezaei N, Farzadfar F. Non-communicable Diseases' Contribution to the COVID-19 Mortality: A Global Warning on the Emerging Syndemics. Arch Iran Med. 2021;24(5):445-6.

120. Bambra C, Riordan R, Ford J, Matthews F. The COVID-19 pandemic and health inequalities. J Epidemiol Community Health. 2020;74(11):964-8.

121. Pan XF, Yang J, Wen Y, Li N, Chen S, Pan A. Non-Communicable Diseases During the COVID-19 Pandemic and Beyond. Engineering (Beijing). 2021;7(7):899-902.

122. Yadav UN, Rayamajhee B, Mistry SK, Parsekar SS, Mishra SK. A Syndemic Perspective on the Management of Non-communicable Diseases Amid the COVID-19 Pandemic in Low- and Middle-Income Countries. Front Public Health. 2020;8:508.

123. Boes S, Sabariego C, Bickenbach J, Stucki G. How to capture the individual and societal impacts of syndemics: the lived experience of COVID-19. BMJ Glob Health. 2021;6(10).

124. Herrick C, Reubi D. The future of the global noncommunicable disease agenda after Covid-19. Health Place. 2021;71:102672.

125. McMahon NE. Understanding COVID-19 through the lens of ‘syndemic vulnerability’: possibilities and challenges. International Journal of Health Promotion and Education. 2021;59(2):67-9.

126. Pirrone I, Dieleman M, Reis R, Pell C. Syndemic contexts: findings from a review of research on non-communicable diseases and interviews with experts. Glob Health Action. 2021;14(1):1927332.

127. Winslow CE. The cost of sickness and the price of health. Word Health Organization. 1951. Bull World Health Organ. 2006;84(2):153-8.

128. Bardey D, Cremer H, Lozachmeur J-M. Competition in Two-Sided Markets with Common Network Externalities. Review of Industrial Organization. 2014;44(4):327-45.

129. Katz ML, Shapiro C. Network Externalities, Competition, and Compatibility. The American Economic Review. 1985;75(3):424-40.

130. Oderanti FO, Li F, Cubric M, Shi X. Business models for sustainable commercialisation of digital healthcare (eHealth) innovations for an increasingly ageing population. Technological Forecasting and Social Change. 2021;171:120969.

131. Economic Commission for Latin America and the Caribbean/PanAmerican Health Organization. COVID-19 Report. Health and the economy: a convergence needed to address COVID-19 and retake the path of sustainable development in Latin America and the Caribbean. 2020.

132. Mohamed B. Coronavirus as a Global Complex Problem Looking for Resilient Solutions. Business Management and Strategy, Macrothink Institute. 2020;11(1):94 - 109.

133. World Health Organization. Health Systems Governance for Universal Health Coverage Action Plan Department of Health Systems Governance and Financing. Geneva: WHO; 2014.

134. Organisation for Economic Co-operation and Development. COVID-19 in Latin America and the Caribbean: An overview of government responses to the crisis. Tackling coronarivirus (COVID-19): Contributing to a global effort. . Paris: OECD; 2020.

135. Pan American Health Organization. Indice de preparación ante emergencias y desastres en salud. Washington, D.C.: PAHO; 2019.

136. World Health Organization. Consideraciones para aplicar y ajustar medidas de salud pública y sociales en el contexto de la COVID-19. Geneva: Organización Mundial de la Salud; 2020.

137. Casalí P, Goldschmit A, Cetrágolo O. Respuestas de corto plazo a la COVID-19 y desafíos persistentes en los sistemas de salud de América Latina.: Oficina de la OIT para los Países Andinos; 2021 Enero 2021.

138. Arancibia Gutiérrez E, Giraldo Palacio M. Local Governance Processes: An Analysis of the Regional Governance and Social Coordination Observatory Regarding COVID-19 in Yucatan, Mexico. Journal Of Public Governance And Policy. 2020;1(9):133 - 51.

139. Martínez-Córdoba P-J, Benito B, García-Sánchez I-M. Efficiency in the governance of the Covid-19 pandemic: political and territorial factors. Globalization and Health. 2021;17(1):113.

140. Bell JA, Nuzo JB. Global Health Security Index: Advancing Collective Action and Accountability Amid Global Crisis, 2021. Washington, D.C.: Nuclear Threat Initiative; 2021.

141. Organisation for Economic Co-operation and Development. Policy Responses to Coronavirus (COVID-19). Tourism Policy Responses to the coronavirus (COVID-19). Paris: OECD; 2020.

142. Comisión Económica para América Latina y el Caribe. Observatorio COVID-19 en América Latina y el Caribe: acciones por país. 2021.

143. Enríquez SC. Primeras lecciones y desafíos de la pandemia de COVID-19 para los paises deal SIC. In: Ciudad de México CEpALyeCC, 2021, editor. 2021.

144. González E HC, Hopkins K, Horwitz L, Nagovitch P, Sonneland HK & ZissisC. . El coronavirus en América Latina. AS/COA. 2021.

145. Acosta L. Capacidad de respuesta frente a la pandemia de COVID-19 en América Latina y el Caribe. Rev Panam Salud Publica. 2020;44(e109).

146. Páges C, Aclan C, Alfonso M, Arroio R, Irigoyen J, Mejía I, et al. From lockdown to reopening: Strategic considerations for the resumption of activities in Latin America and the Caribbean within the framework of Covid-19. Washington, D.C.: Inter-American Development Bank; 2020.

147. Hale T, Angrist N, Goldszmidt R, Kira B, Petherick A, Phillips T, et al. A global panel database of pandemic policies (Oxford COVID-19 Government Response Tracker). Nature Human Behaviour. 2021.

148. Harrison C, Horwitz L, Zissis C. Timeline: Tracking Latin America's Road to Vaccination. AS/COA2021. Available from: https://www.as-coa.org/articles/timeline-tracking-latin-americas-road-vaccination.

149. Organisation for Economic Co-operation and Development. COVID-19 in Latin America and the Caribbean: Regional socio-economic implications and policy priorities. Paris: OECD; 2020.

150. Congressional Research Service. Latin America and the Caribbean: Impact of COVID-19. Washington, D.C.: CRS; 2021.

151. United Nations, Konrad-Adenauer-Stiftung, Inter-American Development Bank. Post Pandemic COVID-19 Economy Recovery. Enabling Latin America and the Caribbean to better harness e-commerce and digital trade. Panama: United Nations; 2020.

152. Comisión Económica para América Latina y el Caribe. Estudio Económico de América Latina y el Caribe. CEPAL, Santiago; 2020.

153. Comisión Económica para América Latina y el Caribe. The recovery paradox in Latin America and the Caribbean: Growth amid persisting structural problems: inequality, poverty and low investment and productivity. CEPAL; 2021.

154. Comisión Económica para América Latina y el Caribe. Panorama Social de América Latina, 2021. Santiago: Comisión Económica para América Latina y el Caribe; 2022. Contract No.: LC/PUB.2021/17-P.

155. International Monetary Fund. Fiscal Monitor Database of Country Fiscal Measures in Response to the COVID-19 Pandemic Washington, D.C.: IMF; [Available from: https://www.imf.org/en/Topics/imf-and-covid19/Fiscal-Policies-Database-in-Response-to-COVID-19.

156. Comisión Económica para América Latina y el Caribe. Panorama fiscal de América Latina y el Caribe. Los desafíos de la política fiscal en la recuperación transformadora pos Covid-19. Santiago: CEPAL; 2021.

157. Lustig N, Tommasi M. El COVID-19 y la protección social de los grupos pobres y vulnerables en América Latina: un marco conceptua. Revista CEPAL. 2020;2020-12(132):283-95.

158. World Health Organization/Europe. Strengthening health-system emergency preparedness. Toolkit for assessing health-system capacity for crisis management. 2008 [Part 1. User manual. 2008:[Available from: https://www.euro.who.int/__data/assets/pdf_file/0008/157886/e96187.pdf.

159. Awoke M, Negin J, Moller J, Farell P, Yawson A, Biritwum R, et al. Predictors of public and private healthcare utilization and associated health system responsiveness among older adults in Ghana. Global health action. 2017;10(1):1301723. .

160. Global Commission on Evidence to Address Societal Challenges. The Evidence Commission report: A wake-up call and path forward for decisionmakers, evidence intermediaries, and impact-oriented evidence producers. Hamilton: McMaster Health Forum; 2022.

161. Pan American Health Organization. A guide for evidence-informed decision-making, including in health emergencies. Washington, D.C.: PAHO; 2022.

162. Pan American Health Organization. Ongoing Living Update of COVID-19 Therapeutic Options: Summary of Evidence. Rapid Review, 4 May 2022. Washington, D.C.: PAHO; 2022.

163. Palmero A, Carracedo S, Cabrera N, Bianchini A. Governance frameworks for COVID-19 research ethics review and oversight in Latin America: an exploratory study. BMC Medical Ethics. 2021;22(1):147.

164. Mansilla C, Herrera CA, Boeira L, Yearwood A, Lopez AS, Colunga-Lozano LE, et al. Characterising COVID-19 empirical research production in Latin America and the Caribbean: A scoping review. PLoS One. 2022;17(2):e0263981.

165. Chapman E, Illanes E, Reveiz L, Saenz C. [Mapping of research protocols, publications, and collaborations on COVID-19 in Latin America and the CaribbeanMapeamento de protocolos de pesquisa, publicações e colaborações sobre COVID-19 na América Latina e no Caribe]. Rev Panam Salud Publica. 2022;46:e42.

166. Carracedo S, Palmero A, Neil M, Hasan-Granier A, Saenz C, Reveiz L. The landscape of COVID-19 clinical trials in Latin America and the Caribbean: assessment and challenges. Rev Panam Salud Publica. 2020;44:e177.

167. World Health Organization. World Health Assembly Resolution: Strengthening clinical trials to provide high-quality evidence on health interventions and to improve research quality and coordination. Geneva: WHO; 2022.

168. Pan American Health Organization. Strengthening national evidence-informed guideline programs. A tool for adapting and implementing guidelines in the Americas. Washington, D.C.: PAHO; 2018.

169. Pan American Health Organization. Consideraciones sobre el uso de antivirales, anticuerpos monoclonales y otras intervenciones para el manejo de pacientes con COVID-19 en América Latina y el Caribe, 26 de abril del 2022. Washington, D.C.: PAHO; 2022.

170. Pan American Health Organization. Guía para el cuidado de pacientes adultos críticos con COVID-19 en las Américas. Versión 3. Washington, D.C.: PAHO; 2021.

171. Pan American Health Organization. Directrices para la profilaxis y el manejo de pacientes con COVID-19 leve y moderada en América Latina y el Caribe. Versión abreviada, octubre del 2021. Washington,D.C.: PAHO; 2021.

172. International Social Security Association. Telemedicina: buenas prácticas en América Latina: ISSA; 2021 [Available from: https://ww1.issa.int/es/analysis/telemedicina-buenas-practicas-en-america-latina.

173. Centers for Disease Control and Prevention. Using Telehealth to Expand Access to Essential Health Services during the COVID-19 Pandemic Washignton, D.C.: CDC; 2020 [updated June 10 2020. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/telehealth.html.

174. Pan American Health Organization. COVID-19 and telemedicine Washington, D.C.: PAHO; 2020 [Available from: https://www3.paho.org/ish/index.php/en/telemedicine.

175. Saigí-Rubio F, Torrent-Sellens J, Robles N, Pérez-Palaci J, MI B. Estudio sobre telemedicina internacional en América Latina: motivaciones, usos, resultados, estrategias y políticas. In: Desarrollo. BId, editor. 2021. p. 953.

176. Asociación Internacional de la Seguridad Social. Telemedicina: buenas prácticas en América Latina 2021 [Available from: https://ww1.issa.int/es/analysis/telemedicina-buenas-practicas-en-america-latina.

177. World Trade Organization. Revista general de la evolución del entorno comercial internacional. Informe anual del Director General. Geneva: WTO; 2020.

178. Economic Commission for Latin America and the Caribbean. Las restricciones a la exportación de productos médicos dificultan los esfuerzos por contener la enfermedad por coronavirus (COVID-19) en América Latina y el Caribe. Santiago: ECLAC; 2020.

179. World Trade Organization. How WTO members have used trade measures to expedite access to COVID-19 critical medical goods and services. Information note. Geneva: WTO; 2020.

180. Binnicker Matthew J, Kraft Colleen S. Challenges and Controversies to Testing for COVID-19. Journal of Clinical Microbiology.58(11):e01695-20.

181. Ceci A, Muñoz-Ballester C, Tegge AN, Brown KL, Umans RA, Michel FM, et al. Development and implementation of a scalable and versatile test for COVID-19 diagnostics in rural communities. Nature Communications. 2021;12(1):4400.

182. Alcántara R, Peñaranda K, Mendoza-Rojas G, Nakamoto JA, Martins-Luna J, del Valle-Mendoza J, et al. Unlocking SARS-CoV-2 detection in low- and middle-income countries. Cell Reports Methods. 2021;1(7):100093.

183. Connor A, Hariharan N, Carson S, Sanders KC, Bradford Vosburg K, Sabot O. Health Affairs Blog [Internet]2021. [cited 2022].

184. Faust L, Zimmer AJ, Kohli M, Saha S, Boffa J, Bayot ML, et al. SARS-CoV-2 testing in low- and middle-income countries: availability and affordability in the private health sector. Microbes and Infection. 2020;22(10):511-4.

185. Post L, Ohiomoba RO, Maras A, Watts SJ, Moss CB, Murphy RL, et al. Latin America and the Caribbean SARS-CoV-2 Surveillance: Longitudinal Trend Analysis. JMIR Public Health Surveill. 2021;7(4):e25728.

186. Pan American Health Organization. List of Priority Medical Devices in the Context of COVID-19, 13 August 2020. Washington, D.C.: PAHO; 2020.

187. Thanh Le T, Andreadakis Z, Kumar A, Gómez Román R, Tollefsen S, Saville M, et al. The COVID-19 vaccine development landscape. Nature Reviews Drug Discovery. 2020;19:305-6.

188. Heaton PM. The Covid-19 Vaccine-Development Multiverse. New England Journal of Medicine. 2020;383(20):1986-8.

189. Francis AI, Ghany S, Gilkes T, Umakanthan S. Review of COVID-19 vaccine subtypes, efficacy and geographical distributions. Postgraduate Medical Journal. 2021:postgradmedj-2021-140654.

190. GAVI. What are whole virus vaccines and how could they be used against COVID-19? Geneva: GAVI; 2020 [30 December 2020].

191. McDonald I, Murray SM, Reynolds CJ, Altmann DM, Boyton RJ. Comparative systematic review and meta-analysis of reactogenicity, immunogenicity and efficacy of vaccines against SARS-CoV-2. npj Vaccines. 2021;6(1):74.

192. Ghazy RM, Ashmawy R, Hamdy NA, Elhadi YA, Reyad OA, Elmalawany D, et al. Efficacy and Effectiveness of SARS-CoV-2 Vaccines: A Systematic Review and Meta-Analysis. Vaccines. 2022;10(3).

193. Andrews N, Stowe J, Kirsebom F, Toffa S, Rickeard T, Gallagher E, et al. Covid-19 Vaccine Effectiveness against the Omicron (B.1.1.529) Variant. N Engl J Med. 2022.

194. Yaffe H. Cuba’s five COVID-19 vaccines: the full story on Soberana 01/02/Plus, Abdala, and Mambisa [Internet]. London: LSE. 2021. [cited 2022]. Available from: https://blogs.lse.ac.uk/latamcaribbean/2021/03/31/cubas-five-covid-19-vaccines-the-full-story-on-soberana-01-02-plus-abdala-and-mambisa/.

195. Brooks D. Las vacunas para el covid-19 que se están desarrollando en América Latina (además de la de AstraZeneca-Oxford). BBC News Mundo. 2020 Aug 14, 2020.

196. Pan American Health Organization. Covax- Working for global equitable access to COVID-19 vaccines Washington, D.C.: PAHO; 2020 [Available from: https://www.who.int/es/initiatives/act-accelerator/covax.

197. Obinna DN. Solidarity across borders: A pragmatic need for global COVID-19 vaccine equity. Int J Health Plann Manage. 2022;37(1):21-9.

198. United Nations Educational, Scientific and Cultural Organization. Covid-19 y vacunación en América Latina y el Caribe: Desafíos, Necesidades y oportunidades. Organización de las Naciones Unidas para la Educación, la Ciencia y la Cultura. Oficina Regional de Ciencia de la UNESCO para ALC; 2021.

199. Urrunaga-Pastor D, Bendezu-Quispe G, Herrera-Añazco P, Uyen-Cateriano A, Toro-Huamanchumo C, Rodriguez-Morales A, et al. Cross-sectional analysis of COVID-19 vaccine intention, perceptions and hesitancy across Latin America and the Caribbean. Travel Medicine and Infectious Disease. 2021;41(102059).

200. Argote Tironi P, Barham E, Zuckerman Daly S, Gerez JE, Marshall J, Pocasangre O. Messages that increase COVID-19 vaccine acceptance: Evidence from online experiments in six Latin American countries. PLoS One. 2021;16(10):e0259059.

201. World Health Organization. Therapeutics and COVID-19: living guideline Geneva: WHO; 2020 [Available from: https://app.magicapp.org/#/guideline/nBkO1E/section/nByvRL.

202. Pan American Health Organization. Considerations on the Use of Antivirals, Monoclonal Antibodies, and Other Interventions for the Management of COVID-19 Patients in Latin America and the Caribbean. Washington, D.C.: PAHO.

203. World Health O. Guidance on maintaining a safe and adequate blood supply during the coronavirus disease 2019 (COVID-19) pandemic and on the collection of COVID-19 convalescent plasma: interim guidance, 10 July 2020. Geneva: World Health Organization; 2020 2020. Contract No.: WHO/2019-nCoV/BloodSupply/2020.2.

204. Schneider ME. Blood Services Around the Globe. ASH Clinical News. 2021.

205. World Health Organization. ACT-Accelerator Strategic Plan & Budget, October 2021 to September 2022. Geneva: World Health Organization; 2021.

206. Pan American Health Organization. Arrival of COVID-19 vaccines to the Americas through COVAX Washington, D.C.: PAHO; 2021 [Available from: https://www.paho.org/en/covax-americas.

207. Pan American Health Organization. Impact of COVID-19 on Human Resources for Health and Policy Response:

the Case of Belize, Grenada, and Jamaica. Washington, D.C.: PAHO; 2022.

208. Hamel L, Kirzinger A, Muñana C, Brodie M. KFF COVID-19 Vaccine Monitor: December 2020. Internet: KFF; 2020.

209. Surgo Ventures. U.S. Healthcare Workers: COVID-19 Vaccine Uptake & Attitudes Internet2021 [Available from: https://surgoventures.org/resource-library/survey-healthcare-workers-and-vaccine-hesitancy.

210. Dror AA, Eisenbach N, Taiber S, Morozov NG, Mizrachi M, Zigron A, et al. Vaccine hesitancy: the next challenge in the fight against COVID-19. European Journal of Epidemiology. 2020;35(8):775-9.

211. Gagneux-Brunon A, Detoc M, Bruel S, Tardy B, Rozaire O, Frappe P, et al. Intention to get vaccinations against COVID-19 in French healthcare workers during the first pandemic wave: a cross-sectional survey. J Hosp Infect. 2021;108:168-73.

212. Kwok KO, Li K-K, Wei WI, Tang A, Wong SYS, Lee SS. Influenza vaccine uptake, COVID-19 vaccination intention and vaccine hesitancy among nurses: A survey. International Journal of Nursing Studies. 2021;114:103854.

213. Lin C, Tu P, Beitsch LM. Confidence and Receptivity for COVID-19 Vaccines: A Rapid Systematic Review. Vaccines. 2021;9(1):16.

214. Freeman D, Loe BS, Chadwick A, Vaccari C, Waite F, Rosebrock L, et al. COVID-19 vaccine hesitancy in the UK: the Oxford coronavirus explanations, attitudes, and narratives survey (Oceans) II. Psychol Med. 2020:1-15.

215. Schwarzinger M, Watson V, Arwidson P, Alla F, Luchini S. COVID-19 vaccine hesitancy in a representative working-age population in France: a survey experiment based on vaccine characteristics. The Lancet Public Health. 2021;6(4):e210-e21.

216. Paul E, Steptoe A, Fancourt D. Attitudes towards vaccines and intention to vaccinate against COVID-19: Implications for public health communications. Lancet Reg Health Eur. 2021;1:100012.

217. Urrunaga-Pastor D, Bendezu-Quispe G, Herrera-Añazco P, Uyen-Cateriano A, Toro-Huamanchumo CJ, Rodriguez-Morales AJ, et al. Cross-sectional analysis of COVID-19 vaccine intention, perceptions and hesitancy across Latin America and the Caribbean. Travel Med Infect Dis. 2021;41:102059.

218. Kuter BJ, Browne S, Momplaisir FM, Feemster KA, Shen AK, Green-McKenzie J, et al. Perspectives on the receipt of a COVID-19 vaccine: A survey of employees in two large hospitals in Philadelphia. Vaccine. 2021;39(12):1693-700.

219. Khubchandani J, Sharma S, Price JH, Wiblishauser MJ, Sharma M, Webb FJ. COVID-19 Vaccination Hesitancy in the United States: A Rapid National Assessment. J Community Health. 2021;46(2):270-7.

220. Pan American Health Organization. Concerns, Attitudes, and Intended Practices of Healthcare Workers toward COVID-19 Vaccination in the Caribbean. Washington, D.C.: PAHO; 2021.

221. Puertas EB, Velandia-Gonzalez M, Vulanovic L, Bayley L, Broome K, Ortiz C, et al. Concerns, attitudes, and intended practices of Caribbean healthcare workers concerning COVID-19 vaccination: A cross-sectional study. Lancet Reg Health Am. 2022;9:100193.

222. Eguia H, Vinciarelli F, Bosque-Prous M, Kristensen T, Saigí-Rubió F. Spain's Hesitation at the Gates of a COVID-19 Vaccine. Vaccines (Basel). 2021;9(2).

223. Gadoth A, Halbrook M, Martin-Blais R, Gray A, Tobin NH, Ferbas KG, et al. Cross-sectional Assessment of COVID-19 Vaccine Acceptance Among Health Care Workers in Los Angeles. Ann Intern Med. 2021;174(6):882-5.

224. Pan American Health Organization. Experiencia y actitudes de vacunación contra COVID-19 entre los trabajadores de salud de 16 países de América Latina. Washington, D.C.: PAHO; 2022.

225. Pan American Health Organization. Policy Brief - Strengthening Human Resources for Health (HRH) to Respond to COVID-19 and Other Emerging Pandemics in the Caribbea. Washington, D.C.: PAHO; 2021.

226. Pan American Health Organization. Policy Brief - Addressing COVID-19 Vaccine Hesitancy Among Healthcare Workers in the Caribbean. Washington, D.C.: PAHO; 2021.

227. Pan American Health Organization. Recommendations to Adapt and Strengthen Response Capacity at the First Level of Care during the COVID-19 Pandemic. Washington, D.C.: PAHO; 2020.

228. Halcomb E, McInnes S, Williams A, Ashley C, James S, Fernandez R, et al. The Experiences of Primary Healthcare Nurses During the COVID-19 Pandemic in Australia. J Nurs Scholarsh. 2020;52(5):553-63.

229. Kearon J, Risdon C. The Role of Primary Care in a Pandemic: Reflections During the COVID-19 Pandemic in Canada. J Prim Care Community Health. 2020;11:2150132720962871.

230. World Health Organization. Role of primary care in the COVID-19 response. Geneva: WHO; 2020.

231. Blumenthal D, Fowler EJ, Abrams M, Collins SR. Covid-19 - Implications for the Health Care System. N Engl J Med. 2020;383(15):1483-8.

232. Pan American Health Organization. Human resources for health and the COVID-19 response in the Caribbean. Washington, D.C.: PAHO; 2020.

233. Rahman R, Ross A, Pinto R. The critical importance of community health workers as first responders to COVID-19 in USA. Health Promot Int. 2021;36(5):1498-507.

234. Inter-American Development Bank. Support the design and implementation of key digital interventions for COVID-19 in Latin America and the Caribbean Washington, D.C.: IADB; 2020.

235. Declaración Universal de Derechos Humanos, (1948).

236. Naciones Unidas. Pacto Internacional de Derechos Económicos, Sociales y Culturales 1966 [Available from: https://www.ohchr.org/SP/ProfessionalInterest/Pages/CESCR.aspx.

237. Comisión Económica para América Latina y el Caribe. Protección social universal en América Latina y el Caribe,. Santiago: CEPAL; 2019.

238. Etienne CF, Fitzgerald J, Almeida G, Birmingham ME, Monica B, Bascolo E, et al. COVID-19: transformative actions for more equitable, resilient, sustainable societies and health systems in the America. BMJ Global Health. 2020;5:e003509.

239. Weekly Press Briefing on COVID-19 [press release]. Washington, D.C.: PAHO, October 6, 2021 2021.

BÚSQUEDA DE LITERATURA INSTITUCIONAL OPS/OMS

Temas relevantes:

BÚSQUEDA DE LITERATURA CIENTÍFICA

Temas relevantes:

Atención

Algunas de estas búsquedas pueden llevar mucho tiempo. Por favor sea paciente.

INDICADORES BÁSICOS

Para obtener los datos más recientes sobre indicadores de salud para la Región de las Américas, asegúrese de visitar el portal de Indicadores Básicos de la OPS.