Browsing by Autor "Natalia Botero-Tovar"

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Factors influencing delivery of intersectoral actions to address infant stunting in Bogotá, Colombia – a mixed methods case study.
(Research Square (United States), 2020) Natalia Botero-Tovar; Gina Paola Arocha Zuluaga; Andrea Ramírez Varela
Abstract Background Intersectoral actions (ISA) are a recognized relationship between the health sector and other sectors to improve health outcomes. Although a frequent topic in public health, evidence for systematic evaluation of implementation of ISA is scarce. An intersectoral health intervention for infants under one-year-old with, and at risk of, stunting (low height-for-age) was developed by a public-private partnership in Bogotá, Colombia, during 2018 and 2019. Here we report a case study conducted in parallel to the intervention designed to assess factors that influenced implementation of the ISA. Methods The case study was developed using a concurrent mixed-methods design, with the qualitative component giving context to the quantitative results. The qualitative component was obtained from four workshops, three focal groups, and 17 semi-structured interviews with actors involved in the intersectoral intervention. The quantitative component was obtained with two questionnaires that evaluated perceptions on improvement and partnership functioning of the ISA. Results This study collected information from 122 participants. The intervention demanded intersectoral collaboration. Political will, motivated human resources, and recognition that health results from collaboration facilitated intersectoral actions. Intersectoral actions were limited by difficulties in engaging the health sector, communication challenges related to local health service decentralization, and administrative barriers. Conclusions Intersectoral actions have been recently discussed in the literature due to challenges on implementation, idealization, inconsistent demands, and doubts about economic outcomes. The implementation of intersectoral public health interventions can be jeopardized by a lack of coordination and management skills.
Factors influencing delivery of intersectoral actions to address infant stunting in Bogotá, Colombia – a mixed methods case study.
(2020) Natalia Botero-Tovar; Gina Paola Arocha Zuluaga; Andrea Ramírez Varela
<title>Abstract</title> Background Intersectoral actions (ISA) are a recognized relationship between the health sector and other sectors to improve health outcomes. Although a frequent topic in public health, evidence for systematic evaluation of implementation of ISA is scarce. An intersectoral health intervention for infants under one-year-old with, and at risk of, stunting (low height-for-age) was developed by a public-private partnership in Bogotá, Colombia, during 2018 and 2019. Here we report a case study conducted in parallel to the intervention designed to assess factors that influenced implementation of the ISA. Methods The case study was developed using a concurrent mixed-methods design, with the qualitative component giving context to the quantitative results. The qualitative component was obtained from four workshops, three focal groups, and 17 semi-structured interviews with actors involved in the intersectoral intervention. The quantitative component was obtained with two questionnaires that evaluated perceptions on improvement and partnership functioning of the ISA. Results This study collected information from 122 participants. The intervention demanded intersectoral collaboration. Political will, motivated human resources, and recognition that health results from collaboration facilitated intersectoral actions. Intersectoral actions were limited by difficulties in engaging the health sector, communication challenges related to local health service decentralization, and administrative barriers. Conclusions Intersectoral actions have been recently discussed in the literature due to challenges on implementation, idealization, inconsistent demands, and doubts about economic outcomes. The implementation of intersectoral public health interventions can be jeopardized by a lack of coordination and management skills.
Organisational responses to mitigate the effects of COVID-19 on healthcare workers: a qualitative case study from Bogotá, Colombia
(2020) Simon Turner; Natalia Niño; Carolina Segura; Natalia Botero-Tovar
<title>Abstract</title> Background Healthcare organisations have undergone organisational change to respond to COVID-19. This pandemic has presented challenges for employee adjustment, with impacts on the availability and coordination of human resources in healthcare. This study aimed to characterise the organisational actions regarding the coordination of human resources in healthcare within Bogotá, Colombia, to respond to the COVID-19 pandemic. Methods We followed a case study approach to understand the response to the emergency taking into account the narratives of the actors who have been directly involved in the planning of guidelines oriented to face the pandemic or in the implementation of health services for COVID-19. Twenty-two interviews with multiple health system organisations within Bogotá were conducted between May and September 2020 and analysed thematically. Results Three themes emerged from the analysis of the interview data: to retain human resources, to implement actions to improve the mental and physical health of the healthcare workers, and to enhance healthcare workers knowledge, skills and availability to respond to COVID-19. Conclusions Organisational actions led by hospital managers to retain, protect, and train human health resources in the dynamic context of the COVID-19 pandemic were identified. Other system-wide organisations like scientific associations contributed to the coordination of human resources across hospitals to respond to COVID-19 in Bogotá, Colombia. The actions of hospital managers, and roles of system-wide intermediary organisations, in coordinating human resources need to be explored in other health system contexts facing COVID-19.