Kathya Cordova-PozoHubert KorziliusE.A.J.A. RouwetteGabriela PĂrizRolando Herrera-GutierrezGraciela Cordova-PozoMiguel Orozco2026-03-222026-03-22202110.3390/ijerph181910002https://doi.org/10.3390/ijerph181910002https://andeanlibrary.org/handle/123456789/46391Citaciones: 4Similar 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.enPreparednessMediationLatin AmericansPandemicContext (archaeology)Public healthEnvironmental healthPsychological interventionPopulationPolitical scienceUsing Systems Dynamics for Capturing the Multicausality of Factors Affecting Health System Capacity in Latin America while Responding to the COVID-19 Pandemicarticle