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Background: The vaccine supply chain (VSC) integrates all activities from production to dispensing, characterized by complexity and low responsiveness. This study aims to define key performance indicators (KPIs) to evaluate the logistic and operational performance during the COVID-19 National Vaccination Plan in Colombia., Methods: This study employed the design science research (DSR) methodology to develop a dashboard for monitoring COVID-19 vaccination progress. DSR is a problem-solving paradigm focused on conceiving, testing, and evaluating artifacts to tackle specific challenges. The dashboard integrated a set of Key Performance Indicators (KPIs) that incorporated three dimensions: epidemiological, humanitarian, and logistical. Both, the dashboard and the KPIs underwent validation through three iterative DSR cycles, in collaboration with both private and public health stakeholders., Results: A set of 38 validated KPIs, grouped into eight categories, was consolidated into an online dashboard. This tool enabled real-time tracking of the National Vaccination Plan at both national and departmental levels, providing stakeholders with a comprehensive view of the vaccine supply chain. It also allowed for the assessment and comparison of the execution and effectiveness of public policies., Conclusions: These KPIs supported decision-making from a logistical standpoint, enhancing the planning, preparation, and continuous improvement of mass vaccination processes, thereby increasing their potential impact even further., Competing Interests: Declarations Ethics approval and consent to participate Not applicable. Consent for publication All authors have read and agreed to the published version of the manuscript. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

The COVID-19 pandemic has impacted the well-being of millions of people around the globe. The evidence has shown that during the COVID-19 pandemic, the mental health of the population was affected, which means that there is an extra demand to implement different actions to mitigate and treat mental health disorders result of the pandemic. According to the literature it was expected that the prevalence of mental health disorders, such as anxiety and depression increased by 25 per cent worldwide, and Colombia was not the exception. However, there is not clear evidence on how much this increase might be. This study aims to estimate the prevalence of anxiety and depression for female and male adolescents and adults in Colombia before and during the COVID-19 pandemic. It estimated the potential increase of the prevalence in each group as a result of the COVID-19 pandemic in 2020. We used the Individual Registry of Health Services Delivery data from 2015-2021 to estimate the observed prevalence of anxiety and depression in Colombia for female and male adults. In addition, using the National Mental Health Survey 2015, we simulated the prevalence of anxiety and depression for adolescents (12 to 17 years) and adults (18 or older) in 2015 and using a static Monte Carlo simulation process we estimated the expected prevalence of depression and anxiety for each group from 2016 to 2021. The results of the analysis using revealed an important increase in the observed prevalence of depression and anxiety for adults and adolescents and men and women between 2015 and February 2020. When we simulated different scenarios using as a base line the National Mental Health Survey and estimated the prevalence of depression and anxiety for female and male adults and adolescents, we found that the prevalence of depression and anxiety has had an important increase in the last five years for all groups and had an important increase during 2020. This increase was greater for women compared to men, and adolescents than adults. Our results show the number of people who need potential attention from the health system in Colombia and highlight the importance to think about how to avoid and detect potential cases of anxiety and depression especially in female adolescents., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Martínez-Cabezas et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: This paper discusses the stages of health system resilience (HSR) and the factors underlying differences in HSR during the covid-19 pandemic, especially the vaccination challenge. We studied the relationship between vaccination strategies and macro-context backgrounds in 21 Latin American countries. Our objective was to capture the impact of those aspects in the SR and identify potential improvements for future crises and for vaccination programs in general., Methods: The study uses mixed-methods research to provide insights into how the countries' backgrounds and vaccination strategies impact the HSR. Particularly, we used explanatory sequential mixed methods, which entails a quantitative-qualitative two-phase sequence. The quantitative phase was conducted using cluster and variance analysis, in which the HSR was measured using as a proxy the covid-19 vaccination outcomes in three cut-offs of reaching 25%, 50%, and 75% of population coverage. This approach allows us to discriminate covid-19 vaccination progress by stages and contrast it to the qualitative stage, in which we performed a country-case analysis of the background conditions and the changes in vaccination strategies that occurred during the corresponding dates., Results: The paper provides a rich comparative case analysis of countries, classifying them by early, prompt, and delayed performers. The results show that differences in vaccination performance are due to flexibility in adapting strategies, cooperation, and the ability to design multilevel solutions that consider the needs of various actors in the health ecosystem. These differences vary depending on the vaccination stage, which suggests the importance of acknowledging learning, diffusion, and feedback processes at the regional level., Conclusions: We identified the importance of societal well-being as an ideal country antecedent for high and sustained levels of performance in covid-19 vaccination. Whereas in other countries where the set-up and beginning phases were rough, the value of the operational decisions and the learning on the move regarding their own and their peers' trajectories were crucial and were reflected in performance improvement. A contribution of this study is that the above-mentioned analysis was done using vaccination coverage cut-off points that allow a performance view that takes into consideration the stages of the vaccination progress and the learning process that goes with it. As well as framing this into the HSR shock cycles that allow to differentiate the stages of resilience on which countries must act., (© 2024. The Author(s).)

Introduction: In Colombia, research on health and conflict has focused on mental health, psychosocial care, displacement, morbidity, and mortality. Few scientific studies have assessed health system functioning during armed conflicts. In a new period characterized by the implementation of the peace agreement with the Revolutionary Armed Forces of Colombia (FARC) armed group, understanding the effects of armed conflict on the health system, the functions, and institutions shaped by the conflict is an opportunity to understand the pathways and scope of post-conflict health policy reforms. Therefore, this study was conducted to assess the effects of armed conflict on the health system, response, and mechanisms developed to protect medical missions during armed conflict in Colombia., Methods: This research was conducted using a qualitative approach with semi-structured interviews and focus group discussions. The qualitative guide collected information in four sections: (1) conflict and health system, effects and barriers in health service provision, (2) actions and coordination to cope with those barriers, (3) health policies and armed conflict, and (4) post-accord and current situation. Twenty-two people participated in the interviews, including eight policymakers at the national level and seven at the local level, including two NGOs and five members of international organizations. An academic project event in December 2019 and four focus groups were developed (World Cafe technique) to discuss with national and local stakeholders the effects of armed conflict on the health system and an analytical framework to analyze its consequences., Results: The conflict affected the health-seeking behavior of the population, limited access to healthcare provision, and affected health professionals, and was associated with inadequate medical supplies in conflict areas. The health system implemented mechanisms to protect the medical mission, regulate healthcare provision in conflict areas, and commit to healthcare provision (mental and physical health services) for the population displaced by conflict., Conclusion: The state's presence, trust, and legitimacy have significantly reduced in recent years. However, it is crucial to restore them by ensuring that state and health services are physically present in all territories, including remote and rural areas., (© 2023. The Author(s).)

Background: The Colombian armed conflict has left millions of victims and has restricted access to different services provided by the government, especially for people with disabilities. This article studies the barriers faced by the victim population with disabilities when they want to access the health system in the department of Meta, Colombia, and offers a perspective from the experiences of people with disabilities who have been victims of the armed conflict in the country., Methods: To carry out this qualitative study, focus groups were conducted to capture the experiences and feelings of this population in the context of violence and high conflict., Results: The results show the barriers encountered by the victim population with disabilities, their families, and their caregivers when they want to access medical or health services., Conclusions: Many problems affect the population with disabilities and the victim population in Colombia today. The Colombian government has not been able to establish adequate policies to eliminate or even reduce access to services such as health, education, housing, and social protection., (© 2023. The Author(s).)

Objective: To identify and assess the effect of community-based Knowledge Translation Strategies (KTS) on maternal, neonatal, and perinatal outcomes. Methods: We conducted systematic searches in Medline, Embase, CENTRAL, CINAHL, PsycInfo, LILACS, Wholis, Web of Science, ERIC, Jstor, and Epistemonikos. We assessed the certainty of the evidence of the studies using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Results: We identified seven quantitative and seven qualitative studies. Quantitative findings suggest that there is a possible effect on reducing maternal mortality (RR 0.65; 95% CI, 0.48-0.87; moderate evidence certainty); neonatal mortality (RR 0.79; 95% CI 0.70-0.90; moderate evidence certainty); and perinatal mortality (RR 0.84; 95% CI 0.77-0.91; moderate evidence certainty) in women exposed to KTS compared to those who received conventional interventions or no intervention at all. Analysis of qualitative studies identified elements that allowed to generate benefit effects in improving maternal, neonatal, and perinatal outcomes. Conclusion: The KTS in maternal, neonatal, and perinatal outcomes might encourage the autonomy of communities despite that the certainty of evidence was moderate., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2023 Montoya-Sanabria, Hernández-Sandoval, Cáceres-Maldonado, Díaz-Barrero, Zapata-Matheus, Mejia-Pérez, De La Torre-Arias, Caballero-Diaz, González-Uribe, Domínguez-Torres, Nguyen and Yepes-Nuñez.)

Background and Objectives: Colombia is one of the countries with the highest levels of internal displacement resulting from armed conflict. This population has greater chances of experiencing a mental health disorder, especially in territories historically affected by armed conflict. Our objective was to compare the levels of possible mental health disorder in people experiencing internal displacement in Meta, Colombia, a department historically affected by armed conflict, compared to the internally displaced population in the National Mental Health Survey of 2015., Methods: Analysis of data collected in the National Mental Health Survey (ENSM) of 2015, study with representative data at national level and the Conflict, Peace and Health survey (CONPAS) of 2014, representative study of the degree of impact of the conflict on the municipality, conducted in the department of Meta, Colombia. To measure possible mental health disorder, the Self-Report Questionnaire-25 (SRQ-25) was used. Internal displacement is self-reported by people surveyed in both studies. An exploratory analysis is used to measure possible mental health disorders in the displaced population in the ENSM 2015 and CONPAS 2014., Results: 1089 adults were surveyed in CONPAS 2014 and 10,870 adults were surveyed in the ENSM 2015. 42.9% (468) and 8.7% (943) of people reported being internally displaced in CONPAS 2014 and ENSM 2015, respectively. In both studies, internally displaced populations have greater chances of experiencing any mental health disorder compared to non-displaced populations. For CONPAS 2014, 21.8% (95%CI, 18.1-25.8) of this population had a possible mental health disorder (SRQ+) compared to 14.0% (95%CI, 11.8-16.3) in the ENSM 2015. Compared with the ENSM 2015, at the regional level (CONPAS 2014), displaced people had a greater chance of presenting depression by 12.4% (95%CI, 9.5-15.7) compared to 5.7% (95%CI, 4.3-7.4) in the ENSM 2015, anxiety in 21.4% (95%CI, 17.7-25.3) compared to 16.5% (95%CI, 14.2-19.1) in the ENSM 2015, and psychosomatic disorders in 52.4% (95%CI, 47.5-56.7) in CONPAS 2014 compared to 42.2% (95%CI, 39.0-45.4) in the ENSM 2015. At the national level (ENSM 2015), displaced people had greater possibilities of presenting, compared to the regional level, suicidal ideation in 11.9% (95%CI, 9.3-14.1) compared to 7.3% (95%CI, 5.0-10.0) in CONPAS 2014 and bipolar disorder in 56.5% (95%CI, 53.2-59.7) compared to 39.3% (95%CI, 34.8-43.9) in CONPAS 2014., Conclusions: The greater possibilities of displaced populations at the regional level of experiencing a mental health disorder, compared to this same population at the national level, may represent and indicate greater needs in mental health care services in territories affected by conflict. Therefore, and given the need to facilitate access to health services in mental health for populations especially affected by armed conflict, there is a need to design health care policies that facilitate the recovery of populations affected by war and, simultaneously, that reduce inequities and promote the fulfilment of one of the most important and, at the same time, least prioritised health objectives in international development: mental health., (Copyright © 2021 Asociación Colombiana de Psiquiatría. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Most women with multiple sclerosis (MS) have childbearing potential. Although fertility and pregnancy are not affected by MS, the fertility preferences of women with MS can change due to the risk of complications for the mother and/or adverse pregnancy outcomes resulting from the disease or its treatment., Objectives: To describe fertility preferences (FPs) and their associated factors, to estimate the Unmet Need for Family Planning (UNFP), use of contraceptives, and history of exposure to disease-modifying therapies (DMTs) during pregnancy in women with MS., Methods: In a cross-sectional observational study, a random sample of women with MS were surveyed with the FP subset of the Demographic and Health Survey of Colombia. Factors associated with FP were evaluated through bivariate and logistic regression analysis. The proportion of pregnancies exposed to DMTs, UNFP, and use of contraceptives was estimated., Results: Of the 141 women interviewed, 101 women had childbearing potential, of whom 49 did not want to have children, 38 were sterilized, 33 wanted to have more children, 19 were undecided, and 2 stated they were unable to bear children (menopause or hysterectomy). No MS-related variables were associated with the preference to have more children. Age (OR 0.91; 95% CI 0.84-0.98) and the number of children (OR 0.23; 95% CI 0.09-0.58) decreased the likelihood of desire for children. Of 116 sexually active women, 87.06 % (101) were using contraceptives, and among them, four were using fertility awareness methods and withdrawal. The UNFP was estimated at 6.03% and was not significantly different from the general population. Eighty-two pregnancies were identified, of which 48 occurred after diagnosis, and 25 were exposed to DMTs., Conclusion: Fertility preference in women with MS is not associated with clinical variables. A large proportion of women choose not to have children and prefer to use permanent contraceptive methods. Although the frequency of contraceptive use was high, some women have the UNFP and use low-efficacy contraceptive methods, which may result in unplanned pregnancies., Competing Interests: Author LL-R has received travel expenses for scientific meetings from Roche, Tecnofarma, and Biogen-Idec and speaking honoraria from Merck, Roche, and Biogen-Idec. Author CG-S reports consulting fees from Novartis, Biogen-Idec, Sanofi-Genzyme, Merck, and Roche and has received travel expenses for scientific meetings from Sanofi-Genzyme, Abbot, and Merck. Author SC-R was an ECTRIMS clinical fellowship awardee 2019–2020 and has received travel expenses for scientific meetings from Genzyme and Merck; compensation for consulting services or participation on advisory boards from Merck, Roche, Biogen-Idec, and Novartis; speaking honoraria from Novartis and Biogen-Idec; and research support from Biogen-Idec and Novartis. The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 López-Reyes, Guío-Sánchez, González-Uribe and Cárdenas-Robledo.)

Background: Artificial Intelligence (AI) and data science research are promising tools to better inform public policy and public health responses, promoting automation and affordability. During the COVID-19 pandemic, AI has been an aid to forecast outbreak spread globally. The overall aim of the study is to contribute to the ongoing public health, socioeconomic, and communication challenges caused by COVID-19. Protocol: COLEV is a five-pronged interdisciplinary mixed methods project based on AI and data science from an inclusive perspective of age and gender to develop, implement, and communicate useful evidence for COVID-19-related response and recovery in Colombia. The first objective is identification of stakeholders' preferences, needs, and their use of AI and data science relative to other forms of evidence. The second objective will develop locally relevant mathematical models that will shed light on the possible impact, trajectories, geographical spread, and uncertainties of disease progression as well as risk assessment. The third objective focuses on estimating the effect of COVID-19 on other diseases, gender disparities and health system saturation. The fourth objective aims to analyze popular social networks to identify health-related trending interest and users that act as 'super spreaders' for information and misinformation. Finally, the fifth objective, aims at designing disruptive cross-media communication strategies to confront mis- and dis-information around COVID-19. To understand stakeholders' perspectives, we will use semi-structured interviews and ethnographic work. Daily cases and deaths of COVID-19 reported from the National Surveillance System (INS) of Colombia will be used for quantitative analysis, and data regarding the online conversation will be obtained from Facebook and Twitter. Conclusions: COLEV intends to facilitate the dialogue between academia and health policymakers. The results of COLEV will inform on the responsible, safe and ethical use of AI and data science for decision-making in the context of sanitary emergencies in deeply unequal settings., Competing Interests: No competing interests were disclosed., (Copyright: © 2022 González-Uribe C et al.)

Introduction: For young adults, the first year of higher education represents a transition period into adulthood associated with an increased risk of developing depression, anxiety, and stress, contributing to deteriorating physical and mental health. The present study aimed to analyze the relationship between depressive symptoms and social capital and lifestyles among Colombian university students., Methods: In 2020, a longitudinal repeated measures study was conducted on first year students at Universidad de los Andes in Bogota, Colombia. The study was conceptualized and approved by the university before the COVID-19 pandemic appeared. Each student completed a self-administered questionnaire including questions on sociodemographic characteristics, depressive symptoms, perceived stress, social capital, and lifestyles. The study's pilot was conducted in November 2019, and the two measurement points were in January 2020 (wave 1, before the COVID-19 pandemic was declared) and in August 2020 (wave 2, during the COVID-19 pandemic). A binary logistic regression analysis was performed to assess the relationship between depressive symptoms, perceived stress, social capital, and lifestyles., Findings: A total of 609 first year students (response rate = 58.11%) participated in wave 1, and 42% of the participants showed signs of clinically relevant depressive symptoms. In wave 2, despite the difficulties encountered in collecting data due to the COVID-19 pandemic, 216 students from wave 1 participated (35.47%). An increase in a sedentary lifestyle was observed (31.49%). We found that cognitive and behavioral social capital levels decreased by 12.03 and 24.54%, respectively. In addition, we observed a 6.5% increase in students with clinically relevant depressive symptoms compared to wave 1. A low level of behavioral [ OR : 1.88; 95% CI (1.16, 3.04)] social capital was associated with clinically relevant depressive symptoms., Conclusion: The health of university students continues to be a public health concern. The study suggests that social capital may play an important role in preventing depressive symptoms. Therefore, universities should put effort into programs that bring students together and promote the creation of social capital., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Sotaquirá, Backhaus, Sotaquirá, Pinilla-Roncancio, González-Uribe, Bernal, Galeano, Mejia, La Torre, Trujillo-Maza, Suárez, Duperly and Ramirez Varela.)

The peace agreement with the Colombian guerrilla group Fuerzas Armadas Revolucionarias de Colombia-Ejército del Pueblo represented an opportunity for peacebuilding and victims' reparation, rather than the end of the internal armed conflict. In this context, this study aimed to uncover the consequences of conflict on victims' health and on health service provision, and their perceived health status during the post-accord stage in the Meta region, located in the country's eastern plains. Historically, this region has been one of the territories most affected by the presence of conflict-related groups and armed confrontations. Through focus groups, this research explored the health perceptions and experiences of victims of armed conflict. Ten focus groups were conducted with men and women, victims of the armed-conflict, in four municipalities with different degrees of armed conflict intensity. The focus group transcripts were coded using NVivo. The results show that the way women have experienced conflict and the effects of conflict on mental health in general for men, women, and children were recurrent themes in the dialogue of victims. Likewise, it highlights the need to understand the barriers that the current health model imposes on the right to health itself. From the victim's perspective, they experience stigmatization, discrimination, and revictimization when accessing health services. These barriers co-occur along with structural limitations of the health system that affect the general population., Competing Interests: The authors have declared that no competing interests exist.