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PurposeThe purpose of this paper is to review the relevant literature in order to identify trends and suggest some possible directions for future research in the framework of humanitarian aid distribution logistics with accessibility constraints.Design/methodology/approachThe authors developed a systematic literature review to study the state of the art on distribution logistics considering accessibility constraints. The electronic databases used were Web of science, Scopus, Science Direct, Jstor, Emerald, EBSCO, Scielo and Redalyc. As a result, 49 articles were reviewed in detail.FindingsThis study identified some gaps, as well as some research opportunities. The main conclusions are the need for further studies on the interrelationships and hierarchies of multiple actors, explore intermodality, transshipment options and redistribution relief goods to avoid severe shortages in some nodes and excess inventory in others, studies of the vulnerability of transport networks, correlational analysis of road failures and other future lines.Research limitations/implicationsThe bibliography is limited to peer-reviewed academic journals due to their academic relevance, accessibility and ease of searching. Most of the studies included in the review were conducted in high-income countries, which may limit the generalizability of the results to low-income countries. However, the authors focused on databases covering important journals on humanitarian logistics.Originality/valueThis paper contextualises and synthesises research into humanitarian aid distribution logistics with accessibility constrains, highlights key themes and suggests areas for further research.

PurposeThe aim of this study is to increase the understanding of collaborative relationships and assess according to the project size, the influence of the contributory factors in shaping collaboration network structure in projects developed in global supply chains (GSC).Design/methodology/approachThe paper used a case study methodology applied to eight global projects developed by an Austrian company leader in global market intra-logistics solutions and warehouse automation. The cases were studied by two approaches in network analysis. First, visual and descriptive analysis to describe structural aspects of the network. Second, stochastic network analysis to evaluate the influence of contributory factors in the structure of the collaboration network.FindingsThe results evidence that independently of the project size and project manager influence, project team roles (PTR) who have a reciprocal communication among other PTR tend to have a higher collaboration intensity (CI). Additionally, the results highlight the influence of the project manager in shaping the collaboration network in standard projects (STP) and small projects (SMP). According to the project size, the results show that the PTR that form complete triangles or cluster or who communicate frequently among each other tend to have a high CI, being more evident these tendencies in large-scale projects than STP and SMP.Originality/valueThis research provides a framework to identify the key actors and contributory factors in shaping collaborative relationships in GSC. The findings could be used to support the decision-making process and formulation strategies for effective collaborative relationship management in GSC.

PurposeIn Latin America and the Caribbean, the access of students to higher education has presented an extraordinary growth over the past fifteen years. This rapid growth has presented a challenge for increasing the system resources and capabilities while maintaining its quality. As a result, the networked universities (NUs) organized themselves as a collaborative network, and they have become an interesting model for facing the complexity driven by globalization, rapidly changing technology, dynamic growth of knowledge and highly specialized areas of expertise. In this article, we studied the NU named Red Universitaria Mutis (Red Mutis) with the aim of characterizing the collaboration and integration structure of the network.Design/methodology/approachNetwork analytic methods (visual analysis, positional analysis and a stochastic network method) were used to characterize the organizational structure and robustness of the network, and to identify what variables or structural tendencies are related to the likelihood that specific areas of a university would collaborate.FindingsRed Mutis is a good example of regional NUs that could take advantage of the strengths, partnerships, information and knowledge of the regional and international universities that form the network. Analyses showed that Red Mutis has a differentiated structure consisting of academic and non-academic university areas with a vertical coordination (by steering and management) of the different university areas.Originality/valueThe methodology could be used as a framework to analyze and strengthen other strategic alliances between universities and as a model for the development of other NU in local and global contexts.

La generacion e implementacion de estrategias para disminuir la transmision de SARS-CoV-2 son un reto imperante para el pais. Las estrategias deben ser dinamicas y especificas para cada region busc...

Cross-impact balance (CIB) analysis leverages expert knowledge pertaining to the nature and strength of relationships between components of a system to identify the most plausible future ‘scenarios’ of the system. These scenarios, also referred to as ‘storylines’, provide qualitative insights into how the state of one factor can either promote or restrict the future state of one or multiple other factors in the system. This paper presents a novel, visually oriented questionnaire developed to elicit expert knowledge about the relationships between key factors in a system, for the purpose of CIB analysis. The questionnaire requires experts to make selections from a series of standardized cause-effect graphical profiles that depict a range of linear and non-linear relationships between factor pairs. The questionnaire and the process of translating the graphical selections into data that can be used for CIB analysis is described using an applied example which focuses on urban health in Latin American cities. • A questionnaire featuring a set of standardized cause-effect profiles was developed. • Cause-effect profiles were used to elicit information about the strength of linear and non-linear bivariate relationships. • The questionnaire represents an intuitive visual means for collecting data required for the conduct of CIB analysis.

Urban health is shaped by a system of factors spanning multiple levels and scales, and through a complex set of interactions. Building on causal loop diagrams developed via several group model building workshops, we apply the cross-impact balance (CIB) method to understand the strength and nature of the relationships between factors in the food and transportation system, and to identify possible future urban health scenarios (i.e., permutations of factor states that impact health in cities). We recruited 16 food and transportation system experts spanning private, academic, non-government, and policy sectors from six Latin American countries to complete an interviewer-assisted questionnaire. The questionnaire, which was pilot tested on six researchers, used a combination of questions and visual prompts to elicit participants’ perceptions about the bivariate relationships between 11 factors in the food and transportation system. Each participant answered questions related to a unique set of relationships within their domain of expertise. Using CIB analysis, we identified 21 plausible future scenarios for the system. In the baseline model, ‘healthy’ scenarios (with low chronic disease, high physical activity, and low consumption of highly processed foods) were characterized by high public transportation subsidies, low car use, high street safety, and high free time, illustrating the links between transportation, free time and dietary behaviors. In analyses of interventions, low car use, high public transport subsidies and high free time were associated with the highest proportion of factors in a healthful state and with high proportions of ‘healthy’ scenarios. High political will for social change also emerged as critically important in promoting healthy systems and urban health outcomes. The CIB method can play a novel role in augmenting understandings of complex urban systems by enabling insights into future scenarios that can be used alongside other approaches to guide urban health policy planning and action., Highlights • We used the CIB method to augment findings from group model building workshops. • The CIB method highlights possible future scenarios to guide health policy planning. • We identified 21 plausible future scenarios for cities in Latin America. • Healthy scenarios featured low car use, high public transport subsidies and safety. • Political will appears critically important in promoting healthy urban scenarios.

Urban transportation is an important determinant of health and environmental outcomes, and therefore essential to achieving the United Nation's Sustainable Development Goals. To better understand the health impacts of transportation initiatives, we conducted a systematic review of longitudinal health evaluations involving: a) bus rapid transit (BRT); b) bicycle lanes; c) Open Streets programs; and d) aerial trams/cable cars. We also synthesized systems-based simulation studies of the health-related consequences of walking, bicycling, aerial tram, bus and BRT use. Two reviewers screened 3302 unique titles and abstracts identified through a systematic search of MEDLINE (Ovid), Scopus, TRID and LILACS databases. We included 39 studies: 29 longitudinal evaluations and 10 simulation studies. Five studies focused on low- and middle-income contexts. Of the 29 evaluation studies, 19 focused on single component bicycle lane interventions; the rest evaluated multi-component interventions involving: bicycle lanes (n = 5), aerial trams (n = 1), and combined bicycle lane/BRT systems (n = 4). Bicycle lanes and BRT systems appeared effective at increasing bicycle and BRT mode share, active transport duration, and number of trips using these modes. Of the 10 simulation studies, there were 9 agent-based models and one system dynamics model. Five studies focused on bus/BRT expansions and incentives, three on interventions for active travel, and the rest investigated combinations of public transport and active travel policies. Synergistic effects were observed when multiple policies were implemented, with several studies showing that sizable interventions are required to significantly shift travel mode choices. Our review indicates that bicycle lanes and BRT systems represent promising initiatives for promoting population health. There is also evidence to suggest that synergistic effects might be achieved through the combined implementation of multiple transportation policies. However, more rigorous evaluation and simulation studies focusing on low- and middle-income countries, aerial trams and Open Streets programs, and a more diverse set of health and health equity outcomes is required., Graphical abstract This figure represents a word network created by extracting keywords from the paper abstracts included in our systematic review. Each keyword represents a node in the network; its size is proportional to the number of abstracts in which it appears. Keywords are connected if they are found in the same abstract. The colours represent different communities of words as identified using the Louvain method.Image 1, Highlights • Bike lanes and bus rapid transit systems promote physical activity and active travel. • Multi-component interventions can act synergistically to increase active travel. • Few longitudinal health evaluations of aerial trams and open streets programs exist. • Low-and-middle income countries are understudied in the literature.

Walking and biking to school represent a source of regular daily physical activity (PA). The objectives of this paper are to determine the associations of distance to school, crime safety, and socioeconomic variables with active school transport (AST) among children from five culturally and socioeconomically different country sites and to describe the main policies related to AST in those country sites. The analytical sample included 2845 children aged 9–11 years from the International Study of Childhood Obesity, Lifestyle and the Environment. Multilevel generalized linear mixed models were used to estimate the associations between distance, safety and socioeconomic variables, and the odds of engaging in AST. Greater distance to school and vehicle ownership were associated with a lower likelihood of engaging in AST in sites in upper-middle- and high-income countries. Crime perception was negatively associated to AST only in sites in high-income countries. Our results suggest that distance to school is a consistent correlate of AST in different contexts. Our findings regarding crime perception support a need vs. choice framework, indicating that AST may be the only commuting choice for many children from the study sites in upper-middle-income countries, despite the high perception of crime.

The explosion of network science has permitted an understanding of how the structure of social networks affects the dynamics of social contagion. In community-based interventions with spill-over effects, identifying influential spreaders may be harnessed to increase the spreading efficiency of social contagion, in terms of time needed to spread all the largest connected component of the network. Several strategies have been proved to be efficient using only data and simulation-based models in specific network topologies without a consensus of an overall result. Hence, the purpose of this paper is to benchmark the spreading efficiency of seeding strategies related to network structural properties and sizes. We simulate spreading processes on empirical and simulated social networks within a wide range of densities, clustering coefficients, and sizes. We also propose three new decentralized seeding strategies that are structurally different from well-known strategies: community hubs, ambassadors, and random hubs. We observe that the efficiency ranking of strategies varies with the network structure. In general, for sparse networks with community structure, decentralized influencers are suitable for increasing the spreading efficiency. By contrast, when the networks are denser, centralized influencers outperform. These results provide a framework for selecting efficient strategies according to different contexts in which social networks emerge.

This paper assesses the potential cohesion effect of a physical activity (PA) school-based intervention potentiated using text messages (SMS) through analyzing longitudinally the friendship network structure and the mechanisms of the formation and dissolution of friendships. Three schools (n = 125 participants) in Bogot&aacute, Colombia, were randomly assigned into three groups: Modulo Activo Recreo Activo (MARA) + SMS (networks 1 and 2), MARA (networks 3 and 4), and control (no intervention: networks 5&ndash, 7). We collected socio-economic, health-related, network structure, and intervention satisfaction variables in the baseline and after 10 weeks on July&ndash, November 2013. For each classroom network, we conducted four models using a temporal and static network approach to assess (1) temporal social network changes, (2) friendship homophily, (3) friendship formation and dissolution mechanisms, and (4) effect of SMS on the networks&rsquo, cohesion. We found that (1) social cohesion emerged in the four intervened networks that were measured over time with transitivity and homophily driven by clustering, (2) the intervention affected the mechanisms of friendship formation and dissolution, and (3) MARA + SMS on average created more social cohesion and 3.8 more friendships than the program alone. Potentially, school-based interventions with information and communication technologies (ICT) such as MARA + SMS could encourage social cohesion among children. The particular characteristics of each school network need to be considered when developing school-based interventions.

Purpose – Overweight, obesity, and physical inactivity have in recent years become an important public health problem worldwide. Investigations that study obesity using a systemic approach in low- and middle-income countries (LMICs) are limited. Therefore, the purpose of this paper is to study the nutritional stages dynamics within the Colombian urban population. Design/methodology/approach – The authors used a population-level systems dynamics (SD) model that captures the transitions of population by body mass index (BMI) categories. The authors proposed a heuristic to estimate the transference rates (TRs) between BMI categories using data from the Colombian Demographic and Health Survey 2005 and 2010. Findings – The Colombian urban population is moving to overweight and obese categories. The TRs from not overweight to overweight and from overweight to obese (0.0076 and 0.0054, respectively) are higher than the TRs from obese to overweight and from overweight to not-overweight (1.025×10e−7 and 3.47×10e−7, respectively). The simulation results show that the prevalences of overweight and obesity will increase by 6.2 and 7.5 percent by 2015, and by 13.4 and 18.9 percent by 2030, respectively. Originality/value – Investigations that study obesity using a systemic approach in LMICs are limited. A SD model was proposed to examine changes in the population’s nutritional stages using population accumulation structures by BMI categories. The authors propose a heuristic to estimate the TRs of individuals between BMI categories. The proposed model can be used to study the effects of policy interventions to prevent overweight and obesity. The authors analyze a few policy intervention strategies.

We study the relevance of considering social network analysis in determining soccer results. As a benchmark, we start using a simple regression model based on past performance to try to determine the main trends of a soccer match based on probabilities of winning, losing or tying, as home or visiting teams. The success of this simple model, based on historical performance, is improved by the addition of network descriptors of both teams in a game. Therefore, such network measures do offer additional useful information in determining match outcomes. We validate our approach using the data of the Spanish League (La Liga) 2012–2013. We observe that betweenness centrality seems to provide additional relevance information related to the performance of a team during the tournament.

ObjectiveWe study the obesity transition by socioeconomic status (SES), gender and age within the Colombian urban population at the country, regional and department levels.DesignThe study is informed by cross-sectional data from the 2005 and 2010 ENSIN survey. We used these data to develop a system dynamics model that simulates the dynamics of obesity by body mass index (BMI) categories, gender and SES at the country, regional and department levels from 2005 to 2030.ParticipantsThe sample size of the 2005 ENSIN comprised 8515 children younger than 5 years, 32 009 children and adolescents aged 5–17 years and 48 056 adults aged 18–64 years. In 2010, the corresponding numbers were 11 368, 32 524 and 64 425, respectively.Primary and secondary outcome measureThe obesity prevalence ratio and prevalence rates for each BMI category.ResultsThe results show, at the country level, transitions from overweight to obesity were projected to increase sharply among lower SES adults, particularly among women, suggesting that these groups will undergo an obesity transition by 2030. The model projections also indicate that the regions of Colombia are in different stages of the obesity transition. In the case of women, five out of the six regions were expected to undergo an obesity transition by SES over time. For men, only one region was expected to undergo an obesity transition. However, at the department level, trends in the burden of obesity varied.ConclusionsWe evidence that the Colombian population could be experiencing an obesity transition where the increase in the GDP could be related to shifts in the burden of obesity from higher to lower SES, especially in women. These patterns support the need for policy planning that considers SES and gender, at the national and subnational levels, as important determinants of overweight and obesity among adults in Colombia.

The incremental trends in the amount of human and material losses, added to a higher frequency of natural disasters, have generated greater interest from different sectors regarding the processes of disaster management. In this sense, it is recognized that the context of disasters is strongly marked by the high diversity and quantity of actors which seek common or conflicting objectives. The aim of this chapter is to present the actors involved in the humanitarian supply chains (HSC) and to highlight the importance of key local actors involved in disaster preparedness and response, the latter from an inter-sectoral perspective towards the importance implied by the coordination of the key actors in terms of the humanitarian purposes. The discussion developed allows for the inference about the critical role of local actors in disaster management and HSC, as well as several topics for the theoretical development of humanitarian logistics, such as the application of decision tools and information technologies, and the use of sustainability approach for disaster management.

We discuss the design, implementation, and results of a collaborative process designed to elucidate the complex systems that drive food behaviors, transport, and health in Latin American cities and to build capacity for systems thinking and community-based system dynamics (CBSD) methods among diverse research team members and stakeholders. During three CBSD workshops, 62 stakeholders from 10 Latin American countries identified 98 variables and a series of feedback loops that shape food behaviors, transportation and health, along with 52 policy levers. Our findings suggest that CBSD can engage local stakeholders, help them view problems through the lens of complex systems and use their insights to prioritize research efforts and identify novel solutions that consider mechanisms of complexity., Highlights • CBSD methods can promote systems thinking and help identify policy approaches. • Stakeholders identified 98 variables driving food behaviors and transport in cities. • Balancing and reinforcing feedbacks drive change in food behavior and transport. • Feedback loops can also explain policy responses and lack of policy responses. • Stakeholders identified 52 policies that leverage variables and feedbacks.

Purpose. Conduct a social network analysis of the health and non–health related organizations that participate in Bogotá's Ciclovía Recreativa (Ciclovía). Design. Cross-sectional study. Setting. Ciclovía is a multisectoral community-based mass program in which streets are temporarily closed to motorized transport, allowing exclusive access to individuals for leisure activities and physical activity. Subjects. Twenty-five organizations that participate in the Ciclovía. Measures. Seven variables were examined by using network analytic methods: relationship, link attributes (integration, contact, and importance), and node attributes (leadership, years in the program, and the sector of the organization). Analysis. The network analytic methods were based on a visual descriptive analysis and an exponential random graph model. Results. Analysis shows that the most central organizations in the network were outside of the Health sector and include Sports and Recreation, Government, and Security sectors. The organizations work in clusters formed by organizations of different sectors. Organization importance and structural predictors were positively related to integration, while the number of years working with Ciclovía was negatively associated with integration. Conclusion. Ciclovía is a network whose structure emerged as a self-organized complex system. Ciclovía of Bogotá is an example of a program with public health potential formed by organizations of multiple sectors with Sports and Recreation as the most central.

IntroductionThe Ciclovía is a worldwide program in which streets are temporarily closed to motorized transport to create a space for recreation and outdoor play among children and adults. The aim of this study was to assess the associations between physical activity (PA), sedentary time (SED), body mass index and Ciclovía participation among children aged 9 to 13 years.MethodsAll students in the 4th and 5th grades from the selected schools were invited to participate in the study. The study included 923 children. PA and SED were measured using waist-worn accelerometers, and height and weight were measured using standardized procedures. Ciclovía participation was self-reported. The analyses included multilevel linear, generalized mixed and generalized additive models.ResultsThe mean age of the sample was 10.1±0.7 years, and 49.5% were boys. In the last year, 46% of the children participated in the Ciclovía, and 34% reported participating frequently (at least once per month). No differences were found in the mean minutes of moderate-to-vigorous PA on weekdays between frequent Ciclovía users and sporadic and non-Ciclovía users (72 vs 69; p = 0.09). In contrast, frequent Ciclovía users had higher moderate-to-vigorous PA on Sundays than sporadic and non-Ciclovía users (65.6 vs 59.2; p = 0.01), specifically between the hours of 12:00 and 16:00. In addition, frequent Ciclovía users did not differ from the sporadic and non-Ciclovía users in SED (515.3 vs 521.3; p = 0.19). Frequent Ciclovía users had lower SED on Sundays than the sporadic and non-Ciclovía users (437.7 vs 456.5; p = 0.005). Additionally, frequent Ciclovía users were more likely to be overweight (28.3% vs 20.4% p = 0.01). We did not find differences in participation by sex, and low-to-middle income children were more likely to participate.ConclusionsThe Ciclovías offer an innovative, inclusive recreational space and consequently provide opportunities to increase moderate-to-vigorous PA and reduce SED among children.

The main aim of this study was to assess the reliability and validity of a food frequency questionnaire with 23 food groups (I-FFQ) among a sample of 9–11-year-old children from three different countries that differ on economical development and income distribution, and to assess differences between country sites. Furthermore, we assessed factors associated with I-FFQ’s performance. This was an ancillary study of the International Study of Childhood Obesity, Lifestyle and the Environment. Reliability (n=321) and validity (n=282) components of this study had the same participants. Participation rates were 95% and 70%, respectively. Participants completed two I-FFQs with a mean interval of 4.9 weeks to assess reliability. A 3-day pre-coded food diary (PFD) was used as the reference method in the validity analyses. Wilcoxon signed-rank tests, intraclass correlation coefficients and cross-classifications were used to assess the reliability of I-FFQ. Spearman correlation coefficients, percentage difference and cross-classifications were used to assess the validity of I-FFQ. A logistic regression model was used to assess the relation of selected variables with the estimate of validity. Analyses based on information in the PFDs were performed to assess how participants interpreted food groups. Reliability correlation coefficients ranged from 0.37 to 0.78 and gross misclassification for all food groups was

Este documento es un tributo a 20 años de ediciones ininterrumpidas de la Revista de Ingeniería de la Universidad de los Andes. En estas dos décadas la revista ha guiado la construcción de capital social de la Facultad de Ingeniería de la Universidad de los Andes. En este artículo se presentan algunas características del capital social de la facultad. Se estudian las relaciones de coautoría en libros, artículos en conferencias, artículos publicados en libros y artículos publicados en revistas indexadas en ISI Web of Knowledge durante los últimos 10 años. El propósito es estudiar la relación entre la producción científica de la Facultad de Ingeniería de la Universidad de los Andes y su acumulación de capital social. Se propone que las relaciones de coautoría representen una red dinámica donde grupos de actores trabajan colectivamente en la producción de conocimiento. Las características estructurales (tamaño y conectividad) de la red de coautorías proporcionan una representación del capital social. El estudio de la dinámica de la red da indicios de la acumulación de capital social y de las estrategias colectivas de producción de conocimiento. Los resultados muestran que existe una relación de dosis-respuesta entre la producción científica y las características estructurales de la red de coautorías. La conectividad de los autores y el tamaño de la red (números de nodos y número de arcos) están relacionados positivamente con las dinámicas de producción de conocimiento.//This work is a tribute to the 20th anniversary of the Revista de Ingeniería de la Universidad de los Andes. In these two decades this journal has guided the construction of social capital of this School of Engineering. This work presents the relationship between the scientific production of the School of Engineering and its accumulation of social capital. Social capital is represented by coauthorships. These relations represent a dynamic network where groups of actors work together in the production of knowledge. The proposal is that structural characteristics (size and connectivity) of the network represent a measure of social capital. Therefore, the study of the dynamics of the network gives hints of the accumulation of social capital and the collective strategies of knowledge production. The results show a dose-response relation between scientific production and the structural characteristics of the network. The connectivity between coauthors and the size of the network (number of nodes and number of arcs) are positively related with the dynamics of knowledge production.

Transport systems can play an important role in increasing physical activity (PA). Bogota has been recognized for its bus rapid transit (BRT) system, TransMilenio (TM). To date, BRTs have been implemented in over 160 cities worldwide. The aim of this study was to assess the association between PA and the use of TM among adults in Bogota. The study consists of a cross-sectional study conducted from 2010 to 2011 with 1000 adults. PA was measured using the International Physical Activity Questionnaire. In a subsample of 250 adults, PA was objectively measured using ActiGraph accelerometers. Analyses were conducted using multilevel logistic regression models. The use of TM was associated with meeting moderate-to-vigorous PA (MVPA). TM users were more likely to complete an average of >22 min a day of MVPA (odds ratio [OR] = 3.1, confidence interval [CI] = 95 % 1.4–7.1) and to walk for transportation for ≥150 min per week (OR = 1.5; CI = 95 % 1.1–2.0). The use of TM was associated with 12 or more minutes of MVPA (95 % CI 4.5–19.4, p

OBJECTIVES: Dietary pattern is defined as a combination of foods and drinks and the frequency of consumption within a population. Dietary patterns are changing on a global level, which may be linked to an increased incidence of chronic diseases. The aim of this study was to identify and compare the dietary patterns among 9–11-year-old children living in urban regions in different parts of the world.METHODS: Participants were 7199 children (54% girls), aged 9–11 years, from 12 countries situated in all major world regions. Food consumption was assessed using a 23-item Food Frequency Questionnaire (FFQ). To identify dietary patterns, principal components analyses (PCA) were carried out using weekly portions as input variables.RESULTS: Both site-specific and pooled PCA resulted in two strong components. Component 1 (‘unhealthy diet pattern’) included fast foods, ice cream, fried food, French fries, potato chips, cakes and sugar-sweetened sodas with >0.6 loadings. The loadings for component 2 (‘healthy diet pattern’) were slightly weaker with only dark-green vegetables, orange vegetables, vegetables in general, and fruits and berries reaching a >0.6 loading. The site-specific diet pattern scores had very strong correlations with the pattern scores from the pooled data: r=0.82 and 0.94 for components 1 and 2, respectively.CONCULSIONS: The results suggest that the same ‘healthier’ and ‘unhealthier’ foods tend to be consumed in similar combinations among 9–11-year-old children in different countries, despite variation in food culture, geographical location, ethnic background and economic development.

En la actualidad, los procesos yactividades propios de las organizaciones vinculadas a la gestión del serviciode salud pública requieren de un gran manejo de datos y velocidad en elprocesamiento de los mismos. En este sentido, es un hecho que las Tecnologíasde Información y Comunicación (TIC) se han constituido en una herramientaesencial para incorporar soluciones novedosas y efectivas (eficaces + eficientes)para el manejo y administración de sistemas de información complejos. En elcaso de la prestación de servicios de salud, el impacto de una mejora en losprocesos de gestión, recae sobre todo, en la población más vulnerable y deescasos recursos, que en una gran proporción reside en zonas rurales. Este artículo da a conocer el caso de un diseñoe implementación de una solución innovadora a la problemática del proceso detrámite manual de autorizaciones de servicios especializados de salud en el departamentodel Tolima, Colombia. La solución alproceso de solicitudes, se apoyó en la tecnología ‘Cloud computing’ y sevalidó con su puesta en marcha y consulta a usuarios. El análisis de losregistros y la consulta de evaluación del servicio, realizada a usuarios detrámites de autorizaciones, revelan el impacto positivo de esta innovación enel proceso. Las variables de desempeño del sistema sugieren una reduccióndel tiempo de respuesta en el servicio del 60% y del costo del trámite hasta enun 40% para los usuarios, a su vez en una mejora en la percepción de la calidaden el servicio. Esta experiencia evidencia que las innovaciones de proceso,soportadas con TIC, representan una alternativa efectiva para mejorar losservicios de salud y ampliar losbeneficios de políticas públicas vinculadas con el sector.