Evidence map›Paper›PMID 42230997›Full record

ArticleJournal of public health policy2026

Local governance dynamics in the Colombian health system: an exploratory cross-sectional study among public health sector officials.

Natalia Losada-Trujillo, Javier Eslava-Schmalbach, Carol C Guarnizo-Herreño

Abstract read
In one paragraph

Article in Journal of public health policy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Natalia Losada-TrujilloSchool of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia. nlosadat@unal.edu.co.
Javier Eslava-SchmalbachSchool of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia.
Carol C Guarnizo-HerreñoSchool of Dentistry, Universidad Nacional de Colombia, Bogotá, Colombia.

Funding

National Institute for Health and Care Research NIHR 150067
6 · The paper itself

Abstract

Health system governance is essential for effective and equitable healthcare delivery. In Colombia, persistent challenges, including delays, denials, barriers to care, and poor system coordination, suggest weaknesses in local governance. This study aimed to explore local health system governance in Colombia by assessing institutional practices, decision-making processes, and perceptions of public health sector officials. Exploratory cross-sectional study using self-administered online surveys (May-July 2025) with a convenient non-probabilistic sample of 44 health sector officials in stewardship, planning, and oversight roles. Descriptive analyses were performed. While we identified high institutional planning capacity, respondents reported limited decision-making autonomy, external pressures on planning and budget allocation, poor integration of information systems, perceived insufficiency of the benefits package and capitation payment, irregular provider payments, and tariff variability. Findings suggest weak local health system governance in Colombia, highlighting the need to implement a comprehensive reform including strengthened stewardship, information systems integration, adequate financing, and fair provider payments.

Indexed as

Delivery of Health CareLocal GovernmentPublic HealthPublic Health AdministrationPublic SectorColombiaCross-Sectional StudiesDecision MakingHealth PolicyHumansPublic Health InfrastructureSurveys and QuestionnairesColombiaDecision-makingFinancing fragmentationHealth policyHealth system governancePublic health officials

Identifiers

PMID42230997
PMCPMC13278946

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.