Healthcare Workers during the COVID-19 Pandemic from a Street-Level Bureaucracy Perspective - A Narrative Review of Literature
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Oct 7, 2021
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Resumo
Street - level bureaucrats are professionals whose main role consists in the implementation of public policies at a community level, guiding themselves through the use of autonomy and discretion.. In this narrative review of literature 44 articles that had information about street level bureaucracy regarding healthcare workers in the covid 19 pandemic in specific countries (China, United States, Italy, Brazil, Mexico and Colombia) were selected from various databases and analyzed to explore how the implementation of health public policies during the current COVID - 19 outbreak impacted and shaped the work of healthcare workers. Various ideas were extracted and analyzed using the street level bureaucracy model as a reference point. We concluded that street level bureaucrats have played a crucial role in this pandemic and that providing them with government support, clear public policies and enough resources is essential for them to correctly manage public health problems. Further research needs to be done regarding the consequences brought upon street level bureaucrats by the pandemic and the impact that street level bureaucrats have had in countries like Colombia.
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References
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3. Zhu S, Zong Z. Why did so few healthcare workers in China get COVID-19 infection. QJM: An International Journal of Medicine - Oxford Academic [Internet]. 2020;1–2. https://doi.org/10.1093/qjmed/hcaa254
4. Parshley L. Who gets to live? How doctors make impossible decisions as COVID-19 surges. National Geographic [Internet]. 2020 Jul 24; https://www.nationalgeographic.com/science/2020/07/how-doctors-make-impossible-decisions-as-coronavirus-surges-cvd/
5. Bergquist S, Otten T, Sarich N. COVID-19 pandemic in the United States. Health Policy and Technology [Internet]. 2020;9(4):623–38. https://doi.org/10.1016/j.hlpt.2020.08.007
6. Al-Tawfiq JA, Al-Yami SS, Rigamonti D. Changes in healthcare managing COVID and non–COVID-19 patients during the pandemic: striking the balance. Diagnostic Microbiology and Infectious Disease. 2020;98(4):19–22.
7. Sanfelici M. The Italian Response to the COVID-19 Crisis: Lessons Learned and Future Direction in Social Development. The International Journal of Community and Social Development [Internet]. 2020;2(2):191–210. https://journals.sagepub.com/doi/pdf/10.1177/2516602620936037
8. Cohen J, Rodgers Y van der M. Contributing factors to personal protective equipment shortages during the COVID-19 pandemic. Preventive Medicine [Internet]. 2020;141(October):106263. https://doi.org/10.1016/j.ypmed.2020.106263
9. Lipsky M. Toward a Theory Of Street - level Bureaucracy. Institute for Research on Poverty [Internet]. 1969 Aug [cited 2020 Dec 10];1–48. https://www.irp.wisc.edu/publications/dps/pdfs/dp4869.pdf
10. Nunes J, Lotta G. Discretion, power and the reproduction of inequality in health policy implementation: Practices, discursive styles and classifications of Brazil’s community health workers. Social Science and Medicine [Internet]. 2019 Dec;242(December):112551. https://doi.org/10.1016/j.socscimed.2019.112551
11. Erasmus E. The use of street-level bureaucracy theory in health policy analysis in low- and middle-income countries: a meta-ethnographic synthesis. Oxford Academic [Internet]. 2014;29(3):70–8. https://pubmed.ncbi.nlm.nih.gov/25435538/
12. Cadena Camargo YML. Heroes or villains? Dilemmas of professionals working with displaced adolescent mothers in Bogotá: an analysis of street-level bureaucracy. In: Medical Risk or Complex Narratives? Using life stories of internally displaced adolescent mothers in Bogotá to put policies in perspective. 2020. p. 113–32.
13. University of Kansas - School of Public Affairs & Administration. Steven Maynard - Moody. Professor [Internet]. https://kupa.ku.edu/steven-maynard-moody-0
14. University of Oregon - Media Relations. Michael Musheno, School of Law [Internet]. https://uonews.uoregon.edu/michael-musheno-school-law
15. Maynard-Moody S, Musheno M. Social equities and inequities in practice: Street-level workers as agents and pragmatists. Public Administration Review [Internet]. 2012;72(SUPPL.1):S16–23. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1540-6210.2012.02633.x%0A
16. Salej S, Ardila A, Bragato J. De vuelta a Lipsky: el caso del Programa Estructural en Áreas de Riesgo (PEAR) del Municipio de Belo Horizonte (Brasil). Revista Española de Investigaciones Sociológicas [Internet]. 2016;(154):119–35. https://www.redalyc.org/pdf/997/99746727007.pdf
17. Carrasco OV. Cómo escribir artículos de revisión. 2009;15(1):63–9.
18. Reich MR. Pandemic Governance in Japan and the United States: The Control-Tower Metaphor. Health Systems & Reform [Internet]. 2020 Dec 1;6(1):e1829314. https://doi.org/10.1080/23288604.2020.1829314
19. Rosenbaum L. Facing Covid-19 in Italy — Ethics, Logistics, and Therapeutics on the Epidemic’s Front Line. New England Journal of Medicine [Internet]. 2020 [cited 2020 Dec 10];1969–73. https://www.nejm.org/doi/full/10.1056/nejmp2005492nejm.org
20. Ramaci T, Ledda C, Barattucci M, Rapisarda V. Social stigma during COVID-19 and its impact on HCWs outcomes. Sustainability. 2020;12(9):1–13.
21. Agren D. Understanding Mexican health worker COVID-19 deaths. The Lancet [Internet]. 2020;396(10254):807. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31955-3/fulltext
22. Lotta G, Coelho VSP, Brage E. How COVID-19 Has Affected Frontline Workers in Brazil: A Comparative Analysis of Nurses and Community Health Workers. Journal of Comparative Policy Analysis: Research and Practice [Internet]. 2020;00(00):1–11. https://doi.org/10.1080/13876988.2020.1834857
23. Revista Semana. “Hay que dejar de ser un país de maricas”: las controvertidas palabras de Jair Bolsonaro sobre covid-19. Revista Semana [Internet]. 2020;: https://www.semana.com/mundo/articulo/hay-que-dejar-de-ser-un-pais-de-maricas-las-controvertidas-palabras-de-jair-bolsonaro-sobre-covid-19/202043/
24. Lima-Silva F, Sandim TL, Magri GM, Lotta G. Street-level bureaucracy in the pandemic: The perception of frontline social workers on policy implementation. Revista de Administracao Publica. 2020;54(5):1458–71.
25. Abuabara YC. Ataque al personal de la salud durante la pandemia de Covid-19 en Latinoamérica. Acta Médica Colombiana. 2020;45(3):1–15.
26. Salud U de. Se dispararon los ataques a la Misión Médica durante la pandemia. El Tiempo [Internet]. 2020; https://www.eltiempo.com/salud/aumentan-ataques-a-la-mision-medica-en-colombia-durante-la-pandemia-544186
27. Monterrosa-Castro A, Dávila-Ruiz R, Mejía-Mantilla A, Contreras-Saldarriaga J, Mercado-Lara M, Florez-Monterrosa C. Estrés laboral, ansiedad y miedo al COVID-19 en médicos generales colombianos. MedUNAB [Internet]. 2020 Jul 22;23(2 SE-Artículo Original):195–213. https://revistas.unab.edu.co/index.php/medunab/article/view/3890
28. Cassiani-Miranda CA, Campo-Arias A, Tirado-Otálvaro AF, Botero-Tobón LA, Upegui-Arango LD, Rodríguez-Verdugo MS, et al. Stigmatisation associated with COVID-19 in the general Colombian population. International Journal of Social Psychiatry [Internet]. 2020 Nov 8;0020764020972445. https://doi.org/10.1177/0020764020972445
29. Ruiz Gómez F. Minsalud destacó inversión en el sector para la atención a la población durante la pandemia. In: Ministerio de Salud y Protección Social [Internet]. 2020. https://www.minsalud.gov.co/Paginas/Minsalud-destaco-inversion-en-el-sector-para-la-atencion-a-la-poblacion-durante-la-pandemia.aspx
30. Ruiz Gómez F. Colombia ha accedido a 5.692 ventiladores durante la pandemia [Internet]. Ministerio de Salud y Protección Social. 2020. https://id.presidencia.gov.co/Paginas/prensa/2020/Colombia-ha-accedido-a-5692-ventiladores-durante-la-pandemia-200722.aspx
31. Redacción Blue Radio RB. Por primera vez en su historia, Chocó tiene una Unidad de Cuidados Intensivos [Internet]. BluRadio. 2020 [cited 2020 Dec 20]. https://www.bluradio.com/salud/por-primera-vez-en-su-historia-choco-tiene-una-unidad-de-cuidados-intensivos
32. Ruiz Gómez F. Total de camas UCI en el país para la atención de covid-19 incrementó 91%. Ministerio de Salud y Protección Social. 2020. [Internet]. https://www.minsalud.gov.co/Paginas/Total-de-camas-UCI-en-el-pais-para-la-atencion-de-covid-19-incremento-91.aspx
33. Cárdenas M, Martínez H. COVID-19 in Colombia: Impact and Policy Responses. Center for Global Development [Internet]. 2020 [cited 2020 Dec 10];(Figure 1):1–19. https://www.cgdev.org/sites/default/files/Cardenas-Beltran-Covid-in-Colombia.pdf
34. Ruiz Gómez F. Van $364 mil millones girados como bonificación a trabajadores de la salud. In: Ministerio de Salud y Protección Social [Internet]. 2020. https://www.minsalud.gov.co/Paginas/Van-364-mil-millones-girados-como-bonificacion-a-trabajadores-de-la-salud.aspx
35. Williams G, Scarpetti G, Bezzina A, Vincenti K, Grech K, Kowalska - Bobko I, et al. HOW ARE COUNTRIES SUPPORTING THEIR HEALTH WORKERS DURING COVID-19? Eurohealth [Internet]. 2020;26(2):58–62. https://www.euro.who.int/en/about-us/partners/observatory/publications/eurohealth/health-system-responses-to-covid-19/12.-how-are-countries-supporting-their-health-workers-during-covid-19
36. European Public Service Union. Germany: latest agreement to boost pay in health and care [Internet]. 2021. https://www.epsu.org/article/germany-latest-agreement-boost-pay-health-and-care
37. Lasco G. Medical populism and the COVID-19 pandemic. Global Public Health [Internet]. 2020 Oct 2;15(10):1417–29. https://doi.org/10.1080/17441692.2020.1807581
38. Merriam - Webster Dictionary. Autonomy [Internet]. https://www.merriam-webster.com/dictionary/autonomy
39. Merriam - Webster Dictionary. Discretion [Internet]. https://www.merriam-webster.com/dictionary/discretion
40. Martin-Delgado J, Viteri E, Mula A, Serpa P, Pacheco G, Prada D, et al. Availability of personal protective equipment and diagnostic and treatment facilities for healthcare workers involved in COVID-19 care: A cross-sectional study in Brazil, Colombia, and Ecuador. PLoS ONE. 2020;15(11 November):1–13.
41. Taylor S, Landry CA, Rachor G, Paluszek M, Asmundson GJ. Fear and avoidance of healthcare workers: An important, under-recognized form of stigmatization during the COVID-19 pandemic. Journal of Anxiety Disorders [Internet]. 2020;75. https://www-sciencedirect-com.ezproxy.javeriana.edu.co/science/article/pii/S0887618520301031?via%3Dihub
42. Trapp E. ENFOQUE EUROPA Coranavirus en Italia: reconocimiento al personal médico. Deutsche Welle [Internet]. 2020; https://www.dw.com/es/coranavirus-en-italia-reconocimiento-al-personal-médico/av-54024099
43. Eurostat - a look at the lives of the elderly in the EU today [Internet]. European Union - Eurostat. 2020. https://ec.europa.eu/eurostat/cache/infographs/elderly/index.html
44. Federación Iberoamericana de Asociaciones de Personas Adultas Mayores. América Latina envejece a pasos de gigante [Internet]. fiapam.org. 2019. https://fiapam.org/america-latina-envejece-a-pasos-de-gigante/
45. National Academy of Science. Aging in Latin America and the Caribbean in Global Perspective. In: Strengthening the Scientific Foundation for Policymaking to Meet the Challenges of Aging in Latin America and the Caribbean: Summary of a Workshop [Internet]. 2015. https://www.ncbi.nlm.nih.gov/books/NBK321995/
46. Pitkala K. COVID-19 has hit nursing homes hard. European Geriatric Medicine [Internet]. 2020; 11:889–91. https://link.springer.com/article/10.1007/s41999-020-00411-1
47. Dhama K, Kumar S, Kumar R, Jigyasa R. Geriatric Population During the COVID-19 Pandemic: Problems, Considerations, Exigencies, and Beyond. Frontiers in Public Health [Internet]. 2020;8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7536316/
48. Meza, O., Pérez-Chiqués, E., Campos González, S. A., & Varela Castro, S. (2020). The Roleplay of Angels Against the Covid-19 Pandemic: A Comparison Between Policy and the Factor Roles Assigned to Healthcare Street-Level Bureaucrats in Mexico. Journal of Comparative Policy Analysis: Research and Practice., 1–20. https://www.researchgate.net/publication/343278705_The_Roleplay_of_Angels_Against_the_Covid-19_Pandemic_A_Comparison_Between_Policy_and_De_Facto_Roles_Assigned_to_Healthcare_Street-Level_Bureaucrats_in_Mexico
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50. Raoofi, A., Takian, A., Sari, A. A., Olyaeemanesh, A., Haghighi, H., & Aarabi, M. (2020). COVID-19 pandemic and comparative health policy learning in Iran. Archives of Iranian Medicine, 23(4), 220–234. https://doi.org/10.34172/aim.2020.02
51. Niburski, K., & Niburski, O. (2020). Impact of Trump’s Promotion of Unproven COVID-19 Treatments on Social Media and Subsequent Internet Trends: Observational Study. Journal of Medical Internet Research, 22(11), e20044. https://doi.org/10.2196/20044
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2. Burki T. China’s successful control of COVID - 19. The Lancet [Internet]. 2020;20(11):1240–1. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30800-8/fulltext
3. Zhu S, Zong Z. Why did so few healthcare workers in China get COVID-19 infection. QJM: An International Journal of Medicine - Oxford Academic [Internet]. 2020;1–2. https://doi.org/10.1093/qjmed/hcaa254
4. Parshley L. Who gets to live? How doctors make impossible decisions as COVID-19 surges. National Geographic [Internet]. 2020 Jul 24; https://www.nationalgeographic.com/science/2020/07/how-doctors-make-impossible-decisions-as-coronavirus-surges-cvd/
5. Bergquist S, Otten T, Sarich N. COVID-19 pandemic in the United States. Health Policy and Technology [Internet]. 2020;9(4):623–38. https://doi.org/10.1016/j.hlpt.2020.08.007
6. Al-Tawfiq JA, Al-Yami SS, Rigamonti D. Changes in healthcare managing COVID and non–COVID-19 patients during the pandemic: striking the balance. Diagnostic Microbiology and Infectious Disease. 2020;98(4):19–22.
7. Sanfelici M. The Italian Response to the COVID-19 Crisis: Lessons Learned and Future Direction in Social Development. The International Journal of Community and Social Development [Internet]. 2020;2(2):191–210. https://journals.sagepub.com/doi/pdf/10.1177/2516602620936037
8. Cohen J, Rodgers Y van der M. Contributing factors to personal protective equipment shortages during the COVID-19 pandemic. Preventive Medicine [Internet]. 2020;141(October):106263. https://doi.org/10.1016/j.ypmed.2020.106263
9. Lipsky M. Toward a Theory Of Street - level Bureaucracy. Institute for Research on Poverty [Internet]. 1969 Aug [cited 2020 Dec 10];1–48. https://www.irp.wisc.edu/publications/dps/pdfs/dp4869.pdf
10. Nunes J, Lotta G. Discretion, power and the reproduction of inequality in health policy implementation: Practices, discursive styles and classifications of Brazil’s community health workers. Social Science and Medicine [Internet]. 2019 Dec;242(December):112551. https://doi.org/10.1016/j.socscimed.2019.112551
11. Erasmus E. The use of street-level bureaucracy theory in health policy analysis in low- and middle-income countries: a meta-ethnographic synthesis. Oxford Academic [Internet]. 2014;29(3):70–8. https://pubmed.ncbi.nlm.nih.gov/25435538/
12. Cadena Camargo YML. Heroes or villains? Dilemmas of professionals working with displaced adolescent mothers in Bogotá: an analysis of street-level bureaucracy. In: Medical Risk or Complex Narratives? Using life stories of internally displaced adolescent mothers in Bogotá to put policies in perspective. 2020. p. 113–32.
13. University of Kansas - School of Public Affairs & Administration. Steven Maynard - Moody. Professor [Internet]. https://kupa.ku.edu/steven-maynard-moody-0
14. University of Oregon - Media Relations. Michael Musheno, School of Law [Internet]. https://uonews.uoregon.edu/michael-musheno-school-law
15. Maynard-Moody S, Musheno M. Social equities and inequities in practice: Street-level workers as agents and pragmatists. Public Administration Review [Internet]. 2012;72(SUPPL.1):S16–23. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1540-6210.2012.02633.x%0A
16. Salej S, Ardila A, Bragato J. De vuelta a Lipsky: el caso del Programa Estructural en Áreas de Riesgo (PEAR) del Municipio de Belo Horizonte (Brasil). Revista Española de Investigaciones Sociológicas [Internet]. 2016;(154):119–35. https://www.redalyc.org/pdf/997/99746727007.pdf
17. Carrasco OV. Cómo escribir artículos de revisión. 2009;15(1):63–9.
18. Reich MR. Pandemic Governance in Japan and the United States: The Control-Tower Metaphor. Health Systems & Reform [Internet]. 2020 Dec 1;6(1):e1829314. https://doi.org/10.1080/23288604.2020.1829314
19. Rosenbaum L. Facing Covid-19 in Italy — Ethics, Logistics, and Therapeutics on the Epidemic’s Front Line. New England Journal of Medicine [Internet]. 2020 [cited 2020 Dec 10];1969–73. https://www.nejm.org/doi/full/10.1056/nejmp2005492nejm.org
20. Ramaci T, Ledda C, Barattucci M, Rapisarda V. Social stigma during COVID-19 and its impact on HCWs outcomes. Sustainability. 2020;12(9):1–13.
21. Agren D. Understanding Mexican health worker COVID-19 deaths. The Lancet [Internet]. 2020;396(10254):807. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31955-3/fulltext
22. Lotta G, Coelho VSP, Brage E. How COVID-19 Has Affected Frontline Workers in Brazil: A Comparative Analysis of Nurses and Community Health Workers. Journal of Comparative Policy Analysis: Research and Practice [Internet]. 2020;00(00):1–11. https://doi.org/10.1080/13876988.2020.1834857
23. Revista Semana. “Hay que dejar de ser un país de maricas”: las controvertidas palabras de Jair Bolsonaro sobre covid-19. Revista Semana [Internet]. 2020;: https://www.semana.com/mundo/articulo/hay-que-dejar-de-ser-un-pais-de-maricas-las-controvertidas-palabras-de-jair-bolsonaro-sobre-covid-19/202043/
24. Lima-Silva F, Sandim TL, Magri GM, Lotta G. Street-level bureaucracy in the pandemic: The perception of frontline social workers on policy implementation. Revista de Administracao Publica. 2020;54(5):1458–71.
25. Abuabara YC. Ataque al personal de la salud durante la pandemia de Covid-19 en Latinoamérica. Acta Médica Colombiana. 2020;45(3):1–15.
26. Salud U de. Se dispararon los ataques a la Misión Médica durante la pandemia. El Tiempo [Internet]. 2020; https://www.eltiempo.com/salud/aumentan-ataques-a-la-mision-medica-en-colombia-durante-la-pandemia-544186
27. Monterrosa-Castro A, Dávila-Ruiz R, Mejía-Mantilla A, Contreras-Saldarriaga J, Mercado-Lara M, Florez-Monterrosa C. Estrés laboral, ansiedad y miedo al COVID-19 en médicos generales colombianos. MedUNAB [Internet]. 2020 Jul 22;23(2 SE-Artículo Original):195–213. https://revistas.unab.edu.co/index.php/medunab/article/view/3890
28. Cassiani-Miranda CA, Campo-Arias A, Tirado-Otálvaro AF, Botero-Tobón LA, Upegui-Arango LD, Rodríguez-Verdugo MS, et al. Stigmatisation associated with COVID-19 in the general Colombian population. International Journal of Social Psychiatry [Internet]. 2020 Nov 8;0020764020972445. https://doi.org/10.1177/0020764020972445
29. Ruiz Gómez F. Minsalud destacó inversión en el sector para la atención a la población durante la pandemia. In: Ministerio de Salud y Protección Social [Internet]. 2020. https://www.minsalud.gov.co/Paginas/Minsalud-destaco-inversion-en-el-sector-para-la-atencion-a-la-poblacion-durante-la-pandemia.aspx
30. Ruiz Gómez F. Colombia ha accedido a 5.692 ventiladores durante la pandemia [Internet]. Ministerio de Salud y Protección Social. 2020. https://id.presidencia.gov.co/Paginas/prensa/2020/Colombia-ha-accedido-a-5692-ventiladores-durante-la-pandemia-200722.aspx
31. Redacción Blue Radio RB. Por primera vez en su historia, Chocó tiene una Unidad de Cuidados Intensivos [Internet]. BluRadio. 2020 [cited 2020 Dec 20]. https://www.bluradio.com/salud/por-primera-vez-en-su-historia-choco-tiene-una-unidad-de-cuidados-intensivos
32. Ruiz Gómez F. Total de camas UCI en el país para la atención de covid-19 incrementó 91%. Ministerio de Salud y Protección Social. 2020. [Internet]. https://www.minsalud.gov.co/Paginas/Total-de-camas-UCI-en-el-pais-para-la-atencion-de-covid-19-incremento-91.aspx
33. Cárdenas M, Martínez H. COVID-19 in Colombia: Impact and Policy Responses. Center for Global Development [Internet]. 2020 [cited 2020 Dec 10];(Figure 1):1–19. https://www.cgdev.org/sites/default/files/Cardenas-Beltran-Covid-in-Colombia.pdf
34. Ruiz Gómez F. Van $364 mil millones girados como bonificación a trabajadores de la salud. In: Ministerio de Salud y Protección Social [Internet]. 2020. https://www.minsalud.gov.co/Paginas/Van-364-mil-millones-girados-como-bonificacion-a-trabajadores-de-la-salud.aspx
35. Williams G, Scarpetti G, Bezzina A, Vincenti K, Grech K, Kowalska - Bobko I, et al. HOW ARE COUNTRIES SUPPORTING THEIR HEALTH WORKERS DURING COVID-19? Eurohealth [Internet]. 2020;26(2):58–62. https://www.euro.who.int/en/about-us/partners/observatory/publications/eurohealth/health-system-responses-to-covid-19/12.-how-are-countries-supporting-their-health-workers-during-covid-19
36. European Public Service Union. Germany: latest agreement to boost pay in health and care [Internet]. 2021. https://www.epsu.org/article/germany-latest-agreement-boost-pay-health-and-care
37. Lasco G. Medical populism and the COVID-19 pandemic. Global Public Health [Internet]. 2020 Oct 2;15(10):1417–29. https://doi.org/10.1080/17441692.2020.1807581
38. Merriam - Webster Dictionary. Autonomy [Internet]. https://www.merriam-webster.com/dictionary/autonomy
39. Merriam - Webster Dictionary. Discretion [Internet]. https://www.merriam-webster.com/dictionary/discretion
40. Martin-Delgado J, Viteri E, Mula A, Serpa P, Pacheco G, Prada D, et al. Availability of personal protective equipment and diagnostic and treatment facilities for healthcare workers involved in COVID-19 care: A cross-sectional study in Brazil, Colombia, and Ecuador. PLoS ONE. 2020;15(11 November):1–13.
41. Taylor S, Landry CA, Rachor G, Paluszek M, Asmundson GJ. Fear and avoidance of healthcare workers: An important, under-recognized form of stigmatization during the COVID-19 pandemic. Journal of Anxiety Disorders [Internet]. 2020;75. https://www-sciencedirect-com.ezproxy.javeriana.edu.co/science/article/pii/S0887618520301031?via%3Dihub
42. Trapp E. ENFOQUE EUROPA Coranavirus en Italia: reconocimiento al personal médico. Deutsche Welle [Internet]. 2020; https://www.dw.com/es/coranavirus-en-italia-reconocimiento-al-personal-médico/av-54024099
43. Eurostat - a look at the lives of the elderly in the EU today [Internet]. European Union - Eurostat. 2020. https://ec.europa.eu/eurostat/cache/infographs/elderly/index.html
44. Federación Iberoamericana de Asociaciones de Personas Adultas Mayores. América Latina envejece a pasos de gigante [Internet]. fiapam.org. 2019. https://fiapam.org/america-latina-envejece-a-pasos-de-gigante/
45. National Academy of Science. Aging in Latin America and the Caribbean in Global Perspective. In: Strengthening the Scientific Foundation for Policymaking to Meet the Challenges of Aging in Latin America and the Caribbean: Summary of a Workshop [Internet]. 2015. https://www.ncbi.nlm.nih.gov/books/NBK321995/
46. Pitkala K. COVID-19 has hit nursing homes hard. European Geriatric Medicine [Internet]. 2020; 11:889–91. https://link.springer.com/article/10.1007/s41999-020-00411-1
47. Dhama K, Kumar S, Kumar R, Jigyasa R. Geriatric Population During the COVID-19 Pandemic: Problems, Considerations, Exigencies, and Beyond. Frontiers in Public Health [Internet]. 2020;8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7536316/
48. Meza, O., Pérez-Chiqués, E., Campos González, S. A., & Varela Castro, S. (2020). The Roleplay of Angels Against the Covid-19 Pandemic: A Comparison Between Policy and the Factor Roles Assigned to Healthcare Street-Level Bureaucrats in Mexico. Journal of Comparative Policy Analysis: Research and Practice., 1–20. https://www.researchgate.net/publication/343278705_The_Roleplay_of_Angels_Against_the_Covid-19_Pandemic_A_Comparison_Between_Policy_and_De_Facto_Roles_Assigned_to_Healthcare_Street-Level_Bureaucrats_in_Mexico
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Como Citar
Mojica - Méndez, D., Michelsen Gómez, S., & Cadena - Camargo, Y. . (2021). Healthcare Workers during the COVID-19 Pandemic from a Street-Level Bureaucracy Perspective - A Narrative Review of Literature. Universitas Medica, 62(4). https://doi.org/10.11144/Javeriana.umed62-4.call
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