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National governance and excess mortality due to COVID-19 in 213 countries: a retrospective analysis and perspectives on future pandemics.
da Silva, Ricardo Eccard; Novaes, Maria Rita Carvalho Garbi; de Oliveira, Cesar; Guilhem, Dirce Bellezi.
Afiliação
  • da Silva RE; Brazilian Health Regulatory Agency - Anvisa, Setor de Indústrias, Trecho 5, Área Especial 57, Brasília-DF, 71205-050, Brazil.
  • Novaes MRCG; Faculty of Health Sciences, University of Brasília - UnB, Campos Univ. Darcy Ribeiro, Asa Norte, Brasília-DF, 70910-900, Brazil.
  • de Oliveira C; Faculty of Health Sciences, University of Brasília - UnB, Campos Univ. Darcy Ribeiro, Asa Norte, Brasília-DF, 70910-900, Brazil.
  • Guilhem DB; Department of Epidemiology & Public Health, University College London (UCL), 1-19 Torrington Place, London, WC1E 6BT, UK. c.oliveira@ucl.ac.uk.
Global Health ; 19(1): 80, 2023 10 31.
Article em En | MEDLINE | ID: mdl-37907968
ABSTRACT

BACKGROUND:

National governance may have influenced the response of institutions to the Covid-19 pandemic, being a key factor in preparing for the next pandemics. The objective was to analyze the association between excess mortality due to COVID-19 (daily and cumulative per 100 thousand people) and national governance indicators in 213 countries.

METHOD:

Multiple linear regression models using secondary data from large international datasets that are in the public domain were performed. Governance indicators corresponded to six dimensions (i) Voice and Accountability; (ii) Political Stability and Absence of Violence/Terrorism; (iii) Government Effectiveness; (iv) Regulatory Quality; (v) Rule of Law and (vi) Control of Corruption. The statistical analysis consisted of adjusting a multiple linear regression model. Excess mortality due to COVID-19 was adjusted for potential confounding factors (demographic, environmental, health, economic, and ethnic variables).

RESULTS:

The indicators Control of Corruption, Government Effectiveness, Regulatory Quality and Rule of Law had a significant inverse association (p < 0.0001) with the estimated excess mortality in 2020, 2021 and 2022. Furthermore, the governance indicators had a direct significant association (p < 0.0001) with the vaccination variables (People_fully_vaccinated; Delivered population; The total number of vaccination doses administered per 100 people at the country level), except for the variables Vaccination policies and Administration of first dose, which were inversely associated. In countries with better governance, COVID-19 vaccination was initiated earlier.

CONCLUSION:

Better national governance indicators were associated with lower excess mortality due to COVID-19 and faster administration of the first dose of the COVID-19 vaccine.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: COVID-19 Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: COVID-19 Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article