Strengthening the humanitarian response to COVID-19 in Colombia

What did the study set out to achieve?

The research aimed to:

1. Determine the variation in implementation, and adherence to public health and social distancing policies during the COVID-19 outbreak among Venezuelan migrant refugees and Colombian citizens across 60 Colombian municipalities.
2. Determine health care utilisation and costs among Venezuelan migrant refugees and Colombian citizens, by municipality.
3. Assess the impact of implementation and adherence to public health policies on the rate of COVID-19 cases, health care utilisation, and mortality, by municipality.
4. Use results to inform global policy and decision-making related to the process of re-opening, especially for countries with refugee and humanitarian populations.

The researchers conducted 1,454 interviews with staff and 215 unique observations of service provision (totaling 334 hours) at four partner NGOs assisting refugees in Lebanon, Turkey, and Jordan.

The study focused on social distancing, mask wearing, and hand hygiene, measuring how well those protocols were followed during different types of services and with different refugee populations. Barriers such as lack of physical space, lack of knowledge about COVID-19, limitations of the services, and attitudes about COVID-19 were measured.

What were the key findings?

• Venezuelans had only one third the rate of hospitalisations and one fifth the rate of consultations compared to Colombians in the same municipality.
• Venezuelans had only one tenth the rates of officially reported COVID-19 cases than Colombians in the same municipality, due largely to Venezuelans’ lower access to testing and treatment for COVID-19.
• Behaviours related to public health and social distancing do not vary considerably between Venezuelan migrants and Colombian nationals, however Venezuelans do report lower rates of COVID testing and use of virtual visits.

Effective policies:

• Self-care (mask-use) and mobility restrictions were highly effective at limiting infection spread.
• Strict policy restrictions do not necessarily stop people from moving.
• Mobility trends change depending on the day of the week (reduced movement on the weekends) and the population density of municipalities.

What does this mean for policy makers and practitioners?

While the Colombian government has made initial strides towards reducing disparities between Colombians and Venezuelan migrants with their expansion of the temporary residence programme, additional policies to improve access may be needed to continue to address the COVID-19 pandemic, particularly to deliver vaccine rollout.

• Mask wearing and mobility restriction are the best tools to reduce COVID cases especially for municipalities with large Venezuelan migrant populations. Mask wearing and mobility restriction are cost effective techniques that reduce cases and should be communicated.
• Mobility trends will help policy makers understand mobility patterns for essential workers; individuals who should be prioritised for access to healthcare services and vaccine rollout.
• Partnering at local levels can encourage the sharing of knowledge and evidence to improve effectiveness of health-services planning and decision making.

Next steps

The study team aim to use the knowledge and insights generated to continue to inform the Colombian response. Information and data produced could be made available in a user-friendly manner to stakeholders through appropriate channels and formats, such as data dashboards, to inform ongoing decision-making. Data could be used to create a linear programming tool for vaccine rollout to help analyze vaccine rollout subject to real world barriers such as population distribution and density, health care utilisation barriers, knowledge of COVID-19, and implemented policy.

Banner photo credit: Venezuelan women and children staying the night in tents next to the Red Cross health centers. © European Union (Photographer N. Mazars) 2018 (Source: Flickr)