Unveiling conflicting strategies in the Brazilian response to COVID-19: A cross-sectional study using the Functional Resonance Analysis Method.

Abstract

By the time the present study was completed, Brazil had been the second epicenter of COVID-19. In addition, the actions taken to respond to the pandemic in Brazil were the subject of extensive debate, since the Federal Government diverged from most recommendations from health authorities and scientists. Since then, the resulting political and social turmoil showed conflicting strategies to tackle the pandemic in Brazil, with visible consequences in the numbers of casualties, but also with effects on the resilience of the overall health system.This article explores the actions taken in Brazil to cope with the pandemic from a systems analysis perspective. The structure of the domain was analyzed using work domain analysis, and the activated functions were analyzed using the Functional Resonance Analysis Method, identifying the potential variability resulting from the conflicting strategies carried out and the consequences to the capacity of the Brazilian health system to respond to the pandemic.Results of the study show that some government authorities introduced functions that overlapped the operation of the overall system as recommended by health authorities, causing the health system to operate under conflicting objectives, in which functions were created to restrict the outcomes of each other during the entire COVID-19 crisis.