The politics of evidence in health system crises: the case of Colombia.
Health systems worldwide are in crisis, facing financial sustainability challenges, workforce shortages and shifting demands due to demographic change. Limited or decreasing public resources, aid cuts, population ageing and health workforce shortages affect countries in different but serious ways, l...
| Published in: | International Affairs Vol. 102; no. 2; pp. 639 - 659 |
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| Format: | Article |
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Oxford University Press / USA
Mar2026
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=192225174&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 192225174 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00205850 INA jtl: International Affairs issn: 00205850 maglogo: N pubinfo: dt: Mar2026 vid: 102 iid: 2 pid: 622 pub: Oxford University Press / USA artinfo: ui: 192225174 10.1093/ia/iiaf266 ppf: 639 ppct: 20 formats: tig: atl: The politics of evidence in health system crises: the case of Colombia. aug: au: Hanrieder, Tine affil: Department of International Development, London School of Economics and Political Science, London WC2A 2AE, UK su: Colombia Health policy Financing of public health Rhetoric & politics Socioeconomic disparities in health Health care reform sug: subj: Health policy Financing of public health Colombia Administration of Public Health Programs Health and Welfare Funds Rhetoric & politics Socioeconomic disparities in health Health care reform keyword: constructivism copyrightHolder:The Royal Institute of International Affairs copyrightYear:2026 global health inLanguage:en international development narratives publisher:Oxford University Press sameAs:https://dx.doi.org/10.1093/ia/iiaf266 social justice constructivism copyrightHolder:The Royal Institute of International Affairs copyrightYear:2026 global health inLanguage:en international development narratives publisher:Oxford University Press sameAs:https://dx.doi.org/10.1093/ia/iiaf266 social justice ab: Health systems worldwide are in crisis, facing financial sustainability challenges, workforce shortages and shifting demands due to demographic change. Limited or decreasing public resources, aid cuts, population ageing and health workforce shortages affect countries in different but serious ways, leading to a sense of ongoing crisis. This article investigates the politics of health system crisis and its contentious interpretation in Colombia, where this issue is highly politicized. I analyse how proponents and opponents of a major health system reform proposal have mobilized evidence in favour and against the reform bill put forward by the leftist government elected in 2022. This analysis yields that the politics of slow, gradual health system crises is also one of sense-making, in which evidence is assembled within larger and changing narratives about development. Colombia's international status as a recent OECD member, the idea of progress and modernity amid social inequality, and the political legitimacy of state and private actors are all renegotiated through evidence about health system performance and crisis. I draw on in-depth qualitative research conducted in 2024 and 2025. The article invites cross-fertilization between analyses of gradual, 'slow-burning' crises and of changing notions of international development. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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