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Governance and state capacities against COVID-19 in Germany and Spain: national responses and health systems from a comparative perspective

Abstract

This study aimed to analyze comparatively strategies and political actions adopted in response to the COVID-19 pandemic in Germany and Spain in 2020. Based on historical institutionalism, we focused on the institutionality of government action in five work dimensions. The results showed different state capacities in coordination, implementation, and effectiveness of strategies. Crisis management and governance strengths are related to recognizing its severity and negotiation skills; national production capacity of supplies and equipment; and broad targeting of fiscal and financial resources from central government to health, social, and economic areas. These aspects varied between cases, acting as a relevant differential in governmental response. Other differentials were health system’s structure; availability of workers; and national science and technology system, highlighting the importance of medium and long-term investments.

Key words:
Coronavirus infections; COVID-19 pandemic; Health systems; Governance; Contextual effects of health Disparities

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