Left out and left behind during the COVID-19 pandemic: a sensemaking study on exclusion, inequality, and resilience among members of equity-deserving groups in Colombia and Venezuela

Across Latin America, equity-deserving groups (EDGs) - including women, persons with disabilities, Indigenous peoples, migrants, and LGBTQI+ individuals - experienced disproportionate socioeconomic and health impacts during COVID-19. However, policies rarely address intersecting vulnerabilities, leaving many without adequate protection. This study examined how EDGs in Colombia and Venezuela experienced the health and health-related social impacts of the COVID-19 pandemic, including barriers to care, service disruption, and coping responses. Using a mixed-methods, cross-sectional, sensemaking design, between August 2024 and January 2025 2,433 participants from Colombia (Bogotá and La Guajira) and Venezuela (Caracas and Falcón) shared 2,591 self-interpreted micronarratives about their COVID-19 experiences. Participants self-identified as belonging to one or more EDGs or served as controls. Sensemaking data combined quantitative interpretation (triads/sliders) and qualitative narratives. Statistical analyses were conducted in R. Three key mixed-methods themes emerged: (1) identity-based barriers to access predominated in rural areas, where women, LGBTQI+ individuals, and persons with disabilities described exclusion from education, health, and employment; (2) policy and system gaps were most pronounced in Venezuela, where participants linked hardship to weak governance and inadequate public support; and (3) financial strain dominated in rural narratives, whereas urban accounts centered on disrupted health care and mental-health challenges. Discrimination generally compounded hardships, although participants also demonstrated resilience through social and community supports. COVID-19 deepened structural inequities, exposing systemic policy failures but also community resilience. Findings underscore the need for intersectional, equity-centered crises responses that integrate gender-responsive planning and disability inclusion, as well as LGBTQI+, migrants, and Indigenous rights, using participatory approaches.