ArticleBMJ open2022
Continuity of community-based healthcare provision during COVID-19: a multicountry interrupted time series analysis.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Understanding pathways from primary health care to universal health coverage outcomes: a realist review.Frontiers in public health · 2026Pooled it
- An Innovative University and Non-Governmental Organization Partnership in Global Health: Application of the Brocher Declaration to 20 Years of Collaboration in Kenya.Annals of global health · 2026Article
- Establishing the effect of COVID-19 lockdown policy on the utilization of facility-based delivery in Kenya: a multi-method study.BMC health services research · 2025Article
- Essential aid made fully visible: understanding the proCHW financing landscape analysing accessible donor data sources.BMJ global health · 2025Article
- Strategies and challenges for maintaining the continuity of essential health services during a pandemic: a scoping review.BMC health services research · 2025Article
- Utilization of upper gastrointestinal tumor inpatient services affected by COVID-19 in China 2018-2021: an interrupted time series analysis.Frontiers in public health · 2025Article
- Documenting Community Health Worker Compensation Schemes and Their Perceived Effectiveness in Seven sub-Saharan African Countries: A Qualitative Study.Global health, science and practice · 2024Article
- Impact of a pandemic shock on unmet medical needs of middle-aged and older adults in 10 countries.BMJ health & care informatics · 2024Article
- The use and potential impact of digital health tools at the community level: results from a multi-country survey of community health workers.BMC public health · 2024Article
- Article
- Brazil towards malaria elimination: A time-series analysis of imported cases from 2007 to 2022.PLOS global public health · 2024Article
- The impact of the Covid-19 pandemic on work accidents with exposure to biological material in Brazil: an interrupted time series analysis.Revista brasileira de epidemiologia = Brazilian journal of epidemiology · 2024Article
- Community health worker perspectives on advocacy: design-based research to develop a digital advocacy training course.Frontiers in public health · 2024Article
- Developing and testing scales for home support service continuity (HSSC): cross-sectional studies in Canada and UK.BMJ open · 2023Article
- COVID-19 impacts on healthcare access in sub-Saharan Africa: an overview.The journal of venomous animals and toxins including tropical diseases · 2023Article
- Training and experience outperform literacy and formal education as predictors of community health worker knowledge and performance, results from Rongo sub-county, Kenya.Frontiers in public health · 2023Article
- Rescinding evidence-based care and practices during the initial COVID-19 outbreak in the United States: a qualitative study of the experiences of lactation support providers.Frontiers in public health · 2023Article
- Lessons from an eight-country community health data harmonization collaborative.Global health action · 2022Article
- Interventions for Maintenance of Essential Health Service Delivery during the COVID-19 Response in Uganda, between March 2020 and April 2021.International journal of environmental research and public health · 2022Review
- Community Health Workers in Pandemics: Evidence and Investment Implications.Global health, science and practice · 2022Article
Corrections and comments
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Authors and funding
15 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPandemics often precipitate declines in essential health service utilisation, which can ultimately kill more people than the disease outbreak itself. There is some evidence, however, that the presence of adequately supported community health workers (CHWs), that is, financially remunerated, trained, supplied and supervised in line with WHO guidelines, may blunt the impact of health system shocks. Yet, adequate support for CHWs is often missing or uneven across countries. This study assesses whether adequately supported CHWs can maintain the continuity of essential community-based health service provision during the COVID-19 pandemic.
methodsInterrupted time series analysis. Monthly routine data from 27 districts across four countries in sub-Saharan Africa were extracted from CHW and facility reports for the period January 2018-June 2021. Descriptive analysis, null hypothesis testing, and segmented regression analysis were used to assess the presence and magnitude of a possible disruption in care utilisation after the earliest reported cases of COVID-19.
resultsCHWs across all sites were supported in line with the WHO Guideline and received COVID-19 adapted protocols, training and personal protective equipment within 45 days after the first case in each country. We found no disruptions to the coverage of proactive household visits or integrated community case management (iCCM) assessments provided by these prepared and protected CHWs, as well as no disruptions to the speed with which iCCM was received, pregnancies were registered or postnatal care received.
conclusionCHWs who were equipped and prepared for the pandemic were able to maintain speed and coverage of community-delivered care during the pandemic period. Given that the majority of CHWs globally remain unpaid and largely unsupported, this paper suggests that the opportunity cost of not professionalising CHWs may be larger than previously estimated, particularly in light of the inevitability of future pandemics.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.