Coronavirus (179) Community Health Research Roundup

22 March, 2020

Read online with links to multiple resources:

The Child Health Task Force writes:

Dear Child Health Task Force Members,

We would like to share the following Special COVID-19 Edition of the Community Health Research Roundup with you. Thank you to Dr. Madeleine Ballard & team and Feven Tassaw Mekuria for sharing these resources.

You will find below an interesting paper on community health worker roles in pandemics and epidemics as well as other COVID-19 resources.

The paper makes some recommendations for supporting CHWs to protect themselves from the infection while carrying out their potential roles and responsibilities in the response to COVID-19. That could include multiple considerations such as:

Age disaggregation of CHWs based on vulnerability to the virus;

Use of IT platforms to perform some of their roles (promoting social distancing) and creative ways of training CHWs on the response and prevention methods (eliminating the need to bring them together in large groups); and,

Ways for regular reflection/counseling to address burnout among CHWs on the front line of the response in the long run.

Be safe and healthy.

The Child Health Task Force Secretariat

USAID Advancing Nutrition

2733 Crystal Drive

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From the American People


Community Health Research Round-Up, Issue 028

Special COVID-19 Edition

Community Health Workers and Pandemic Preparedness: Current and Prospective Roles

Comments: Perspective piece drawing from the response to the 2014 Ebola and 2015 Zika epidemics

Methods: Perspective

Takeaway: CHWs promoted pandemic preparedness prior to the epidemics by increasing the access to health services and products within communities, communicating health concepts in a culturally appropriate fashion, and reducing the burdens felt by formal healthcare systems. During the epidemics, CHWs promoted pandemic preparedness by acting as community-level educators and mobilizers, contributing to surveillance systems, and filling health service gaps.

Lessons Learned from Reinforcing Epidemiologic Surveillance During the 2017 Ebola Outbreak in the Likati District, Democratic Republic of the Congo

Comments: Comprehensive lessons from ebola in DRC - community health recommendations highlighted below

Methods: Case study

Takeaway: Community health workers supported case finding and contact monitoring activities. At the community level, provide participatory training and supportive supervision to community health workers by reinforcing:

Knowledge of EVD signs and symptoms;

Comprehension and application of outbreak definitions relevant to community health worker roles/responsibilities (community case definition, alert, contact);

Procedures for reporting alerts, suspected cases, and other unexplained illness or deaths in the community;

Procedures for tracing and monitoring contacts; and

Best practices for infection prevention and control to protect against disease exposure during direct interactions with suspected cases and contacts.

Protecting Home Health Care Workers: A Challenge to Pandemic Influenza Preparedness Planning

Comments: A great summary of healthcare safety, security and wellness considerations

Method: Summarized findings from a national stakeholder meeting

Takeaway: Federal, state, and local pandemic preparedness planners should consider approaches to help home health care workers protect their income; obtain access to health care, especially in light of their low rate of insurance coverage; obtain structural support for child care and transportation; and receive the necessary training for caring for clients

The first mile: community experience of outbreak control during an Ebola outbreak in Luwero District, Uganda

Comments: Interesting piece on the cultural dimensions of public health messaging (adaptation!)

Method: First-hand ethnographic data from the center of an Ebola outbreak in Luwero Country, Uganda

Takeaway: Explanations of the disease were undermined by an insensitivity to local culture, a mismatch between information circulated and the local interpretative framework, and the inability of the emergency response team to take the time needed to listen and empathize with community needs. Stigmatization of the local community - in particular its belief in amayembe spirits - fueled historical distrust of the external health system and engendered community-level resistance to early detection.

Piloting a participatory, community-based health information system for strengthening community-based health services: findings of a cluster-randomized controlled trial in the slums of Freetown, Sierra Leone

Comments: Helpful trial of a CHIS during three separate epidemic shocks

Method: C-RCT

Takeaway: Implemented under challenging conditions of cholera and Ebola epidemics, the study provides evidence of moderate effectiveness of the PCBHIS intervention in: improving CHW functionality, improving healthy household behaviors and healthcare-seeking behaviors, as well as strengthening the capacity of Ward Development Committees to fulfill their roles.

Effect of the Ebola-virus-disease epidemic on malaria case management in Guinea, 2014: a cross-sectional survey of health facilities &

Implementation research on community health workers' provision of maternal and child health services in rural Liberia

Comments: A pair of complementary studies: the first demonstrating the interruption of PHC services during an epidemic in the context of a weak CH system, the second demonstrating the alternative!

Method: x-sectional (Guinea), repeated cross-sectional cluster surveys before (Liberia)


The reduction in the delivery of malaria care because of the Ebola-virus-disease epidemic threatened malaria control in Guinea.

Despite the Ebola virus disease outbreak, which caused substantial declines in health-care utilization in other regions of Liberia, a district with a strong CHW program showed increases in health-care use from formal providers for fever, acute respiratory infection and diarrhoea among children and facility-based delivery among pregnant women

Forwarded by Neil Pakenham-Walsh, HIFA moderator