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Continuity of community-based healthcare provision during COVID-19: a multicountry interrupted time series analysis by Madeleine Ballard; Helen E Olsen; Anoushka Millear; Jane Yang; Caroline Whidden; Amanda Yembrick; Dianne Thakura; Afra Nuwasiima; Molly Christiansen; Daniele J Ressler; Wycliffe Okoth Omwanda; Diego Lassala; Daniel Palazuelos; Carey Westgate; Fabien Munyaneza is a Medicine article available to read on EtoBox.

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## Background Pandemics 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. ## Methods Interrupted 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. ## Results CHWs across all sites were supported in line with the WHO Guideline and received COVID-19 adapted pro

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Author

Madeleine Ballard; Helen E Olsen; Anoushka Millear; Jane Yang; Caroline Whidden; Amanda Yembrick; Dianne Thakura; Afra Nuwasiima; Molly Christiansen; Daniele J Ressler; Wycliffe Okoth Omwanda; Diego Lassala; Daniel Palazuelos; Carey Westgate; Fabien Munyaneza

Publisher

BMJ

Published

2022

Language

EN

Field

Medicine (Health Sciences)