Cross-country learning on health system resilience: synthesis of OPM findings on the role of community health workers in COVID-19 and on governance for health system responses to emergencies

 

Over the last few years, OPM has undertaken a wide range of research on the health system response to COVID-19 and other emergencies. Examples include ethnographic work and interviews with frontline health workers in India on their experience during COVID-19, research on the continuity of essential health services during COVID-19 in Bangladesh [opens new tab], research on COVID-19 and other emergencies in Sierra Leone, Bangladesh, Kenya and Pakistan, and a range of analysis around COVID-19 and disaster management under the Building Resilience in Ethiopia programme [opens new tab].

 

Bringing together findings from these different projects can provide more understanding of contextual influences and broader cross-country learning about effective approaches. Through ReBUILD for Resilience support, OPM is synthesising findings from these and other OPM reports, focusing on two main areas: community health workers (CHWs) and governance.

 

The CHW synthesis will examine CHWs’ experiences and roles during COVID-19, the effects of COVID-19 on their routine service delivery, challenges experienced and support provided. The governance synthesis will focus on the effectiveness of coordination structures and cross-sector partnerships for emergency response. Through these syntheses, we aim to provide lessons on how to support an effective CHW role, strengthen coordination and build partnerships as part of enhancing resilience capacities in fragile and shock prone settings.

Our research questions

Community health workers

Overall research question: what can we learn from research on community health workers’ roles during COVID-19 about building resilience capacities in fragile and shock prone settings?

1. What roles have CHWs played in the COVID-19 response, including vaccine delivery?
• What support was provided to enable CHWs’ roles in the COVID-19 response, and how effective was this support?
• What challenges did CHWs experience in relation to COVID-19 response activities, and what led to these difficulties?

2. How has CHWs’ routine service delivery been affected by COVID-19?
• What adaptations have enabled continued service delivery?
• What challenges did CHW experience in continuing routine services during COVID-19, and what led to these difficulties?
• What helped or hindered continued service delivery, including ability to adapt? (e.g. planned and adaptive resilience; support among CHW or from managers; training; community engagement; domestic burdens).

Governance

Overall research question: what can we learn from research on COVID-19 and other public health emergencies about building effective coordination and partnerships to enhance resilience capacities in fragile and shock prone settings?

1. What government and stakeholder coordination structures exist at national and sub-national levels to support the response to COVID-19 and other emergencies?
• What are the strengths and weaknesses of coordination structures, and how does this affect emergency preparedness and response?

2. How have partnerships with different stakeholders (e.g. NGOs, development partners, private sector, local leaders) contributed to the response to COVID-19 and other emergencies?
• What strengths and weaknesses or gaps exist in relation to partnership, and how does this affect emergency preparedness and response?

 

Image: Fight Against COVID-19 @ Jangamakote Village, India – Trinity Care Foundation via Flickr [opens new tab]

"ReBUILD for Resilience brings together partners to share experiences, to discuss our contexts, and to create an appropriate model that helps build resilience in health systems across the country and beyond"

Sushil Baral, HERD International