Community Health Toolkit

Monitoring Primary Healthcare Delivery During COVID-19

“During times of crisis, essential health services often decline - which can ultimately kill more people than the pandemic itself. One of the pandemic’s greatest dangers is interrupting care for other conditions, by overwhelming already under-resourced health systems. For example, during the Ebola epidemic, access to healthcare services fell by half, dramatically increasing deaths from malaria, HIV/AIDS, and tuberculosis. The vulnerable bore the brunt of the pandemic: childhood immunizations were significantly reduced and, in some areas, the number of pregnant women delivering in health facilities decreased by more than 80 percent.” ~ Ballard et al. 2020

As COVID-19 began to spread around the world, several people from the Research & Learning team at Medic Mobile worked with a team of about 30 other scientists and community health practitioners to rapidly draft a position paper, Priorities for the Global COVID-19 Response: The Role for Community Health. This paper outlines four critical priorities:

  1. PROTECT health care workers

  2. INTERRUPT the virus

  3. MAINTAIN existing health care services while surging their capacity

  4. SHIELD the most vulnerable from socioeconomic shocks

The priority placed on maintaining existing services reflects an important insight: that major outbreaks often have a range of indirect impacts on the health of communities.

At Medic Mobile, a number of members of our Research & Learning team have been engaged in proactively monitoring the impact of COVID-19 - and associated global, national, and place-based policies in response to the pandemic - using a subset of community health impact metrics focused on maintenance of primary care.

These metrics are aligned with a broader set of metrics used by members of the Community Health Impact Coalition in metrics harmonization efforts, and include the following categories:

  • CHW Activity

  • Household Coverage


  • iCCM, Immunization & Malnutrition

  • Family Planning

We have been generating reports on these monitoring data at a varying level of frequency, and sharing our findings with CHT implementing partners in order to drive iteration and adaptation of workflows to support care delivery and ensure disruptions are mitigated. As we continue this work, we will also be posting updates on our findings to the forum in order to engage our community with this valuable work!

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I’d love to hear from members of the CHT community on how you are monitoring care delivery during the COVID-19 pandemic, as well as any relevant scholarship you’ve found on measuring the impact of the pandemic on care delivery across different areas of work.

In my work on the Research & Learning team, I’ve found a a few different publications that speak to the quantification of disruptions to PHC during the COVID-19 pandemic. An incomplete list is included below for reference:

Modeled Estimates

Observational Data


Also, it is worth noting that Exemplars in Global Health has published some opinion pieces, as well as outlining the approach to quantifying potential impacts of COVID-19 in Goalkeepers 2020 via the use of modeled estimates from the Global Burden of Disease study.

Let us know if there are any other resources that we should include in this growing list of references. Looking forward to hearing from you.