Table 1

Illustrative examples of areas indirectly affected by COVID-19 requiring mitigation measures

IssueCOVID-19 impactMitigation measures
Short- term measures
Birth registrationBirth registration stopped during country lockdowns. Sustainable Development Goal target 16.9 aims to achieve universal registration of all births by 2030.Temporary processing of birth certificates at health facilities to catch up infants not registered at birth.
Visits by CHWs to all households with children under 1 year to check birth registration status.
Breast feedingPotential for declines due to mother-infant separation and health worker fears of COVID-19 transmission.Rapidly disseminate strong messages through community-based organisations and CHWs about the importance of breast feeding in the context of COVID-19, and the harmful consequences of separating mothers and newborns.
ImmunisationDeclines in routine immunisation due to health service disruptions, reallocation of staff to COVID-19 and fears of mothers to attend health facilities.Visits by CHWs to all households with children under 5 years of age to check immunisation status.
Catch up immunisation campaigns in schools and Early Child Development centres.
Chronic medicationDisruptions to chronic medication distribution leading to gaps in adherence.Establish community distribution points
CHWs supporting medication distribution to households with elderly or ill.
Long-term measures
Weak community platform with too few CHWs to augment public sector response to crisesCHWs re-assigned to COVID-19 unable to perform their usual household visits and functions.Strengthen community delivery platforms with increased numbers of CHWs.
High coverage of households to undertake detailed assessments of COVID-19 recovery needs.
Lack of forums for communities/civil society in decision-makingCivil society actions to support COVID-19 were implemented in parallel to government actions with little/no co-ordination or community consultation on the appropriateness of government solutions.Policy mandated forums for community consultation and accountability mechanisms to ensure feedback and progress tracking.
Prioritisation of domestic spendingCOVID-19 stimulus packages risk deepening inequity by prioritising large companies and leaving behind small business and community enterprises.Embark on a transparent, participatory prioritisation process to inform the allocation of COVID-19 stimulus funding with a focus on growing ‘township’ economies.
  • CHWs, community health workers.