Community health care and COVID-19 pandemic: Experimental evidence

The limited capacity of the health systems in many low-income countries, especially in rural areas, suggests that the rapid spreading of the COVID-19 virus could have huge consequences in those areas. On top of the direct impact of the virus, a growing concern is that the shift in attention and resources towards the COVID-19 pandemic might crowd-out other essential care-seeking behaviour and health services, leading to higher overall morbidity and mortality. This is a general concern, but may be particularly acute in low-income countries given the higher incidence of deadly infectious diseases.

This study aims to do the following:

• First, by collecting novel data using mobile phone surveys we will document both the extent of (self-reported) incidence of COVID-19 and, importantly, the extent to which respondents adjust their health-seeking behaviour in response to the pandemic. This will allow us to estimate a more comprehensive measure of the impact of COVID-19 pandemic in rural Africa that embraces increases in morbidity and mortality from all conditions.
• Second, by exploiting the unique framework provided by an ongoing large-scale randomised controlled trial (RCT), we will then test whether an innovative Community Health Worker (CHW) programme can be effective in reducing this shift away from effective preventive and curative treatments, and possible misconceptions about COVID-19, cushioning the overall impact of the current pandemic.
• Finally, we will implement a field experiment, focusing on households in the treatment group of the larger trial mentioned above, where will test how different messages regarding COVID-19 and the importance of preventive and curative care more generally influence households health behaviour and outcomes.

The results from this study will enhance our understanding of the impact that the current pandemic is having in rural areas of a low-income country. The evidence can be readily used to inform other programs and guide international organisations, governments and stakeholders to design effective programmes to address the health crisis. In particular, the results related to the alternative messaging can provide lessons that can immediately feed into the government actions and can be easily scaled up at very low costs.