Intersectoral Collaboration and Health Services during COVID19: A multi-stage, multi-level mixed-methods study in Ahmedabad, India

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Intersectoral collaboration for health is one of the key principles of primary health care, as adopted as a global program in Alma Ata in 1978 and repeatedly reaffirmed by the World Health Organization to this day. This approach has received a new impetus in recent years from One Health, where the lack of collaboration at the interfaces of human, animal, and environmental health became so apparent that its enabling and hindering factors could be particularly well studied here.Subsequently, the proposed study pursues as a central research question how intersectoral collaboration can minimize the disruption of basic health services during a pandemic outbreak. Intersectoral collaboration for health in the western Indian metropolitan City of Ahmedabad has already been studied and compared by us for the avian influenza H5N1 outbreak (2017) and the subsequent non-outbreak period in a multi-stage and multi-level approach using various qualitative and quantitative methods. By collecting data again in a similar manner, it will be possible to examine the impact of the Covid 19 pandemic in real time, and thus with less recall bias than for 2017, while generating another opportunity for comparison with the future recovery period. In addition, the pandemic impact on primary health care can be explored simultaneously with little additional effort, using maternity services as an example.Therefore, the project simultaneously pursues two different objectives that centrally concern essential basic public health tasks in population protection and outbreak control on the one hand and basic health care services on the other:1) Assess the extent of intersectoral collaboration during the COVID-19 pandemic at three levels of the health system, i.e. health administration, health service providers, and community, by analyzing knowledge, experiences, and perspectives, and visualizing the intensity of linkages.2) Assess the extent to which the COVID-19 pandemic disrupted the delivery of primary health care services, both public and private, as measurable by the impact on ante-natal care, hospital delivery, and postpartum care, including qualitatively comparing the experiences of mothers who tested negative and positive for SARS-CoV-2.