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

卫生部门间合作是初级卫生保健的主要原则之一，1978年在阿尔马作为一项全球方案通过，世界卫生组织至今一再重申。近年来，这种方法得到了新的推动，从一个健康，在那里缺乏合作的界面，人类，动物和环境健康变得如此明显，其有利和不利因素可以特别好地研究在这里。随后，拟议的研究追求作为一个中心的研究问题，如何跨部门的合作，可以尽量减少中断的基本卫生服务在流行病爆发。印度西部大都市阿赫梅达巴德的卫生部门间合作已经被我们研究和比较了H5 N1禽流感爆发（2017年）和随后的非爆发期，采用各种定性和定量方法，采用多阶段和多层次的方法。通过以类似的方式再次收集数据，将有可能在真实的时间内检查Covid 19大流行的影响，从而减少比2017年更少的回忆偏差，同时产生另一个与未来复苏期进行比较的机会。 此外，以产妇服务为例，可以同时探讨大流行病对初级保健的影响，而不需要额外的努力，因此，该项目同时追求两个不同的目标，一方面集中关注人口保护和疾病爆发控制等基本公共卫生任务，另一方面关注基本保健服务：1）通过分析知识，评估在COVID-19大流行期间卫生系统三个层面（即卫生行政部门、卫生服务提供者和社区）的跨部门合作程度，2）评估COVID-19大流行对公共和私人初级卫生保健服务的中断程度，可通过对产前护理、住院分娩和产后护理的影响来衡量，包括定性比较SARS-CoV-2检测呈阴性和阳性的母亲的经历。

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.