A Rapid Assessment of impact of Covid-19 Outbreak and Its Impact on the Availability and Access of Health and Nutrition Services

The study seeks to understand the impact that the Covid-19 epidemic and lockdown measures have had on the availability and access to health and nutrition services, in rural contexts in India.


The specific objectives of the study, in the context of the Covid-19 epidemic, are to understand:

  • Availability and access to outreach/ community-based health and nutrition services provided by front-line workers (FLWs - ASHA’s, AWWs, ANMs)
  • Availability and access to facility-based services (at Health Subcenters, PHCs and local private/other care providers)
  • Availability and access to products and commodities – such as IFA tablets, sanitary pads, contraceptives

Approach and methodology

The rapid assessment, undertaken over a 15-day period, used mixed methods, comprising of-

  • Secondary review of Government orders, advisories, and media articles
  • Phone survey with Front-line Workers – ASHA, ANM, AWW
  • Qualitative phone interviews with Front-line Workers, Grassroots organizations, and community members
The study was undertaken in five states – Jharkhand, Odisha, Rajasthan, Uttar Pradesh, and Bihar. The selection of states and respondents was purposive, given the short timeline, and limited to where potential partner organizations of CIFF, PFI, and Development Solutions could support phone interactions with FLWs and community members. Thus, the results of the study, while enabling an understanding of the current situation, are not generalizable.


The pandemic and lockdown have indeed led to an unprecedented socioeconomic and health crisis. Despite the efforts of central and states governments, significant challenges remain. More challenges are likely to emerge too. Some of the study findings include-

  • For women, children, and adolescents, access to outreach health services provided by FLWs has been affected. States such as Odisha and Rajasthan have done relatively well in enabling access to care in the absence of routine outreach services.
  • Limited access to sanitary pads has led to several women and girls switching to the use of cloth as a menstrual absorbent. Those who could afford to were reported to be purchasing commercial pads.
  • Owing to finishing stocks and limited new supplies of contraceptives, stakeholders raised concerns on unwanted pregnancies and unsafe abortions.
With the increasing number of Covid-19 positive cases, the engagement of FLWs and other healthcare workers in the epidemic response, and emerging health and socio-economic challenges, there is a need to re-imagine the provision of healthcare. Not just essential healthcare, but universal access that is affordable.


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