Community health workers reveal COVID-19 disaster in Brazil

Lotta, Gabriela; Wenham, Clare; Nunes, João; Pimenta, Denise Nacif

doi:10.1016/s0140-6736(20)31521-x

Cited by 153Healthcare Systems and ChallengesDisaster Response and ManagementHealth, Nursing, Elderly Care

Community health workers reveal COVID-19 disaster in Brazil

Open access

Lotta, Gabriela, Wenham, Clare, Nunes, João, Pimenta, Denise Nacif·2020·The Lancet

DOI 10.1016/s0140-6736(20)31521-xPMC PMC7351420

Open this paper in CoChat — free account Open PDF

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1016/s0140-6736(20)31521-x

Cites

6 of 6 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

COVID-19 in Latin America
Burki, T. K. (2020) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(20)30303-0 · Cited by 286 · see citing works
National UK programme of community health workers for COVID-19 response
Haines, A., de Barros, E. F., Berlin, A., Heymann, D. L., & Harris, M. J. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30735-2 · Cited by 237 · see citing works
WHO Guideline on health policy and system support to optimize community health worker programmes
Porignon, D. (2018) · Cited by 197 · see citing works
The everyday political economy of health: community health workers and the response to the 2015 Zika outbreak in Brazil
Nunes, J. (2019) · Review of International Political Economy · doi:10.1080/09692290.2019.1625800 · Cited by 78 · see citing works
Self-citation
Discretion, power and the reproduction of inequality in health policy implementation: Practices, discursive styles and classifications of Brazil's community health workers
Nunes, J., & Lotta, G. (2019) · Social Science & Medicine · doi:10.1016/j.socscimed.2019.112551 · Cited by 61 · see citing works
Self-citation
Recomendações para adequação das ações dos agentes comunitários de saúde frente à atual situação epidemiológica referente ao Covid-19: versão 2
Saúde, B. M. D. S. S. D. A. P. À. (2020) · Cited by 5 · see citing works

Flagged first, then by citations

Sorted by citations

The Lancet Commission on lessons for the future from the COVID-19 pandemic
Sachs, J. D., Karim, S. S. A., Aknin, L., Allen, J., Brosbøl, K., Colombo, F., Barron, G. C., Espinosa, M. F., Gaspar, V., Gaviria, A., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(22)01585-9 · Cited by 842 · see citing works
COVID-19 pandemic and the social determinants of health
Paremoer, L., Nandi, S., Serag, H., & Baum, F. (2021) · BMJ · doi:10.1136/bmj.n129 · Cited by 553 · see citing works
Spatiotemporal pattern of COVID-19 spread in Brazil
Castro, M. C., Kim, S., Barberia, L., Ribeiro, A. F., Gurzenda, S., Ribeiro, K. B., Abbott, E., Blossom, J. C., Rache, B., & Singer, B. H. (2021) · Science · doi:10.1126/science.abh1558 · Cited by 345 · see citing works
Primary Health Care in Brazil
OECD (2021) · OECD Reviews of Health Systems · doi:10.1787/120e170e-en · Cited by 171 · see citing works
Reduction in life expectancy in Brazil after COVID-19
Castro, M. C., Gurzenda, S., Turra, C. M., Kim, S., Andrasfay, T., & Goldman, N. (2021) · Nature Medicine · doi:10.1038/s41591-021-01437-z · Cited by 164 · see citing works
Community health workers at the dawn of a new era: 6. Recruitment, training, and continuing education
Schleiff, M., Aitken, I. W., Alam, M. A., Damtew, Z. A., & Perry, H. B. (2021) · Health Research Policy and Systems · doi:10.1186/s12961-021-00757-3 · Cited by 132 · see citing works
Healthcare Workers in Brazil during the COVID-19 Pandemic: A Cross-Sectional Online Survey
Cotrin, P., Moura, W. D. S., Gambardela-Tkacz, C. M., Pelloso, F. C., dos Santos, L., Carvalho, M. D. D. B., Pelloso, S. M., & de Freitas, K. M. S. (2020) · INQUIRY The Journal of Health Care Organization Provision and Financing · doi:10.1177/0046958020963711 · Cited by 102 · see citing works
Os impactos sociais da Covid-19 no Brasil: populações vulnerabilizadas e respostas à pandemia
Matta, G. C., Rego, S., Souto, E. P., & Segata, J. (2021) · Série Informação para ação na Covid-19 | Fiocruz eBooks · doi:10.7476/9786557080320 · Cited by 97 · see citing works
Desafios para a Atenção Primária à Saúde no Brasil: uma análise do trabalho das agentes comunitárias de saúde durante a pandemia de Covid-19
Fernandez, M., Lotta, G., & Corrêa, M. (2021) · Trabalho Educação e Saúde · doi:10.1590/1981-7746-sol00321 · Cited by 52 · see citing works
Self-citation
Indirect implications of COVID-19 prevention strategies on non-communicable diseases
Modesti, P. A., Wang, J., Damasceno, A. A. M., Agyemang, C. O., Bortel, L. M. V., Persu, A., Zhao, D., Jarraya, F., Marzotti, I., Bamoshmoosh, M., et al. (2020) · BMC Medicine · doi:10.1186/s12916-020-01723-6 · Cited by 59 · see citing works
“Brazil performed testing only on patients with severe symptoms, and a shortage of materials such as masks, N95 masks, gloves, and hand sanitizer was reported [46, 47].”
Background
Agentes comunitárias de saúde: práticas, legitimidade e formação profissional em tempos de pandemia de Covid-19 no Brasil
Méllo, L. M. B. D. D. E., de Albuquerque, P. C., dos Santos, R. C., Felipe, D. A., & de Queirós, A. A. L. (2021) · Interface - Comunicação Saúde Educação · doi:10.1590/interface.210306 · Cited by 58 · see citing works
Comparative Federalism and Covid-19
Steytler, N. (2021) · Routledge eBooks · doi:10.4324/9781003166771 · Cited by 56 · see citing works
Joint impacts of media, vaccination and treatment on an epidemic Filippov model with application to COVID-19
Deng, J., Tang, S., & Shu, H. (2021) · Journal of Theoretical Biology · doi:10.1016/j.jtbi.2021.110698 · Cited by 55 · see citing works
“The epidemic situation in severe countries such as the US, Brazil, Russia is mainly caused by the lack of attention to epidemic by the government, the unimplemented stringent control measures timely, or the inadequacy of medical facilities (van Dorn et al., 2020; Lancet, 2020; Lotta et al., 2020).”
Background
OECD Reviews of Health Systems
OECD (2009) · OECD Reviews of Health Systems · doi:10.1787/19901410 · Cited by 52 · see citing works
Modified scoping review of the enablers and barriers to implementing primary health care in the COVID-19 context
Edelman, A., Marten, R., Montenegro, H., Sheikh, K., Barkley, S., Ghaffar, A., Dalil, S., & Topp, S. M. (2021) · Health Policy and Planning · doi:10.1093/heapol/czab075 · Cited by 45 · see citing works
“, 2020) • Expansion of telehealth services, including for vulnerable populations and in remote areas (Ariadne Labs, 2020; Giannopoulou and Tsobanoglou, 2020) • Lack of nation-wide guidelines for PHC services relating to the COVID-19 response (Lotta et al., 2020; Souza et al., 2020) • Rapid deployment of frontline ment…”
BackgroundInfluential
Working through the fog of a pandemic: Street‐level policy entrepreneurship in times of crises
Gofen, A., Lotta, G., & da Costa, M. M. (2021) · Public Administration · doi:10.1111/padm.12745 · Cited by 44 · see citing works
“Consequently, while it had been provided all around the country during ordinary times, community healthcare services, and CHWs as its frontline workforce, were marked as unimportant and irrelevant to the pandemic response (Lotta et al., 2020a).”
BackgroundInfluentialSelf-citation
Pandemic Policymaking in Presidential Federations: Explaining Subnational Responses to Covid-19 in Brazil, Mexico, and the United States
Bennouna, C., Giraudy, A., Moncada, E., Rios, E., Snyder, R., & Testa, P. F. (2021) · Publius The Journal of Federalism · doi:10.1093/publius/pjab025 · Cited by 44 · see citing works
The vulnerabilities of the Brazilian health workforce during health emergencies: Analysing personal feelings, access to resources and work dynamics during the COVID‐19 pandemic
Lotta, G., Fernández, M., & Corrêa, M. (2021) · The International Journal of Health Planning and Management · doi:10.1002/hpm.3117 · Cited by 38 · see citing works
“16,21 Political instability added to the disorder in the Health Ministry, which spent three months without a Heath Minister.”
BackgroundSelf-citation
How COVID-19 Has Affected Frontline Workers in Brazil: A Comparative Analysis of Nurses and Community Health Workers
Lotta, G., Coelho, V. S. P., & Brage, E. (2020) · Journal of Comparative Policy Analysis Research and Practice · doi:10.1080/13876988.2020.1834857 · Cited by 41 · see citing works
“On the other hand, as they are connected to the territory, it was expected that they would be better able to use their discretion in adapting the recommendations for citizens locally (Lotta et al. 2020a).”
BackgroundMethodInfluentialSelf-citation
The workforce crisis in healthcare: Moving the debate to bridge evidence and policy
Kuhlmann, E., Lotta, G., Dussault, G., Falkenbach, M., & Correia, T. (2024) · The International Journal of Health Planning and Management · doi:10.1002/hpm.3792 · Cited by 35 · see citing works
Self-citation
Management of the health workforce in facing COVID-19: disinformation and absences in Brazil’s Public Policies
Leite, S. N., Finkler, M., Martini, J. G., Heidemann, I. T. S. B., Verdi, M. I. M., Hellmann, F., & Vásquez, M. F. (2021) · Ciência & Saúde Coletiva · doi:10.1590/1413-81232021265.01252021 · Cited by 33 · see citing works
The impact of the COVID-19 pandemic in the frontline health workforce: perceptions of vulnerability of Brazil's community health workers
Lotta, G., Nunes, J., Fernandez, M., & Garcia Correa, M. (2022) · Health Policy OPEN · doi:10.1016/j.hpopen.2021.100065 · Cited by 29 · see citing works
“Only one document ( “ Recommendations for Community Health Workers During the Pandemic ” ) proposed changes in the work of CHWs during the pandemic [40,11].”
BackgroundResultInfluentialSelf-citation
Maintaining population health in low‐ and middle‐income countries during the COVID‐19 pandemic: Why we should be investing in Community Health Workers
Palafox, B., Renedo, A., Lasco, G., Palileo‐Villanueva, L. M., Balabanova, D., & McKee, M. (2020) · Tropical Medicine & International Health · doi:10.1111/tmi.13498 · Cited by 28 · see citing works
“These critical challenges have been noted in the Philippines,(12) just as in some well-resourced health systems;(13) and have already contributed to the loss of at least 50 CHWs in Brazil.(14) Crucially, CHWs in LMICs must be supported to continue their normal duties to minimise the negative A cc ep te d A rt ic le”
Background
COVID-19 and Co-production in Health and Social Care Research, Policy and Practice: Volume 1: The Challenges and Necessity of Co-production
Williams, O., Tembo, D., Ocloo, J. E., Kaur, M., Hickey, G., Farr, M., Beresford, P., Hensman, S., Allam, A., Boolaky, U., et al. (2021) · Policy Press eBooks · doi:10.47674/9781447361770 · Cited by 28 · see citing works
Crisis lifecycle, policy response, and policy effectiveness
Zheng, S., Li, H., & Sun, H. (2021) · Public Management Review · doi:10.1080/14719037.2021.1972683 · Cited by 28 · see citing works
“For example, in Brazil, Bolsonaro’s government took no direct actions during the early stage of the pandemic, although Congress did pass some social benefit packages (Lotta et al. 2020; Rozell and Wilcox 2020).”
Background
Disparities in Excess Mortality Between Indigenous and Non-Indigenous Brazilians in 2020: Measuring the Effects of the COVID-19 Pandemic
Soares, G. H., Jamieson, L., Biazevic, M. G. H., & Michel‐Crosato, E. (2021) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-021-01162-w · Cited by 27 · see citing works
Between science and populism: the Brazilian response to COVID-19 from the perspective of the legal determinants of Global Health
Martins, J., & Ventura, D. D. F. L. (2020) · Revista de Direito Internacional · doi:10.5102/rdi.v17i2.6687 · Cited by 34 · see citing works
Tackling the primary healthcare workforce crisis: time to talk about health systems and governance—a comparative assessment of nine countries in the WHO European region
Kuhlmann, E., Falkenbach, M., Brînzac, M. G., Correia, T., Panagioti, M., Rechel, B., Sagan, A., Santric-Milicevic, M. M., Ungureanu, M., Wallenburg, I., et al. (2024) · Human Resources for Health · doi:10.1186/s12960-024-00965-2 · Cited by 25 · see citing works
Mental images of nurses regarding COVID‐19: A metaphor study
Durgun, H., Dalcalı, B. K., & Bayraktar, F. (2021) · Journal of Nursing Management · doi:10.1111/jonm.13482 · Cited by 25 · see citing works
“Due to reasons such as the COVID-19 pandemic changing the lives of people in the whole world in a moment, worsening prognosis at unexpected moments and rapid spread, many publications in the literature have defined COVID-19 as a disaster (Agarwal et al., 2020; Cvetkovi c et al., 2020; Lotta et al., 2020).”
Background
Risk governance in the response to global health emergencies: understanding the governance of chaos in Brazil’s handling of the Covid-19 pandemic
Giulio, G. M. D., Mendes, I. M., Dos-Reis-Campos, F., & Nunes, J. (2023) · Health Policy and Planning · doi:10.1093/heapol/czad016 · Cited by 24 · see citing works
Self-citation
How do community health workers institutionalise: An analysis of Brazil’s CHW programme
Krieger, M. G. M., Wenham, C., Pimenta, D. N., Nkya, T. E., Schall, B., Nunes, A. C., Menezes, A. D., & Lotta, G. (2021) · Global Public Health · doi:10.1080/17441692.2021.1940236 · Cited by 23 · see citing works
“6) and the effectiveness of CHW programmes depend on the improvement of clinical service in the most deprived areas (Lotta et al., 2020).”
BackgroundSelf-citation
Pandemia e crimes contra a humanidade: o “caráter desumano” da gestão da catástrofe sanitária no Brasil
Ventura, D. D. F. L., Perrone-Moisés, C., & Martin-Chenut, K. (2021) · Revista Direito e Práxis · doi:10.1590/2179-8966/2021/61769 · Cited by 22 · see citing works
Notas sobre a trajetória da Covid-19 no Brasil
Bueno, F. T. C., Souto, E. P., & Matta, G. C. (2021) · Série Informação para ação na Covid-19 | Fiocruz eBooks · doi:10.7476/9786557080320.0002 · Cited by 20 · see citing works
Agentes Comunitárias de Saúde na pandemia de Covid-19: scoping review
Méllo, L. M. B. D. D. E., dos Santos, R. C., & de Albuquerque, P. C. (2022) · Saúde em Debate · doi:10.1590/0103-11042022e125 · Cited by 18 · see citing works
“primeiros socorros ou avaliação de emergências médicas25 Inglaterra (25) Mitos e verdades sobre testes e tratamento para covid-1937 EUA (37) Uso adequado de EpIs37 EUA (37) Condições de Trabalho Insuficiência de EpIs20,26,32,34,42 Brasil (32), Índia (42), África (26) e peru (34) Baixos salários, atrasos no pagamento,…”
Background
Navigating fear and care: The lived experiences of community-based health actors in the Philippines during the COVID-19 pandemic
Dodd, W., Brubacher, L. J., Kipp, A., Wyngaarden, S., Haldane, V. E., Ferrolino, H., Wilson, K., Servano, D., Lau, L. L., & Wei, X. (2022) · Social Science & Medicine · doi:10.1016/j.socscimed.2022.115222 · Cited by 18 · see citing works
When informal work and poor work conditions backfire and fuel the COVID‐19 pandemic: Why we should listen to the lessons from Latin America
Lotta, G., & Kuhlmann, E. (2020) · The International Journal of Health Planning and Management · doi:10.1002/hpm.3104 · Cited by 17 · see citing works
Self-citation
Examining Roles, Support, and Experiences of Community Health Workers During the COVID-19 Pandemic in Bangladesh: A Mixed Methods Study
Roy, S., Kennedy, S., Hossain, S., Warren, C., & Sripad, P. (2022) · Global Health Science and Practice · doi:10.9745/ghsp-d-21-00761 · Cited by 17 · see citing works
Not separate, but certainly unequal: The burdens and coping strategies of low‐status street‐level bureaucrats
Lotta, G., Krieger, M. G. M., Cohen, N., & Kirschbaum, C. (2023) · Governance · doi:10.1111/gove.12815 · Cited by 17 · see citing works
Self-citation
The impact of the Covid-19 pandemic on the performance of street level bureaucrats in Brazil
Lotta, G., Magri, G., Nunes, A. C., Benedito, B. S., Aliberti, C., Ribeiro, E. C., Lima‐Silva, F., Thomazinho, G., Pereira, G. N., Miranda, J. R., et al. (2021) · Revista Brasileira de Ciência Política · doi:10.1590/0103-3352.2021.35.243776 · Cited by 17 · see citing works
Self-citation
Shifting roles of community health workers in the prevention and management of noncommunicable disease during the COVID-19 pandemic: a scoping review
Haregu, T., Delobelle, P., Shrestha, A., Jeemon, P., Thankappan, K. R., Ganeshkumar, P., Schouw, D. D., Ramalingam, A., Issaka, A., Cao, Y., et al. (2024) · Health Policy and Planning · doi:10.1093/heapol/czae049 · Cited by 16 · see citing works
The Brazilian primary health care response to the COVID-19 pandemic: individual and collective approaches
Bousquat, A., Giovanella, L., Facchini, L. A., de Mendonça, M. H. M., Nedel, F. B., Cury, G. C., Mota, P. H. D. S., Schenkman, S., Chueiri, P. S., & Alves, M. C. G. P. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1212584 · Cited by 15 · see citing works
“Unfortunately, this potential was wasted by the policy carried out by the Ministry of Health, (39).”
Background
COVID-19 and health promotion in Brazil: community health workers between vulnerability and resistance
Lotta, G., & Nunes, J. (2021) · Global Health Promotion · doi:10.1177/17579759211012375 · Cited by 15 · see citing works
“CHWs are in many respects, the ‘canary in the coal mine’ of Brazilian public health (28).”
BackgroundSelf-citation
Resolution of Resilience: Empirical Findings on the Challenges Faced and the Mitigation Strategies Adopted by Community Health Workers (CHWs) to Provide Maternal and Child Health (MCH) Services during the COVID-19 Pandemic in the Context of Odisha, India
Mishra, B. K., Kanungo, S., Patel, K., Swain, S. P., Dwivedy, S., Panda, S., Karna, S., Bhuyan, D., Som, M., Merta, B. R., et al. (2022) · Healthcare · doi:10.3390/healthcare10010088 · Cited by 16 · see citing works
“Similar to our study findings, other studies have revealed that CHWs encountered threats and hostility in their field areas [17,18].”
Result
Populist government support and frontline workers' self‐efficacy during crisis
Lotta, G., Thomann, E., Fernández, M., Vogler, J. P., Leandro, A., & Corrêa, M. (2024) · Governance · doi:10.1111/gove.12851 · Cited by 14 · see citing works
Self-citation
Comparing Health Workforce Policy during a Major Global Health Crisis: A Critical Conceptual Debate and International Empirical Investigation
Kuhlmann, E., Denis, J., Côté, N., Lotta, G., & Neri, S. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20065035 · Cited by 14 · see citing works
“Surveys carried out in April 2021 showed that more than 50% of the HCWs did not receive adequate PPE, 70% did not receive training, 65% did not feel supported by the government, and 80% had mental health issues [13,14].”
BackgroundInfluentialSelf-citation
Projeto Integra: fortalecimento da participação social na agenda das políticas, serviços e tecnologias em saúde
Leite, S. N., Bermudez, J. A. Z., Melecchi, D. R., da Veiga, A. R., Oliveira, A. L. B., de Sousa, A. C. M., Chaves, C. M. G., Manzini, F. C., Dutra, L. S., Chaves, L. A., et al. (2021) · Ciência & Saúde Coletiva · doi:10.1590/1413-812320212611.18212021 · Cited by 13 · see citing works
Extending health systems resilience into communities: a qualitative study with community-based actors providing health services during the COVID-19 pandemic in the Philippines
Haldane, V. E., Dodd, W., Kipp, A., Ferrolino, H., Wilson, K., Servano, D., Lau, L. L., & Wei, X. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-08734-4 · Cited by 13 · see citing works
“During outbreaks and pandemics, communitybased health actors employed by NGOs are activated and use their status as trusted messengers to deliver public health messages in communities, link individuals to care in the health system, and ensure ongoing access to social and economic supports [12, 13].”
Background
Resilience in interconnected community and formal health (and connected) systems
Fortnam, M., Hailey, P., Witter, S., & Balfour, N. (2024) · SSM - Health Systems · doi:10.1016/j.ssmhs.2024.100027 · Cited by 13 · see citing works
Potencialidades da Educação Popular em tempos de pandemia da Covid-19 na Atenção Primária à Saúde no Brasil
Fernandes, R. S., FANK, E. I., Mendes, L. E. F., de Araújo, R. S., & Barbosa, D. D. S. (2022) · Interface - Comunicação Saúde Educação · doi:10.1590/interface.210142 · Cited by 12 · see citing works
The Gendered Experience of Close to Community Providers during COVID-19 Response in Fragile Settings: A Multi-Country Analysis
Raven, J., Arjyal, A., Baral, S., Chand, O., Hawkins, K., Kallon, L. H., Mansour, W., Parajuli, A., Than, K. K., Wurie, H. R., et al. (2022) · Social Sciences · doi:10.3390/socsci11090415 · Cited by 11 · see citing works
“This resonates with findings from other settings such as Brazil where community health workers experienced threats and aggression (Lotta et al. 2020) and in India where harassment and disrespect fuelled by fears of COVID‑19 have been reported (Nanda et al. 2020).”
Result
Desigualdades e subjetividade: construção da práxis no contexto da pandemia de covid-19 em território vulnerável
Silva, C. R. D. C. E., Ianni, Á. M. Z., & Forte, E. C. N. (2021) · Saúde e Sociedade · doi:10.1590/s0104-12902021210029 · Cited by 11 · see citing works
Inequality in the middle of a crisis: an analysis of health workers during the COVID-19 pandemic from the profession, race, and gender perspectives.
Magri, G., Fernandez, M., & Lotta, G. (2022) · Ciência & Saúde Coletiva · doi:10.1590/1413-812320222711.01992022 · Cited by 12 · see citing works
Self-citation
Enhancing the capacity of community health workers in prevention and control of epidemics and pandemics in Wakiso district, Uganda: evaluation of a pilot project
Musoke, D., Lubega, G. B., Twesigye, B., Nakachwa, B., Brown, M. O., & Gibson, L. M. (2024) · BMC Family Practice · doi:10.1186/s12875-024-02522-1 · Cited by 10 · see citing works
“This training was conducted due to the vital role played by CHWs in supporting health systems at the grassroots, particularly during epidemics and pandemics [22, 27].”
Background
Pandemic-Related Impairment in the Monitoring of Patients With Hypertension and Diabetes and the Development of a Digital Solution for the Community Health Worker: Quasiexperimental and Implementation Study
Cimini, C. C. R., Maia, J. X., Pires, M. C., Ribeiro, L. B., Pinto, V. S. D. O. E. A., Batchelor, J., Ribeiro, A. L. P., & Marcolino, M. S. (2022) · JMIR Medical Informatics · doi:10.2196/35216 · Cited by 10 · see citing works
Características do trabalho do agente comunitário de saúde na pandemia de COVID-19 em municípios do Nordeste brasileiro
França, C. D. J., Nunes, C. A., Vilasbôas, A. L. Q., Aleluia, Í. R. S., Aquino, R., Nunes, F. G. D. S., & Prado, N. M. D. B. L. (2023) · Ciência & Saúde Coletiva · doi:10.1590/1413-81232023285.18422022 · Cited by 9 · see citing works
“É necessário acompanhar as mudanças efeti-vas provocadas nas práticas reais de trabalho, as exigências geradas, as construções sociotécnicas que as materializam, seus efeitos sobre a saúde e as dimensões do trabalho 30 .”
Background
Hear my voice: understanding how community health workers in the Peruvian Amazon expanded their roles to mitigate the impact of the COVID-19 pandemic through community-based participatory research
Samsamshariat, T., Madhivanan, P., Prada, A. R. F., Moya, E. M., Meza, G., Reinders, S., & Blas, M. M. (2023) · BMJ Global Health · doi:10.1136/bmjgh-2023-012727 · Cited by 8 · see citing works
A scoping review of the roles, challenges, and strategies for enhancing the performance of community health workers in the response against COVID-19 in low- and middle-income countries
Zulu, J. M., Silumbwe, A., Munakampe, M. N., Chavula, M. P., Mulubwa, C., Sirili, N. S., Zulu, W., Michelo, C., & Tetui, M. (2025) · BMC Family Practice · doi:10.1186/s12875-025-02853-7 · Cited by 9 · see citing works
“This gap hinders the development of resilient CHSs for future infectious outbreaks [19].”
Breastfeeding Practices Before and During the COVID-19 Pandemic in Fortaleza, Northeastern Brazil
Farías-Antúnez, S., Correia, L. L., Araújo, D. A. B. S., Penna, A. L., de Sousa, G. D. S., Silva, A. C. E., Campos, J. S., Rocha, H. A. L., de Aquino, C. M., Castro, M. C., et al. (2022) · Journal of Human Lactation · doi:10.1177/08903344221101874 · Cited by 8 · see citing works
“, 2021), disruption of primary care (Lotta et al. 2020), deterioration of health conditions (Barone et al.”
Background
COVID-19, Older Adults and the Ageing Society
Chatterjee, S. C., & Chatterjee, D. (2022) · Routledge eBooks · doi:10.4324/9781003286936 · Cited by 7 · see citing works
Medos, desejos e preocupações acerca da sindemia de Covid-19 e sofrimento psíquico: experiências extensionistas no sul da Bahia, Brasil
Cardoso, A. J. C., & da Silva, G. A. (2022) · Interface - Comunicação Saúde Educação · doi:10.1590/interface.210675 · Cited by 7 · see citing works
Leaving No Women Behind: Evaluating the Impact of the COVID-19 Pandemic on Livelihood Outcomes in Kenya and Ethiopia
Makate, M., & Makate, C. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20065048 · Cited by 7 · see citing works
A Tale of Two Crashes: Pandemic Politics in Brazil and Peru
Cameron, M. A., Hurtado, V., Villagarcía, P. S., & Gombata, M. (2023) · Latin American Perspectives · doi:10.1177/0094582x231179931 · Cited by 7 · see citing works
An Instant Update on Viruses
Simon, U. K. (2021) · The American Biology Teacher · doi:10.1525/abt.2021.83.3.147 · Cited by 7 · see citing works
Inequality in the middle of a crisis: an analysis of health workers during the COVID-19 pandemic from the profession, race, and gender perspectives
Magri, G., Fernández, M., & Lotta, G. (2022) · Ciência & Saúde Coletiva · doi:10.1590/1413-812320222711.01992022en · Cited by 6 · see citing works
Self-citation
Street-level quasi-bureaucracy and professional discretion: how transformational leadership and public service motivation influence village health volunteers' professional discretion
Wongpreedee, A., & Sudhipongpracha, T. (2024) · International Journal of Sociology and Social Policy · doi:10.1108/ijssp-04-2023-0083 · Cited by 12 · see citing works
Estimating time-varying epidemiological parameters and underreporting of Covid-19 cases in Brazil using a mathematical model with fuzzy transitions between epidemic periods
Lima, H. S., Tupinambás, U., & Guimarães, F. G. (2024) · PLoS ONE · doi:10.1371/journal.pone.0305522 · Cited by 9 · see citing works
“However, the federal government in Brazil failed to comply with these recommendations and neglected to coordinate a national response to the pandemic [31–35].”
Background
Racismo e impactos da COVID-19 na população da cidade de São Paulo
Nisida, V. C., & Cavalcante, L. A. (2020) · Revista Brasileira de Direito Urbanístico | RBDU · doi:10.55663/rbdu.v6i10.80 · Cited by 6 · see citing works
Factors influencing the willingness of primary care physicians to provide care during the coronavirus disease pandemic: a nationwide survey in Taiwan
Huang, H., Jan, C.-F. J., Chang, B. B.-J., & Chiu, T. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-049148 · Cited by 6 · see citing works
The Brazilian PHC response to the COVID-19 pandemic: individual and collective comprehensiveness and performance profilesPreprint
Bousquat, A., Giovanella, L., Facchini, L. A., de Mendonça, M. H. M., Nedel, F. B., Cury, G. C., Mota, P. H. D. S., Schenkman, S., Chueiri, P. S., & Alves, M. C. G. P. (2022) · Research Square · doi:10.21203/rs.3.rs-1909134/v1 · Cited by 6 · see citing works
São Paulo State Primary Health Care in coping with COVID-19: A population size analysis
Viana, M. M. D. O., Duarte, L. S., Escuder, M. M. L., Garcia, M. T., Fernández, M., Costa, M. I. S., & Neves, M. V. F. (2023) · Ciência & Saúde Coletiva · doi:10.1590/1413-812320232812.09282023en · Cited by 5 · see citing works
“Also, regarding territory and community prevention actions, the Ministry of Health 18 formulated generic and contradictory recommendations, indicating underutilization of PHC and ACS 19,20 , putting the expanded care continuity in the territory at risk 6 .”
BackgroundInfluential
The role of primary healthcare amid the COVID-19 pandemic: Evidence from the Family Health Strategy in Brazil
Teixeira, A. D., Postali, F. A. S., Ferreira‐Batista, N. N., Díaz, M. D. M., & Moreno‐Serra, R. (2024) · Social Science & Medicine · doi:10.1016/j.socscimed.2024.117221 · Cited by 5 · see citing works
Performance of Subnational Governments in the COVID-19 Pandemic: An Analysis of the Public and Private Health Services in Brazil
Paschoalotto, M. A. C., Lopes, J. E. F., de Oliveira, P. H., & Barros, P. P. (2022) · BAR - Brazilian Administration Review · doi:10.1590/1807-7692bar2022220034 · Cited by 5 · see citing works
Characteristics of the community health agent’s work in the COVID-19 pandemic in municipalities of Northeastern Brazil
França, C. D. J., Nunes, C. A., Vilasbôas, A. L. Q., Aleluia, Í. R. S., Aquino, R., Nunes, F. G. D. S., & Prado, N. M. D. B. L. (2023) · Ciência & Saúde Coletiva · doi:10.1590/1413-81232023285.18422022en · Cited by 5 · see citing works
Atuação da APS em tempos de crise: uma análise da discricionariedade dos profissionais de saúde na pandemia da COVID-19
Fernández, M., Magri, G., Pontes, B. M. L. M., & Lotta, G. (2023) · Ciência & Saúde Coletiva · doi:10.1590/1413-812320232812.09312023 · Cited by 5 · see citing works
Self-citation
Uma experiência de pesquisa/intervenção da terapia ocupacional social para um cuidado ativo e democrático a jovens estudantes no contexto pós-pandêmico
Lopes, R. E., Pereira, B. P., Pan, L. C., Barreiro, R. G., da Silva, M. J., Malfitano, A. P. S., Farias, M. N., Braga, I. F., Ito, G. G., Reis, S. C. C. A. G., et al. (2024) · Cadernos Brasileiros de Terapia Ocupacional · doi:10.1590/2526-8910.ctore288637481 · Cited by 5 · see citing works
Atenção em saúde para migrantes internacionais em São Paulo, Brasil: acesso e universalidade no contexto da pandemia de Covid-19
Martin, D., Inoue, S. R. V., & Silveira, C. (2022) · Revista del CESLA International Latin American Studies Review · doi:10.36551/2081-1160.2022.29.49-68 · Cited by 5 · see citing works
Barriers and Facilitators to Integrating Depression Treatment Within a TB Program and Primary Care in Brazil
Sweetland, A. C., Mann, C. G., Fernandes, M. J., Silva, F. V. S. D. M., Matsuzaka, C. T., Cavalcanti, M. D. L. T., Fortes, S., Kritski, A. L., Su, A. Y., Ambrosio, J. C., et al. (2023) · Health Promotion Practice · doi:10.1177/15248399231183400 · Cited by 5 · see citing works
Voice-based diagnosis of covid-19: ethical and legal challenges
Almada, M., & Maranhão, J. S. D. A. (2021) · International Data Privacy Law · doi:10.1093/idpl/ipab004 · Cited by 5 · see citing works
Community health workers: a comparative assessment of capacities of a global policy approach in selected European health systems
Kuhlmann, E., Lotta, G., Burau, V., Correia, T., Falkenbach, M., Ungureanu, M., Wallenburg, I., Williams, G. A., & Lehmann, U. (2025) · Health Policy · doi:10.1016/j.healthpol.2025.105541 · Cited by 5 · see citing works
Self-citation
Informal practices in politics and society in Brazil
Santos, A. A. D. S. (2022) · Contemporary Social Science · doi:10.1080/21582041.2022.2042588 · Cited by 4 · see citing works
Latin Amerika’da Covid-19 Pandemisinin Sosyoekonomik Etkileri: Brezilya ve Meksika Örnekleri
Oğuz, C. U., & Sezek, E. N. (2020) · Ekonomi Politika ve Finans Arastirmalari Dergisi · doi:10.30784/epfad.811206 · Cited by 4 · see citing works
Leituras de gênero sobre a Covid-19 no Brasil
Pimenta, D. N., Wenham, C., Rocha, M. C., Schall, B., Bonan, C., Mendes, C. H. F., do Nascimento, M. A. F., Lotta, G., Tamaki, E. R., & Porto, P. S. S. (2021) · Série Informação para ação na Covid-19 | Fiocruz eBooks · doi:10.7476/9786557080320.0013 · Cited by 4 · see citing works
Self-citation
Viés noticioso e exposição seletiva nos telejornais brasileiros durante a pandemia de COVID-19
Mundim, P. S., Gramacho, W. G., Turgeon, M., & Stabile, M. (2022) · Opinião Pública · doi:10.1590/1807-01912022283615 · Cited by 4 · see citing works
Dr. Jekyll e Mr. Hyde nos trópicos: governança disruptiva e justiça ambiental face à Covid-19
Torres, P. H. C., Travassos, L., Moreira, R. M. P., & Fernandes, B. D. S. (2022) · Século XXI - Revista de Ciências Sociais · doi:10.5902/2236672568224 · Cited by 4 · see citing works
Building back from the ground up: the vital role of communities
Doherty, T., Kroon, M., Reynolds, L. G., Fawcus, S., Lake, L., & Solanki, G. C. (2020) · BMJ Global Health · doi:10.1136/bmjgh-2020-003928 · Cited by 4 · see citing works
Community Health Workers
Schleiff, M., & Rifkin, S. B. (2024) · Elsevier eBooks · doi:10.1016/b978-0-323-99967-0.00014-4 · Cited by 4 · see citing works
Organização da Atenção Primária paulista no enfrentamento da COVID-19: análise segundo porte populacional
Viana, M. M. D. O., Duarte, L. S., Escuder, M. M. L., Garcia, M. T., Fernández, M., Costa, M. I. S., & Neves, M. V. F. (2023) · Ciência & Saúde Coletiva · doi:10.1590/1413-812320232812.09282023 · Cited by 3 · see citing works
Habilidades dos agentes comunitários de saúde: análises com estudantes do curso técnico do Programa Saúde com Agente
Giugliani, C., Friedrich, D. B. D. C., Duro, C. L. M., Pilger, D., Kolling, A. F., Silocchi, C., Knauth, D. R., Teixeira, L. B., Raizer, L., & Pires, F. S. (2024) · Revista de APS · doi:10.34019/1809-8363.2023.v26.42466 · Cited by 3 · see citing works
Brazil and the Fight Against Covid-19
Rodrigues, G. M. A., de Oliveira, V. E., de Araújo, M. L. C., & Ferrari, S. (2021) · Routledge eBooks · doi:10.4324/9781003166771-17 · Cited by 3 · see citing works
Community health workers and COVID-19 in a Brazilian state capital
Monreal, T. J., de Oliveira, E. F., Ajalla, M. E. A., Zanoni, D. A., & Santos-Pinto, C. D. B. (2022) · Sociological Spectrum · doi:10.1080/02732173.2022.2081949 · Cited by 3 · see citing works
The role of PHC in times of crisis: an analysis of discretion of health workers during the COVID-19 pandemic
Fernández, M., Magri, G., Pontes, B. M. L. M., & Lotta, G. (2023) · Ciência & Saúde Coletiva · doi:10.1590/1413-812320232812.09312023en · Cited by 3 · see citing works
“In this respect, ambiguity in regulations and lack of federal government support created more room for the exercise of discretion by SLBs 42 .”
BackgroundSelf-citation
Impact of the COVID-19 Pandemic on the Scientific Production of Physical Education Researchers: A Five-Year Follow-Up Study
de Melo, S. J. L., Pinto, V. P., Sebastião, É., Corrêa, É. D. M. S., & Christofoletti, G. (2024) · Behavioral Sciences · doi:10.3390/bs14060475 · Cited by 3 · see citing works
“In Brazil, this scenario was aggravated by conflicting governmental policies that recommended the use of medications with dubious efficacy against COVID-19 and delayed vaccine acquisition [4–7].”
Background
Exploring the Nexus of Common Good and the Neo‐Weberian State: A Comparative Analysis of Brazil and Mexico
Galego, D., Lotta, G., & Baker, K. P. (2025) · Public Administration and Development · doi:10.1002/pad.2105 · Cited by 4 · see citing works
“These three phases are used to characterize the crisis management in Brazil and Mexico (Table 1), two countries where COVID‐19 strongly affected the health system, frontline workers, and the governments had similar response strategies in different phases (Lotta et al. 2020, 2023).”
Self-citation
Community Health Workers in the Covid-19 pandemic: scoping review
Méllo, L. M. B. D. D. E., dos Santos, R. C., & de Albuquerque, P. C. (2022) · Saúde em Debate · doi:10.1590/0103-11042022e125i · Cited by 3 · see citing works
Estratégias de coping de profissionais da saúde de Piracicaba durante a COVID-19
de Rezende, A. A. F., & Pereira, A. C. (2023) · Revista Psicologia Diversidade e Saúde · doi:10.17267/2317-3394rpds.2023.e5214 · Cited by 2 · see citing works
Reframing the method: Report on the adaptation of an ethnographic study to virtual collaborative research on mental health in a low-income neighbourhood during the COVID-19 pandemic in Sao Paulo, Brazil
Szabzon, F., Bruhn, L., Abarca, C., Cabrini, D., Miranda, E., Santana, G. L., & Andrade, L. H. (2024) · SSM - Qualitative Research in Health · doi:10.1016/j.ssmqr.2024.100417 · Cited by 2 · see citing works
COVID-19 and Co-production in Health and Social Care Research, Policy, and Practice
Beresford, P., Farr, M., Hickey, G., Kaur, M., Ocloo, J. E., Tembo, D., & Williams, O. (2021) · Policy Press eBooks · doi:10.56687/9781447361770 · Cited by 2 · see citing works
Community health system capacities and capabilities within an evolving community health policy framework: mixed methods study of stakeholders in central Uganda
Kabanda, R., Ocaatre, R. M., Atwine, D., Kim, B., Waiswa, S. E., Kavuma, P. D., Lee, Y., Mutoni, L., Kim, S., Park, Y., et al. (2025) · BMJ Open · doi:10.1136/bmjopen-2023-082085 · Cited by 1 · see citing works
The NUS–Lancet PRIME Commission: transforming pandemic readiness for equity
Calderón‐Larrañaga, S., Bakhti, R., Etemadi, M., Fakih, L., Vandeskog, H. O., Shrestha, P., He, S., Chua, A. Q., Heymann, D., Tangcharoensathien, V., et al. (2026) · The Lancet · doi:10.1016/s0140-6736(26)01146-3 · Cited by 1 · see citing works
Self-citation
How Has Population Health Been Amplified Through Integrated Indigenous Community Networks? Opportunities During the COVID-19 Pandemic
Ortiz-Rico, C. (2022) · Springer eBooks · doi:10.1007/978-3-030-84678-7_35 · Cited by 1 · see citing works

COVID-19 and health promotion in Brazil: community health workers between vulnerability and resistance
Lotta, G., & Nunes, J. (2021) · Global Health Promotion · doi:10.1177/17579759211012375 · Cited by 15 · see citing works
Self-citation
Community health workers’ attitudes, practices and perceptions towards the COVID-19 pandemic in brazilian low-income communities
Costa, N. D. R., Bellas, H. C., da Silva, P. R. F., de Carvalho, P. V. R., Uhr, D., Vieira, C., & Jatobá, A. (2021) · Work · doi:10.3233/wor-205000 · Cited by 46 · see citing works
Community health workers and COVID-19 in a Brazilian state capital
Monreal, T. J., de Oliveira, E. F., Ajalla, M. E. A., Zanoni, D. A., & Santos-Pinto, C. D. B. (2022) · Sociological Spectrum · doi:10.1080/02732173.2022.2081949 · Cited by 3 · see citing works
Readiness of Community Health Agents for COVID19
Vieira‐Meyer, A. P. G. F., Guimarães, J., Morais, A., Dias, M., Vieira, N. F. C., Farias, S. F., Oliveira, A., Meyer, C., Vasconcelos, M., & Yousafzai, A. K. (2022) · European Journal of Public Health · doi:10.1093/eurpub/ckac129.546 · Cited by 3 · see citing works
How Community Health Workers are facing COVID-19 Pandemic in Brazil: Personal Feelings, Access to Resources and Working Process
Michelle, F., & Lotta, G. (2020) · Archives of Family Medicine and General Practice · doi:10.36959/577/492 · Cited by 25 · see citing works

Authors: Lotta, G., Wenham, C., Nunes, J., & Pimenta, D. N.
Affiliations: Fundação Getulio Vargas (BR)
London School of Economics and Political Science (GB)
University of York (GB)
Fiocruz Minas (BR)
Corresponding author: Lotta, Gabriela
ORCID: Lotta, Gabriela
Wenham, Clare
Nunes, João
Pimenta, Denise Nacif
Venue: The Lancet
Publisher: Elsevier BV
Published: 2020-08
Volume: 396
Issue: 10248
Pages: 365-366
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(20)31521-x
PMC: PMC7351420
OpenAlex: W3041305424
Cited by: 153
References: 6
Citations by year: 2026: 7 · 2025: 12 · 2024: 22 · 2023: 17 · 2022: 48 · 2021: 37 · 2020: 9
FWCI: 28.98
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
doi.org/10.15223/policy-017 (stm-asf)
doi.org/10.15223/policy-037 (stm-asf)
doi.org/10.15223/policy-012 (stm-asf)
doi.org/10.15223/policy-029 (stm-asf)
doi.org/10.15223/policy-004 (stm-asf)
Locations: The Lancet (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Arca - Repositório Institucional da Fiocruz (submittedVersion, other-oa)
LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
Topics: Health Sciences › Health Professions › General Health Professions › Healthcare Systems and Challenges
Health Sciences › Health Professions › Emergency Medical Services › Disaster Response and Management
Health Sciences › Health Professions › General Health Professions › Health, Nursing, Elderly Care
Keywords: community health workers, COVID-19 pandemic, Brazil, primary care, infection control training, personal protective equipment
MeSH terms: Personal Protective Equipment, Betacoronavirus, COVID-19, SARS-CoV-2, Brazil, Community Health Workers, Health Policy, Humans, Leadership, Pneumonia, Viral, Politics, Infectious Disease Transmission, Patient-to-Professional, Coronavirus Infections, Pandemics

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Community health workers reveal COVID-19 disaster in Brazil

Integrity signals

Claims the paper makes

Self-check

Cites

Cited by

Related

Record

About these checks