Foot soldiers of the pandemic: the role of frontline health workers in building community healthcare resilience in rural Karnataka

Recent crises have affected the health and well-being of rural communities in many low-and-middle income countries (LMICs) focusing attention on building resilience to better withstand and recover from shocks. Drawing on an institutional perspective, this paper analyses how the role, function and participation of frontline health workers in rural India in the years prior to COVID-19 have shaped the conduct of village health governance structures during and in the aftermath of the pandemic. Our study combines observational data from village health committees in Karnataka with rich narrative accounts from health workers. We showcase the historical influences that have shaped the functioning of village health committees to sustain both routine health priorities and COVID-19 activities before, during and in the aftermath of the pandemic. Our study holds broader implications for how the actions of frontline health workers may lead to building community healthcare resilience.