"You Start With the Community": The Value of Community-Based Approaches to COVID-19 in Sri Lanka.

Background: Despite the previous success of a universal health care system, Sri Lanka is facing novel challenges including non-communicable diseases such as diabetes and cancer, an aging population, and most recently, the COVID-19 pandemic. Previous pandemic and disaster responses worldwide have centered local community approaches as crucial for effective solutions. However, there is a gap in the literature surrounding the role of community organizations in Sri Lanka's public health response. Purpose: This study investigates the role of community-based responses during the COVID-19 pandemic in Sri Lanka through the perspective of public health professionals and nongovernmental organization (NGO) affiliates. Research Design: The study is based on qualitative interviews and the antecedent literature review, used to triangulate the collected qualitative data.Study Sample: Ten interviews were conducted to gain an understanding of the role of community organizations in Sri Lanka's COVID-19 pandemic response from both those who work within the public health sector as well as community organizations that assisted with public health efforts. Results: Findings demonstrate that community organizations aided in the COVID-19 response through various forms of hands-on support, most commonly including fundraising and the provision of resources, food, safety equipment, and educational materials. In addition, community organizations' were most successful in navigating the pandemic climate when they communicated closely with communities, engaged in ongoing collaboration with the government, and used innovative strategies. Conclusion: We see this work as exploratory and important for informing future research on the Sri Lankan public health context. Our findings suggest that community organizations should not be overlooked in global public health contexts as they are often well positioned to combat arising public health issues through their unique networks and potential for new and creative solutions.