Background: The COVID-19 pandemic has highlighted that community engagement and health governance are critical for mitigating the impact and enhanced preparedness. This study assesses the knowledge, attitudes, and practices (KAP) among elected Gram panchayat representatives (Sarpanches) and volunteers. The study explores enablers and barriers for community-level management of COVID-19 and vaccination in two states of South India – Andhra Pradesh (AP) and Telangana (TS). In addition, the availability and utilization of COVID-19 related care and other Primary Healthcare services including Non-COVID clinical care, Maternal and Child health services was also studied.Methods: A mixed-method cross-sectional study consisting of 183 semi-structured interviews and 15 in-depth interviews from two districts of AP and TS. In depth interviews were conducted with 10 COVID-19 recovered patients and 20 lactating mothers were conducted. Results: Quantitative findings suggest a significant association between socioeconomic status and educational level with knowledge. 74% of participants practiced wore masks and 59% washed hands whereas 91% were vaccinated. Sarpanches ensured community compliance and supported the COVID-19 control activities. Most of the COVID-19 patients reported being stigmatized even after recovery. Lactating mothers were dissatisfied with services in government hospitals and high expenditures in private hospitals.Conclusion: The study established the crucial role of sarpanches and volunteers in COVID-19 response. It is important to build their capacities further for better community-based preparedness. Primary health care services should be strengthened for uninterrupted access during such pandemics.
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