To reduce the risk of COVID-19 infections as well as in response to local and global non-pharmaceutical interventions, national governments, UNHCR and partners adapted their implementation strategies to maintain health service provision as much as possible, in both refugee camps/settlements and in urban areas. It is therefore of strategic importance to document how strategies and activities were adapted in different contexts and which approaches were most effective to respond to refugees’ needs. This will guide future policy and program implementation in these countries and in other forced displacement settings, where resources remain limited. Furthermore, understanding which adaptations may be worth being maintained beyond the COVID-19 context to facilitate access to services would contribute improving the design of health service provision strategies in forced displaced settings. This study aims are therefore threefold:

1. Estimate how health service provision and outcomes have changed during the COVID-19 pandemic in refugee camps/settlements, and in selected urban health facilities providing services to refugees.

2. Characterize adaptations in health service delivery modalities and strategies implemented by Ministry of Health (MoH), UNHCR and partners to maintain health services provision; identify which adaptations were most effective and accepted, as well as which modifications should be maintained beyond the context of COVID-19.

3. Integrate a community perspective by investigating how refugees were involved in designing and implementing adaptations, how these were perceived, which barriers refugees encountered, and how they adapted health seeking behaviors during the pandemic.