Many of the measures required to control COVID-19 also produce ‘collateral damage’. Such damage is particularly harmful in Sub-Saharan Africa (SSA) where health systems are relatively under-resourced and where there is a high burden of poverty and disease. There is also evidence of a greater level of harm affecting children compared to adults, and girls and women compared to boys and men. We propose conducting a rapid and urgent impact assessment of COVID-19 and COVID-19 control measures on health systems functioning, child health and women’s health and some endemic infectious disease controls in Ghana, Tanzania, Uganda, and Zimbabwe. We will also describe the design and evolution of COVID-19 control measures across these countries and identify interventions, including further research, which will minimize harm to children and women, and avoid worsening gender inequalities. This proposal builds on a published analysis of the design and implementation of COVID-19 control measures between April and June 2020 in nine SSA countries (including those listed here) which found differences in the design and implementation of COVID-19 control policy and plans, including measures to mitigate the negative effects of ‘lockdown’, as well as evidence of harm to population health due to health systems disruption, economic contraction and other unintended consequences of lockdown. We will use mixed methods of data collection and analysis to produce a set of country case study reports. This will include a national-level analysis, drawing primarily on secondary data analysis and key informant interviews, as well as an in-depth study of two selected sites (one urban and one rural) in each country which will include primary data collection at the health facility, community, and household levels. Of particular importance to this proposal are measures to ensure maximum policy relevance and impact by involving key stakeholders as key informants, and as participants in various discussion forums and research dissemination meetings