1 Indirect impacts of the COVID-19 pandemic at two tertiary neonatal units in Zimbabwe and Malawi: an interrupted time series analysis Simbarashe Chimhuya, MMED* 1 , Samuel R. Neal, MRes* 2 , Gwendoline Chimhini, MMED 1 , Hannah Gannon, MBChB 2 , Mario Cortina-Borja, PhD 2 , Caroline Crehan, MSc 2 , Deliwe Nkhoma, BSc 3 , Tarisai Chiyaka, BSc 4 , Emma Wilson, PhD 2 , Tim Hull- Bailey, MPhil 2 , Felicity Fitzgerald, PhD† 5 , Msandeni Chiume, MBBS ‡ 6 , and Michelle Heys, MD(Res)‡ 2 1. Child and Adolescent Health Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe 2. Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, UK 3. Parent and Child Health Initiative Trust, Lilongwe, Malawi 4. Biomedical Research and Training Institute, Harare, Zimbabwe 5. Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, University College London, UK 6. Department of Paediatrics, Kamuzu Central Hospital, Lilongwe, Malawi *Contributed equally as first author †Corresponding author ‡ Contributed equally as last author Correspondence to: Dr Michelle Heys Population, Policy and Practice Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH Email: m.heys@ucl.ac.uk Telephone: +44 (0)20 7905 2212 Word count: 2917 Keywords: COVID-19, neonatal, NICU, low-income countries, developing countries, global health . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) The copyright holder for this preprint this version posted January 6, 2021. ; https://doi.org/10.1101/2021.01.06.21249322 doi: medRxiv preprint NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.