Women's well-being during a pandemic and its containment

Influences of public health emergency and social isolation on older adults' wellbeing: evidence from a longitudinal study

Previous research has identified social isolation as a significant detriment to the wellbeing of older adults. However, studies that consider endogenous issues are scarce. The present paper examines the impact of the recent exogenous shock, the COVID-19 pandemic on the wellbeing of the older adult population using a longitudinal dataset from China for the period 2016-2020. The results of this study indicate that the life satisfaction of Chinese older adults was negatively affected, e particularly in regions where social distancing measures were more strictly enforced. Declines in physical and mental health were found to be attributable to declines in life satisfaction. Those who experienced greater exposure to the pandemic were more likely to suffer from chronic disease, illness, and insomnia, and many found it challenging to complete tasks during the lockdown. Furthermore, heterogeneity estimation shows that these effects are stronger among the rural older adult, females, those without a spouse, and those with less education.

"Ten Days of Paid Incarceration and Mental Torture" Experiences of Quarantined Individuals Arriving in the UK from Red Listed Countries in Southern Africa Amid the COVID-19 Pandemic

COVID-19 has affected many communities across the world prompting different strategies of containing it. The strategies to contain COVID-19 included restrictive environments such as self-isolation and quarantine. This research study was set to explore the experiences of quarantined individuals arriving in the United Kingdom (UK) from red listed countries in Southern Africa. This research study utilises an exploratory qualitative approach. Semi-structured interviews were used to collect data from twenty-five research participants. A thematic approach underpinning the four phases of data analysis in The Silence Framework (TSF) was used to analyse the data. The study found that the research participants reported confinement, dehumanisation, feeling swindled, depressed, anxious and stigmatised. Less restrictive and non-oppressive quarantine regimes should be considered to foster positive mental health outcomes on individuals undergoing quarantine during pandemics.

Long COVID: The evolution of household welfare in developing countries during the pandemic

This study examines household welfare dynamics during the COVID-19 pandemic, using harmonized data from over 300 phone surveys in 80 countries during 2020 and 2021, representing more than 2.5 billion people. The analysis traces out the evolution of employment and income across and within countries as restrictions on economic activity were relaxed. We show some groups initially experiencing higher rates of employment loss - including women, informal workers, and those with less education - also recovered jobs at a slower pace. Based on panel regressions, changes in policy stringency were associated with unequal employment outcomes. Labor market transitions were toward jobs of inferior quality on average, especially for workers with less education. Household income dynamics suggest uneven impacts in the intensive margin of employment consistent with these transitions. Lower wages were not offset by additional social assistance. Taken together, these dynamics may amplify the inequality impacts of the pandemic over the medium to long term.

Effects of the COVID-19 pandemic on sales of sexual and reproductive health products: an ecological study of pharmacies in Kenya

OBJECTIVES

To examine how sales of sexual and reproductive health (SRH) products varied among pharmacies in Kenya using administrative data, leveraging natural variation in the COVID-19 pandemic and accompanying policy restrictions between 2019 and 2021.

DESIGN AND SETTING

Ecological study of pharmacies in Kenya.

PARTICIPANTS

761 pharmacies using the Maisha Meds product inventory management system (capturing 572 916 products sold).

OUTCOMES

Sales quantity, price and revenue of SRH products sold per pharmacy per week.

RESULTS

COVID-19 deaths were associated with a -2.97% (95% CI -3.82%, -2.11%) decrease in sales quantity, a 1.09% (95% CI 0.44%, 1.72%) increase in sales price and a -1.89% (-1.00%, -2.79%) decrease in revenues per pharmacy per week. Results were similar when considering new COVID-19 cases (per 1000) and the Average Policy Stringency Index. Results differed substantially between individual SRH products-a large decrease in sales quantity in pregnancy tests, injectables and emergency contraception, a modest decrease in condoms and no change in oral contraception. Sales price increases were similarly varied; four of the five most sold products were revenue neutral.

CONCLUSIONS

We found a robust negative association between SRH sales at pharmacies in Kenya and COVID-19 reported cases, deaths and policy restriction. Although our data cannot definitively point to reduced access, existing evidence from Kenya regarding unchanged fertility intentions, increases in unintended pregnancies and reported reasons for non-use of contraceptives during COVID-19 suggests a prominent role of reduced access. While policymakers may have a role in sustaining access, their role may be limited by broader macroeconomic problems, such as global supply chain disruptions and inflation, during supply shocks.

The Gendered Consequences of COVID-19 for Internal Migration

Scant evidence exists to identify the effects of the pandemic on migrant women and the unique barriers on employment they endure. We merge longitudinal data from mobile phone surveys with subnational data on COVID cases to examine whether women were left more immobile and vulnerable to health risks, relative to men, during the pandemic in Kenya and Nigeria. Each survey interviewed approximately 2000 men and women over three rounds (November 2020-January 2021, March-April 2021, November 2021-January 2022). Linear regression analysis reveals internal migrants are no more vulnerable to knowing someone in their network with COVID. Rather, rural migrant women in Kenya and Nigeria were less vulnerable to transmission through their network, perhaps related to the possible wealth accumulation from migration or acquired knowledge of averting health risks from previous destinations. Per capita exposure to COVID cases hinders the inter-regional migration of women in both countries. Exposure to an additional COVID case per 10,000 people resulted in a decline in women's interregional migration by 6 and 2 percentage points in Kenya and Nigeria, respectively.

Does the female-headed household suffer more than the male-headed from Covid-19 impact on food security? Evidence from Ethiopia

Covid-19 pandemic and accompanying policy measures affected women's economic and social lives differently from men. However, its effect on the food security situation of women and men remains unclear. This study investigated whether female-headed households suffer more from covid 19 impact on food security than male-headed households in Ethiopia using the World Bank High Frequency Phone Survey data. Food Insecurity Experience Scale (FIES) is applied to measure food insecurity and multilevel-mixed effect random intercept linear model is used to analyze the determinants. The survey data show that, during the pandemic in 2020, nearly 27% of households face moderate or severe food insecurity and close to 6% face severe food insecurity. Regression results revealed that the pandemic and accompanying policy measures affected food security of female-headed households differently from male-headed households. The likelihood of female-headed households experiencing moderate or severe food insecurity is significantly higher by 5.7% points than male-headed households. Education level of the household head is the critical determinant of women's food insecurity. Every additional year of education of female heads has a significantly higher impact in reducing the likelihood of experiencing food insecurity than that of male-headed households. It is also found that having access to basic food items reduces the likelihood of facing moderate or severe food insecurity by 7.4% points. Besides, education level of the household head, income change and family size are critical determinants for food insecurity of the sample households. It is recommended that stakeholders and policy makers focus in the gender aspect while designing policy measures to control pandemics and fucus on improving accessibility of basic needs such as food items to all.

Leaving No Women Behind: Evaluating the Impact of the COVID-19 Pandemic on Livelihood Outcomes in Kenya and Ethiopia

The SARS-CoV-2 pandemic has revolutionised our lives, bringing with it the twin crises of illness and the need for an optimal mix of policies to alleviate its impact on the population. There needs to be more evidence on the effects of the pandemic on livelihood outcomes, including an understanding of whether female-headed families in low-income countries fare worse than their male-headed counterparts during pandemics. Using high-frequency phone surveys conducted in Ethiopia and Kenya, we examine the aggregate impact of the pandemic on income and consumption losses, as well as food insecurity. The empirical analysis estimates linear probability models that relate livelihood outcomes with household headship and other socioeconomic characteristics as controls. Overall, the pandemic increased the likelihood of food insecurity while decreasing income and consumption, particularly among female-headed households. In Kenya, living in a female-headed home increased the possibility of an adult going without food by about 10%, an adult skipping a meal by about 9.9%, and a child missing a meal by about 17% in the seven days preceding the telephone survey. In Ethiopia, living in a female-headed household increased the likelihood of an adult going hungry, skipping a meal, and running out of food by about 24.35%, 18.9%, and 26.7%, respectively. Salient pre-existing socioeconomic inequalities further exacerbated the effects of the pandemic on livelihoods. The findings have important implications for public policy and preparations by governments and other organisations interested in developing suitable gender-sensitive measures to lessen the impact of future pandemics in low- and middle-income countries.

Unintended consequences of lockdowns, COVID-19 and the Shadow Pandemic in India

Violence against women is a problem worldwide, with economic costs ranging from 1% to 4% of global gross domestic product. During the coronavirus disease 2019 lockdowns, the United Nations coined the term the Shadow Pandemic to describe the increase in global violence against women. Here, using variation in the intensity of government-mandated lockdowns in India, we show that domestic violence complaints increase significantly in districts with the strictest lockdown rules. We find similarly large increases in cybercrime complaints. However, rape and sexual assault complaints decrease in districts with the strictest lockdowns, consistent with decreased female mobility in public spaces, public transport and workplaces where they might be at greater risk for rape and sexual assault. Medium-term analysis shows that increases in domestic violence complaints persist 1 year later, while other complaints related to rape, sexual assault and cybercrimes return to pre-lockdown levels.

Systems thinking on the gendered impacts of COVID-19 in Bangladesh: A systematic review

The COVID-19 pandemic has disproportionately affected women and threatens to overturn four decades of progress in Sustainable Development Goal (SDG) 5: Gender Equality and Women's Empowerment. To better grasp the key areas of concern that gender inequality exists, gender studies and sex-disaggregated evidence are required. Using the PRISMA technique, this review paper is the first attempt to present a comprehensive and current picture of the gendered dimensions of the COVID-19 pandemic in Bangladesh regarding economic well-being, resource endowments, and agency. This study found that women were more likely to face hardship as widows, mothers, or sole breadwinners after the loss of husbands and male household members because of the pandemic. The evidence suggests that the advancement of women during this pandemic was hampered by poor reproductive health outcomes; girls' dropping out of school; job loss; less income; a comparable wage gap; a lack of social security; unpaid work burnout; increased emotional, physical, and sexual abuse; an increase in child marriages; and less participation in leadership and decision-making. Our study found inadequate sex-disaggregated data and gender studies on COVID-19 in Bangladesh. However, our research concludes that policies must account for gender disparities and male and female vulnerability across multiple dimensions to achieve inclusive and effective pandemic prevention and recovery.

Gender and social protection and health policies promoted during the COVID-19 pandemic: Global scoping review and future challenges

Background

Governmental interventions have been important tools for mitigating COVID-19 transmission, but they have also negatively impacted different gender-related components. We aimed to answer the following questions: What is the scope of the gender approach in the literature analysing health and social protection policies promoted during the COVID-19 pandemic? What are the challenges and recommendations for gender-sensitive policies for the post-pandemic and future crises?

Methods

The study design is based on three stages: a global synthesis of the evidence through a scoping review, the generation of a framework of emerging inequalities based on sociocultural markers, and the creation of a matrix with the challenges and recommendations. In this scoping review, we searched 10 online databases for studies published until April 2022 and conducted a content analysis on the extracted studies.

Results

Of the 771 identified records, 67 met our inclusion criteria. Most studies had a female person (52/67) as the first author. The binary model was the main approach addressed in the studies (61/67). The literature showed that the closure, distancing, and other social policies did not include a gender approach and generated negative gaps related to economic instability, reproductive roles, and gender violence. In the intersectionality dimension, multiple aspects emerged (macro, meso, micro-social level, and individual level). Greater gender gaps in connection with employment (related to increased housework) were observed during the closure and distancing stage of the pandemic. Asymmetries related to female participation in the management of the pandemic and an increase in discrimination and abuse of diversity groups were detected.

Conclusions

We observed gaps both in the gender approach both in knowledge and in policy implementation during the pandemic in the different countries explored in this work. This is a call to attention and action for researchers, political decision-makers, and other interested parties to incorporate and accentuate the gender perspective in all policies related to the post-pandemic period and future social and health crises.

Indian female migrants face greater barriers to post-Covid recovery than males: Evidence from a panel study

Background

India's abrupt nationwide Covid-19 lockdown internally displaced millions of migrant workers, who returned to distant rural homes. Documenting their labour market reintegration is a critical aspect of understanding the economic costs of the pandemic for India's poor. In a country marked by low and declining female labour force participation, identifying gender gaps in labour market reintegration - as a marker of both women's vulnerability at times of crisis and setbacks in women's agency - is especially important. Yet most studies of pandemic-displaced internal migrants in India are small, rely on highly selected convenience samples, and lack a gender focus.

Methods

Beginning in April 2020 we enrolled roughly 4,600 displaced migrants who had, during the lockdown, returned to two of India's poorest states into a cohort observational study which tracked enrolees through July 2021. Survey respondents were randomly selected from the states' official databases of return migrants, with sampling stratified by state and gender. 85% of enrolees (3950) were working prior to the pandemic. Our difference-in-means analysis uses three survey waves conducted in July to August 2020, January to March 2021, and June to July 2021. Our analysis focuses on a balanced panel of 1780 previously working enrolees (the 45% of respondents present in the first wave that also participated in the subsequent two survey rounds). Primary outcomes of interest include labour market re-entry, earnings, and measures of vulnerability by gender.

Findings

Before the March 2020 national lockdown, 98% (95% CI [97,99]) of workers were employed in the non-agricultural sector. In July 2020, one month after the end of the lockdown, incomes plummet, with both genders earning roughly 17% of their pre-pandemic incomes. 47% (95% CI [45,49]) were employed in agriculture and 37% (95% CI [35,39]) were unemployed. Remigration is critical to regaining income - by January 2021, male re-migrants report earnings on par with their pre-pandemic incomes, while men remaining in rural areas earn only 23% (95% CI [19,27]) of their pre-pandemic income. Remigration benefits women to a lesser extent - female re-migrants regain no more than 65% (95% CI [57,73]) of their pre-pandemic income at any point. Yet men and women struggle to remigrate throughout - by July 2021, no more than 63% (95% CI [60,66]) of men and 55% (95% CI [51,59]) of women had left their home villages since returning. Gender gaps in income recovery largely reflect higher rates of unemployment among women, both among those remaining in rural areas (9 percentage points (95% CI [6,13]) higher than men across waves) and among those who remigrate (13 percentage points (95% CI [9,17]) higher than men across waves). As a result, we observe gender gaps in well-being: relative to male counterparts, women across waves were 7 percentage points (95% CI [4,10]) more likely to report reduced consumption of essential goods and fared 6 percentage points (95% CI [4,7]) worse on a food insecurity index.

Interpretation

Displaced migrants of both genders experienced persistent hardships for over a year after the initial pandemic lockdown. Women fare worse, driven by both lower rates of remigration and lower rates of labour market re-entry both inside and outside home villages. Some women drop out of the labour force entirely, but most unemployed report seeking or being available to work. In short, pandemic-induced labour market displacement has far-reaching, long-term consequences for migrant workers, especially women.

Funding

Survey costs were funded by research grants from IZA/FCDO Gender, Growth, and Labour Markets in Low Income Countries Programme, J-PAL Jobs and Opportunity Initiative, and the Evidence-based Measures of Empowerment for Research on Gender Equality (EMERGE) program at University of California San Diego.

The impact of COVID-related economic shocks on household mental health in Pakistan

We combine data collected just prior to the unfolding of COVID-19 with follow-up data from July 2020 to document the adverse economic effects of the pandemic and resulting impact on parental and child mental well-being in peri-urban Pakistan. 22% of the households in our sample are affected by job loss, with monthly income down 38% on average. Our difference-in-difference results show that job loss is associated with a 0.88 standard deviation (SD) increase in adult mental distress scores (K10), a 0.43 SD reduction in a Hope index of children's aspirations, agency and future pathways, and a 0.39 SD increase in children's depression symptoms. In addition, we observe higher levels of parental stress and anger reported by children, as well as an increase in reported prevalence of domestic violence. Overall, we document that the pandemic has disproportionately and negatively affected the economic and mental well-being of the most vulnerable households in our sample.

Adapting to an aggregate shock: The impact of the Covid-19 crisis on rural households

We examine the response of rural Ugandan households to a large aggregate shock, the Covid-19 pandemic, during and one year after the first lockdown in March 2020. Using 6 rounds of phone surveys from 558 households in western Uganda, we find that household income recovery from the lockdown differs by whether households had a business pre-pandemic. After an initial sharp fall, the incomes of those without a business have recovered to pre-pandemic levels. However, the relatively better-off households with a business before the pandemic still have one-third lower income, due to sustained closure of businesses even after the end of the first lockdown restrictions. Additionally, business-owning households have 30% lower wealth one-year into the pandemic, driven by 44% lower assets, 45% drop in savings, and a 15 fold increase in net-borrowing, suggesting long-term damage. Our findings point to the need to support households who face dwindling finances to fall back on.

Psychological and Social Vulnerability in Spaniards' Quality of Life in the Face of COVID-19: Age and Gender Results

Following the serious health situation in Spain and around the world in 2020 and 2021 stemming from COVID-19, this paper examines how the most vulnerable groups (in social and health terms) in Spanish society suffered the worst impacts on their quality of life during the pandemic. The review of the literature and publications released by the health authorities highlight the high number of cases of illness and death due to COVID-19; however, there are no studies about how it has affected aspects of citizens' daily lives, considering some of their sociodemographic characteristics such as age and gender. A key issue when measuring citizens' quality of life is that we typically see a U-shaped curve by age group, where young people register the highest shares along with the elderly; nevertheless, the pandemic has clearly brought about a change in this regard. In this study, we corroborate this finding, along with the psychological issues underlying this fact in young people and the physical ones in the elderly. To do so, we use an ANOVA and regression analysis with data from a sample of 908 Spanish citizens belonging to different age groups. These data were collected through an online survey distributed throughout Spain, mostly by email and social media, between 15 February and 15 April 2021 with a margin of error of 3.25% and a confidence level of 95%. Furthermore, the analysis allowed us to determine how aspects of daily life-family situation, living conditions, social environment, employment and financial situation-have been negatively affected during the pandemic, clearly depending on the age of the people surveyed, pushing them towards social and health vulnerability.

Pandemics and technology engagement: New evidence from m-Health intervention during COVID-19 in India

Information provision for social welfare via cheap technological media is now a widely available tool used by policymakers. Often, however, an ample supply of information does not translate into high consumption of information due to various frictions in demand, possibly stemming from the pecuniary and non-pecuniary cost of engagement, along with institutional factors. We test this hypothesis in the Indian context using a unique data set comprising 2 million call records of enrolled users of ARMMAN, a Mumbai-based nongovernmental organization that sends timely informational calls to mobile phones of less-privileged pregnant women. The strict lockdown induced by COVID-19 in India was an unexpected shock on engagement with m-Health technology, in terms of both reductions in market wages and increased time availability at home. Using a difference-in-differences design on unique calls tracked at the user-time level with fine-grained time-stamps on calls, we find that during the lockdown period, the call durations increased by 1.53 percentage points. However, technology engagement behavior exhibited demographic heterogeneity increasing relatively after the lockdown for women who had to borrow the phones vis-à-vis phone owners, for those enrolled in direct outreach programs vis-à-vis self-registered women, and for those who belonged to the low-income group vis-à-vis high-income group. These findings are robust with coarsened exact matching and with a placebo test for a 2017-2018 sample. Our results have policy implications around demand-side frictions for technology engagement in developing economies and maternal health.