Managing the COVID-19 pandemic in poor urban neighborhoods: The case of Accra and Johannesburg

Factors affecting hand hygiene practice during the COVID-19 pandemic in the Zimbabwean population: a qualitative study

BACKGROUND

Practicing hand hygiene is recommended as one of the key preventive measures for reducing the transmission of COVID-19 and other infectious agents. However, it is often not practiced frequently enough or correctly by the public. We aimed to identify barriers to and facilitators of hand hygiene in the Zimbabwean population during the COVID-19 pandemic.

METHODS

A qualitative study was conducted with a purposive sample of health workers, village health workers, church leaders, traditional healers, teachers, youth leaders and the general population selected from ten districts across the country from September to October 2022. Semistructured interviews were conducted with 3 key informant interviews per site. In addition, one homogenous focus group discussion was also conducted per site using a focus group discussion guide. The data were recorded on audiotapes, transcribed verbatim, and translated into English. All the analyses were performed manually using thematic analysis.

RESULTS

Two themes were identified as facilitators of hand hygiene. These include individual factors (knowledge of hand hygiene practices and how they are performed) and access-related factors (access to hand washing infrastructure, soap, and sanitizers). Among the barriers to hand hygiene, four themes were identified: individual factors (knowledge gaps in proper hand washing, lack of conviction about hand hygiene, and habitual behaviour), access-related factors (lack of access to hand washing infrastructure, soap, and sanitizers), safety concerns (concern about the side effects of sanitizers), and sociocultural and religious factors (social customs, cultural beliefs, values, and religious practices).

CONCLUSION

During public health emergencies, there is a need for people to access uninterrupted, on-premises water supplies to promote compliance with hand hygiene. The provision of clean water and hand washing facilities is critical for vulnerable communities to afford them the opportunity to improve quality of life and facilitate resilience in the event of future pandemics. Community engagement is important for identifying vulnerability factors to provide appropriate mitigatory measures.

Evidence of COVID-19 fatalities in Swedish neighborhoods from a full population study

The COVID-19 pandemic has highlighted a debate about whether marginalized communities suffered the disproportionate brunt of the pandemic's mortality. Empirical studies addressing this question typically suffer from statistical uncertainties and potential biases associated with uneven and incomplete reporting. We use geo-coded micro-level data for the entire population of Sweden to analyze how local neighborhood characteristics affect the likelihood of dying with COVID-19 at individual level, given the individual's overall risk of death. We control for several individual and regional characteristics to compare the results in specific communities to overall death patterns in Sweden during 2020. When accounting for the probability to die of any cause, we find that individuals residing in socioeconomically disadvantaged neighborhoods were not more likely to die with COVID-19 than individuals residing elsewhere. Importantly, we do find that individuals show a generally higher probability of death in these neighborhoods. Nevertheless, ethnicity is an important explanatory factor for COVID-19 deaths for foreign-born individuals, especially from East Africa, who are more likely to pass away regardless of residential neighborhood.

Community engagement and involvement in managing the COVID-19 pandemic among urban poor in low-and middle-income countries: a systematic scoping review and stakeholders mapping

BACKGROUND

Community engagement and involvement (CEI) was crucial for the COVID-19 pandemic response, particularly among the urban poor in low-and middle-income countries (LMICs). However, no evidence synthesis explores how CEI can benefit public health emergencies.

OBJECTIVE

We conducted a systematic scoping review of the CEI with an emphasis on stakeholder identification, accountability mapping, the support system, and the engagement process among urban poor populations in LMICs during the COVID-19 pandemic.

METHODS

We searched eleven databases, including PubMed, Embase, Web of Science, and CINAHL, following the PRISMA-2020 guidelines to find articles published between November 2019 and August 2021. PROSPERO registration No: CRD42021283599. We performed the quality assessment using a mixed-method appraisal tool. We synthesized the findings using thematic framework analysis.

RESULTS

We identified 6490 records. After the title and abstract screening, 133 studies were selected for full-text review, and finally, we included 30 articles. Many stakeholders were involved in COVID-19 support, particularly for health care, livelihoods, and WASH infrastructure, and their accountability mapping by adopting an interest - influence matrix. This review emphasizes the significance of meaningful CEI in designing and implementing public health efforts for pandemic management among urban slum populations. The interest - influence matrix findings revealed that specific community volunteers, community-based organizations, and civil society organizations had high interest but less influence, indicating that it is necessary to recognize and engage them.

CONCLUSION

Motivation is crucial for those with high influence but less interest, such as corporate responsibility/conscience and private food supply agencies, for the health system's preparedness plan among urban populations.

Association between wealth, insurance coverage, urban residence, median age and COVID-19 deaths across states in Nigeria

This study measures associations between COVID-19 deaths and sociodemographic factors (wealth, insurance coverage, urban residence, age, state population) for states in Nigeria across two waves of the COVID-19 pandemic: February 27th 2020 to October 24th 2020 and October 25th 2020 to July 25th 2021. Data sources include 2018 Nigeria Demographic and Health Survey and Nigeria Centre for Disease Control (NCDC) COVID-19 daily reports. It uses negative binomial models to model deaths, and stratifies results by respondent gender. It finds that overall mortality rates were concentrated within three states: Lagos, Edo and Federal Capital Territory (FCT) Abuja. Urban residence and insurance coverage are positively associated with differences in deaths for the full sample. The former, however, is significant only during the early stages of the pandemic. Associative differences in gender-stratified models suggest that wealth was a stronger protective factor for men and insurance a stronger protective factor for women. Associative strength between sociodemographic measures and deaths varies by gender and pandemic wave, suggesting that the pandemic impacted men and women in unique ways, and that the effectiveness of interventions should be evaluated for specific waves or periods.

Was lockdown worth it? community perspectives and experiences of the Covid-19 pandemic in remote southwestern Haiti

Public experiences of COVID-19 pandemic lockdown differed dramatically between countries and socio-economic groups. Low-income countries raise unique empirical and ethical concerns about (1) the balance between benefits and social harms and (2) how explanatory disease models and everyday life realities influenced the experience and interpretation of lockdown itself. In this paper, we present qualitative data on community perceptions and experiences of the pandemic from a remote area of Haiti, with a focus on the 2020 lockdown. We conducted in-depth interviews with 30 community leaders in Grand'Anse Department, southwest Haiti, at two time periods: May 2020 and October-December 2021. We divide our results into five sections. First, our analysis showed that lockdown was widely considered ineffective at controlling COVID-19. Despite the lack of testing, community leaders believed most of the local population had caught COVID-19 in the first half of 2020, with limited reported mortality. Public concern about the pandemic largely ended at this time, overtaken by other socio-economic and political crises. Second, we found that popular explanations for the low fatality rate were related to various coping strategies: the strength of people's immune systems, use of natural prophylactic folk teas, beliefs about the virus, spiritual protections and the tropical weather. Third, we found that lockdown was widely seen to have not been appropriate for the Haitian context due to various challenges with compliance in the face of socio-economic vulnerability. Fourth, we found strong negative feelings about the social consequences of lockdown measures, which lasted from March-August 2020, including adverse effects on: food security, household income, education, health, and psychosocial well-being. Finally, these perceptions and experiences reinforced popular ideas that lockdown had been imposed by elites for financial and/or political gain, something that was also reflected in the discourse about the low vaccine acceptance rate. Our study showed that pandemic respiratory virus response in Haiti should better balance restrictive non-pharmaceutical interventions (NPIs) with existing socio-economic vulnerability. Local socio-behavioral dynamics and risk perceptions decrease the overall effectiveness of NPIs in fragile states and alternatives to lockdown, such as shielding the most vulnerable, are likely to be a more appropriate strategy.

Measurement of SARS-CoV-2 RNA in wastewater: A case study of the Northern Cape, South Africa

The SARS-CoV-2 pandemic has resulted in the infection and death of many South Africans. This is in part due to a lack of testing facilities, equipment, and staff in many areas, particularly those with low population densities. The study focused on the infection dynamics of the virus in the Northern Cape province in all five municipalities investigating wastewater-based surveillance for the province. Reverse transcription was used to identify the virus, and SARS-CoV-2 RNA was detected in a batch of wastewater from four of the five areas sampled and was collected in the months that fall within the third wave of COVID as well as the winter season (May-July). The detection of the SARS-CoV-2 RNA correlated with infection statistics as well as the seasonality of the virus. This research showed a positive result in using wastewater epidemiology to track the spread of the virus but also highlighted the need for improved methodology when it comes to this surveillance. This includes sampling smaller areas and frequent sampling in multiple areas to show clear patterns within smaller, sparsely populated communities.

COVID-19 and food security risk in Nkambe Cameroon: perceptions, drivers and household response measures

This study focuses on COVID-19 and food security risk, capturing perceptions, drivers and household response measures. Using a mixed research design, the researchers investigated food security risk in Nkambe Cameroon during peak periods of COVID-19. Data were collected through a structured questionnaire distributed to 400 respondents and key informant interviews, and it was analysed using both descriptive and inferential statistics. Results showed significant differences in the food security dynamics among COVID-19-infected and non-infected households (19% and 33%, respectively, p = 0.002), with non-infected households being more food secure than COVID-19-infected ones. Significant positive effects between variables, like age of respondent, household size, level of education and food security of affected households were identified. The regression model explains 82.8% of the food security determinants in the midst of COVID-19's peak period. Both COVID-19-infected and non-infected households responded to food insecurity through food rationing and consumption frequency rationing, instead of reducing food consumption frequency. The researchers recommend increasing the efficacy of safety nets and other social assistance programmes in the face of shocks by targeting households most vulnerable to COVID-19-induced food insecurity. Expanding this research agenda to other study sites with a gender lense can provide insights for food security policies post COVID-19.

A neighborhood-level analysis of association between social vulnerability and COVID-19 in ahvaz, Iran

Social vulnerability and society's resilience are two concepts frequently used to examine the capacity of social systems to prepare, absorb, and adapt to environmental hazards and shocks. With the emergence of the COVID-19 pandemic, the role of social vulnerability in dealing with risks has gained renewed attention. Assessing social vulnerability can help managers and planners prioritize budgets, develop prevention programs, and enhance risk preparedness. This study aimed to determine the association between social vulnerability and COVID-19 in the neighborhoods of Ahvaz, Iran. To assess the social vulnerability of Ahvaz neighborhoods, decision-making techniques (best-worst method and weighted aggregated sum product assessment method) and geographic information systems were applied. Moreover, to investigate the relationship between social vulnerability and COVID-19 cases, the Pearson correlation test was used. The results showed that the '20-meteri shahrdari' neighborhood has the highest level of social vulnerability, and the lowest level of social vulnerability among the neighborhoods of Ahvaz belongs to the neighborhood of 'Shahrak Naft'. There is a low inverse association between the integrated index of social vulnerability and the incidence of COVID-19 per 1000 people in Ahvaz. By revealing the most important details at the neighborhood level and levels of vulnerability, the results can inform effective planning actions at the neighborhood level.

Exploring potential risk pathways with high risk groups for urban Rift Valley fever virus introduction, transmission, and persistence in two urban centers of Kenya

Rift Valley fever virus (RVFV) is a zoonotic arbovirus that has profound impact on domestic ruminants and can also be transmitted to humans via infected animal secretions. Urban areas in endemic regions across Africa have susceptible animal and human hosts, dense vector distributions, and source livestock (often from high risk locations to meet the demand for animal protein). Yet, there has never been a documented urban outbreak of RVF. To understand the likely risk of RVFV introduction to urban communities from their perspective and guide future initiatives, we conducted focus group discussions with slaughterhouse workers, slaughterhouse animal product traders, and livestock owners in Kisumu City and Ukunda Town in Kenya. For added perspective and data triangulation, in-depth interviews were conducted one-on-one with meat inspector veterinarians from selected slaughterhouses. A theoretical framework relevant to introduction, transmission, and potential persistence of RVF in urban areas is presented here. Urban livestock were primarily mentioned as business opportunities, but also had personal sentiment. In addition to slaughtering risks, perceived risk factors included consumption of fresh milk. High risk groups' knowledge and experience with RVFV and other zoonotic diseases impacted their consideration of personal risk, with consensus towards lower risk in the urban setting compared to rural areas as determination of health risk was said to primarily rely on hygiene practices rather than the slaughtering process. Groups relied heavily on veterinarians to confirm animal health and meat safety, yet veterinarians reported difficulty in accessing RVFV diagnostics. We also identified vulnerable public health regulations including corruption in meat certification outside of the slaughterhouse system, and blood collected during slaughter being used for food and medicine, which could provide a means for direct RVFV community transmission. These factors, when compounded by diverse urban vector breeding habitats and dense human and animal populations, could create suitable conditions for RVFV to arrive an urban center via a viremic imported animal, transmit to locally owned animals and humans, and potentially adapt to secondary vectors and persist in the urban setting. This explorative qualitative study proposes risk pathways and provides initial insight towards determining how urban areas could adapt control measures and plan future initiatives to better understand urban RVF potential.

Mobility in informal settlements during a public lockdown: A case study in South Africa

Many African countries quickly responded to the COVID-19 pandemic in 2020 with lockdowns of public life. Yet, many have large numbers of dense informal settlements where infrastructure is shared, houses are small, and residents live on low incomes. These conditions make complying with curfews extraordinarily difficult. Using pedestrian motion sensors installed throughout an informal settlement in Cape Town, South Africa, we study how the lockdown affected mobility in the evenings, early mornings, and during the nights between February 14 and June 18, 2020. We find that mobility was already decreasing in March prior to the start of lockdown by 23% in paths-about half of the overall decline-and by 19% in shared courtyards. Starting with the lockdown on March 27, pedestrian activity decreased by 48% in comparison to February 2020 across paths and by 61% in shared courtyards. We notice the biggest changes on weekends, normally key leisure times, and between 6:00 pm and 9:00 pm and between 6:00 am and 8:00 am, spanning typical commute hours, though these hours continue to have the most activity indicating some people continue to commute. The results show that mobility reduction is large, though generally smaller than reductions observed in high-income countries. We find that residents of informal settlements comply with state-mandated lockdowns to the best of their ability given the circumstances, but that awareness of COVID-19 with less strict regulations prior to lockdown also led to mobility declines.

Does poverty increase COVID-19 in Africa? A cross-country analysis

BACKGROUND

Most economies in African countries are informal. As such, households in these countries tend to face higher levels of informality coupled with a lack of social protection, and have no replacement income or savings in the event of unexpected external shocks, such as COVID-19. Thus, the COVID-19 shock and its negative economic effects triggered a cascade of income losses and bankruptcies that pushed a significant share of households in African countries into poverty. This research analyzes the effect of poverty on the spread of COVID-19 using a sample of 52 African countries.

METHODS

To achieve the objective of this research, this paper uses a multiple linear regression model and a sample of 52 African countries observed in 2020 to conduct a cross-country analysis. More importantly, two COVID-19 indicators (total number of officially reported cases and disease severity) and six poverty indicators (average poverty, poverty incidence, poverty depth, poverty severity, multidimensional poverty index, and extreme poverty) were used in this research.

RESULTS

The results show a positive and significant relationship between poverty and the spread of COVID-19.

CONCLUSIONS

These results suggest that more attention needs to be paid to poor populations in African countries during the pandemic. These populations are generally vulnerable, and there is a need for support programs targeting them to be put in place quickly. These programs may include food aid, distribution of supplies, health care support, fee waivers, and interest deferrals. In addition, sensitization of these disadvantaged groups on vaccination against COVID-19 to achieve herd immunity is strongly encouraged.

Understanding the policy dynamics of COVID-19 vaccination in Ghana through the lens of a policy analytical framework

Background

Ghana became the first African country to take delivery of the first wave of the AstraZeneca/Oxford vaccine from the COVAX facility. But why has this promising start of the vaccination rollout not translated into an accelerated full vaccination of the population? To answer this question, we drew on the tenets of a policy analytical framework and analysed the diverse interpretations, issue characteristics, actor power dynamics and political context of the COVID-19 vaccination process in Ghana.

Methods

We conducted a rapid online review of media reports, journal articles and other documents on debates and discussions of issues related to framing of the vaccination rollout, social constructions generated around vaccines, stakeholder power dynamics and political contentions linked to the vaccination rollout. These were complemented by desk reviews of parliamentary reports.

Results

The COVID-19 vaccination was mainly framed along the lines of public health, gender-centredness and universal health coverage. Vaccine acquisition and procurement were riddled with politics between the ruling government and the largest main opposition party. While the latter persistently blamed the former for engaging in political rhetoric rather than a tactical response to vaccine supply issues, the former attributed vaccine shortages to vaccine nationalism that crowded out fair distribution. The government’s efforts to increase vaccination coverage to target levels were stifled when a deal with a private supplier to procure 3.4 million doses of the Sputnik V vaccine collapsed due to procurement breaches. Amidst the vaccine scarcity, the government developed a working proposal to produce vaccines locally which attracted considerable interest among pharmaceutical manufacturers, political constituents and donor partners. Regarding issue characteristics of the vaccination, hesitancy for vaccination linked to misperceptions of vaccine safety provoked politically led vaccination campaigns to induce vaccine acceptance.

Conclusions

Scaling up vaccination requires political unity, cohesive frames, management of stakeholder interests and influence, and tackling contextual factors promoting vaccination hesitancy.

Infodemic Management Using Digital Information and Knowledge Cocreation to Address COVID-19 Vaccine Hesitancy: Case Study From Ghana

Background

Infodemic management is an integral part of pandemic management. Ghana Health Services (GHS) together with the UNICEF (United Nations International Children's Emergency Fund) Country Office have developed a systematic process that effectively identifies, analyzes, and responds to COVID-19 and vaccine-related misinformation in Ghana.

Objective

This paper describes an infodemic management system workflow based on digital data collection, qualitative methodology, and human-centered systems to support the COVID-19 vaccine rollout in Ghana with examples of system implementation.

Methods

The infodemic management system was developed by the Health Promotion Division of the GHS and the UNICEF Country Office. It uses Talkwalker, a social listening software platform, to collect misinformation on the web. The methodology relies on qualitative data analysis and interpretation as well as knowledge cocreation to verify the findings.

Results

A multi-sectoral National Misinformation Task Force was established to implement and oversee the misinformation management system. Two members of the task force were responsible for carrying out the analysis. They used Talkwalker to find posts that include the keywords related to COVID-19 vaccine-related discussions. They then assessed the significance of the posts on the basis of the engagement rate and potential reach of the posts, negative sentiments, and contextual factors. The process continues by identifying misinformation within the posts, rating the risk of identified misinformation posts, and developing proposed responses to address them. The results of the analysis are shared weekly with the Misinformation Task Force for their review and verification to ensure that the risk assessment and responses are feasible, practical, and acceptable in the context of Ghana.

Conclusions

The paper describes an infodemic management system workflow in Ghana based on qualitative data synthesis that can be used to manage real-time infodemic responses.

The Impact of COVID-19 on Economic Growth of Countries: What Role Has Income Inequality in It?

This paper argues that income inequality explains the variation in the economic performance of different countries over the first year of the COVID-19 pandemic. Unlike the conclusions reported by some studies, this study shows that health casualties caused by COVID-19 has had a higher adverse economic impact on countries with lower income inequality. Notwithstanding, the decline in the economic growth as well as the number of casualties caused by COVID-19 were, overall, proportionate to the level of income inequality of the country. Furthermore, the results showed that countries with more dependence on the service sector and countries that implemented more restrictive measures (lockdowns) experienced a higher decline in GDP growth over the first year of the pandemic period. The paper concludes with some important policy implications that support the role of strong institutions in making economies resilient over a period of pandemic.

The short-term effect of the government of Ghana’s decision to open borders at the early-onset of the COVID-19 pandemic

Non-Pharmaceutical Interventions (NPI) are used in public health to mitigate the risk and impact of epidemics or pandemics in the absence of medical or pharmaceutical solutions. Prior to the release of vaccines, COVID-19 control solely depended on NPIs. The Government of Ghana after assessing early NPIs introduced at the early stage of the pandemic began to ease some restrictions by the opening of international borders with isolation and quarantine measures enforced. It was argued by some experts that this was a hasty decision. In this study, we assessed the impact of the opening of borders to ascertain if this action caused a surge or otherwise in cases in the country. Using data from the database on Africa’s records of COVID-19 from the John Hopkins University, the Generalized Linear Model (GLM) time-series regression model for count data was applied to study effects in Ghana during a 4-month and 8-month period post-opening of borders. The study showed that after the decision of the government to open international borders, Ghana's expected case count declined by 72.01% in the 4-month period and 54.44% in the 8-month period. This gives an indication of the gradual reversal of the gains made due to the early implementation of NPIs. Notably, this may not only be attributed to the opening of borders but the relaxation of the strict enforcement measures that were put in place at the onset of the pandemic in Ghana. There is therefore the need for continuous enforcement of intervention measures to reduce case counts, particularly with the emergence of new COVID-19 virus strains. The study provides some recommendations for policy and improvements in model building such as developing better data collection system in Ghana, investigating more control variables, estimating the decaying effect of interventions, and ensuring better preparations prior to easing of public health restrictions.

An index of access to essential infrastructure to identify where physical distancing is impossible

To identify areas at highest risk of infectious disease transmission in Africa, we develop a physical distancing index (PDI) based on the share of households without access to private toilets, water, space, transportation, and communication technology and weight it with population density. Our results highlight that in addition to improving health systems, countries across Africa, especially in the western part of Africa, need to address the lack of essential domestic infrastructure. Missing infrastructure prevents societies from limiting the spread of communicable diseases by undermining the effectiveness of governmental regulations on physical distancing. We also provide high-resolution risk maps that show which regions are most limited in protecting themselves. We find considerable spatial heterogeneity of the PDI within countries and show that it is highly correlated with detected COVID-19 cases. Governments could pay specific attention to these areas to target limited resources more precisely to prevent disease transmission.

Lack of private infrastructure remains a major challenge potentially hampering a societies’ ability to contain the transmission of communicable diseases. Areas at high risk in Africa are identified based on access to essential basic infrastructure.

Economic Recovery but Stagnating Mental Health During a Global Pandemic? Evidence from Ghana and South Africa

Ghana and South Africa proactively implemented lockdowns very early in the pandemic. We analyze a three-wave panel of households in Accra and Greater Johannesburg to study the mental and economic well-being of the urban poor between the COVID-19 lockdown and the "new normal" one year later. We find that even if economic well-being has mostly recovered, life satisfaction has only improved slightly and feelings of depression are again at lockdown levels one year into the pandemic. While economic factors are strongly correlated with mental health and explain the differences in mental health between South Africa and Ghana, increasing worries about the future and limited knowledge about the pandemic (both countries) as well as deteriorating physical health (South Africa) and trust in government (Ghana) explain why mental health has not recovered. Therefore, we need broad and country-specific policies, beyond financial support, to accelerate the post-pandemic recovery of the urban poor.

Urban health challenges: Lessons from COVID-19 responses

The COVID-19 pandemic has forced a re-examination of our societies and in particular urban health. We argue that urban health needs to address three inter-related challenge areas - the unequal impacts of climate change, changing patterns of urbanization, and the changing role of the local government - across multiple spatial scales: from individual, households to neighbourhoods, cities, and urban hinterlands. Urban health calls for nimble institutions to provide a range of responses while adapting to crisis situations, and which operate beyond any one spatial scale. We illustrate our argument by drawing on South and Southeast Asian examples where responses to the pandemic have confronted these challenges across scales. A multiscalar definition of urban health offers an opportunity to challenge dominant approaches to urban health in research, policy, and practice.

COVID-19 and Its Effects on the Mental Health of People Living in Urban Slums in India

The COVID-19 pandemic has had a devastating effect on the mental health of people from different backgrounds; these effects have been particularly acute among the lower-income households and in slums. There has been a steep rise in mental illness and behaviours associated with it since 2020, especially in the slums characterised by poverty, poor housing, high density and unhealthy environments. This paper aims to examine the effect of COVID-19 on the mental health of people living in the slums of Vijayawada and Visakhapatnam in the state of Andhra Pradesh in India. The results of the study confirm that more than three-fourth of people suffer from mental stress due to the spread of COVID-19 and the lockdown imposed by the government. Also, 80% of those surveyed stated that stress affected their decision-making. The study also confirms that the number of dependents, monthly income, number of living rooms, maintenance of physical distancing norms, avoidance of social gatherings, government support, health insurance and living in a rented house are significantly related to the mental stress of people living in the slums in Andhra Pradesh in India.

Microfinance loan officers before and during Covid-19: Evidence from India

The Microfinance industry has been severely affected by Covid-19. We provide detailed insights into how loan officers, the key personnel linking the lender to its borrowers, are affected in their performance and adapt their work to the pandemic. We use administrative records of an Indian Microfinance Institution and detailed panel survey data on performance, performed tasks, and work organization to document how the work environment became more challenging during the pandemic. Loan officers operate in a setting where work from home is hard to implement due to the nature of the tasks and technological constraints. The usual performance indicators appear to be mainly driven by external factors such as the nation-wide debt moratorium. Loan officers worked similar hours, but engaged less in planning activities and completed fewer of the usual tasks. Work perceptions and mental health of loan officers reflect these changes, and perceived stress was particularly high during the period of the debt moratorium.

Knowledge, attitude and perception of West Africans towards COVID-19: a survey to inform public health intervention

BACKGROUND

The first case of the novel coronavirus disease-2019 (COVID-19) in West Africa was first confirmed in Nigeria in February 2020. Since then, several public health interventions and preventive measures have been implemented to curtail transmission of the causative agent, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Therefore, this study was performed to assess the knowledge, attitudes, and perceptions of West Africans towards COVID-19.

METHODS

An online survey was conducted between 29 September to 29 October 2020 among West Africans. Thirty-three survey questions were designed to collect sociodemographic data and participants' knowledge, attitude and perception towards COVID-19. The study targeted all West African nationals who were 18 years and above, and willing to participate in the study. Participants were either in-country or abroad.

RESULTS

Overall, 1106 respondents (≥18 years) from 16 West African countries, with about 12.1% of them residing outside the West African subregion, participated in the survey. The respondents had an average COVID-19 knowledge score of 67.82 ± 8.31, with knowledge of the disease significantly associated with the country of residence (p = 0.00) and marginally (p = 0.05) so with settlement types (i.e., urban, suburban and rural areas). Most respondents (93.4%) could identify the main COVID-19 symptoms, and 73.20% would consult a healthcare professional if infected with SARS-CoV-2. Also, 75.2% of the respondents are willing to receive the COVID-19 vaccine, whereas 10.40% and 14.40% are unwilling and undecided, respectively. Perceptions of what constitute COVID-19 preventive measures were highly variable. Approximately, 8% of the respondents felt that their government responded excellently in managing the pandemic while a third felt that the response was just good. Also, more than half (54%) opined that isolation and treatment of COVID-19 patients is a way of curbing SARS-CoV-2 spread.

CONCLUSIONS

Most West Africans have basic knowledge of COVID-19 and showed a positive attitude, with likely proactive practice towards the disease. However, results showed that these varied across countries and are influenced by the types of settlements. Therefore, the health and education authorities in various countries should develop focused measures capturing people in different settlements to improve their preventative measures when designing public health interventions for COVID-19 and any future epidemics or pandemics.

Food security, poverty and household resilience to COVID-19 in Burkina Faso: Evidence from urban small traders' households

Analyses of the effects of the COVID-19 pandemic on food security of urban households and their resilience are increasingly receiving scholarly interest. In Burkina Faso, urban households whose primary activity is trade were the most immediately impacted by COVID-19 due to the closure of markets. The objective of this research was to analyze the effect of income loss due to COVID-19 on food security and poverty among urban small traders' households by considering their resilience capacity. A survey was performed on 503 households of small traders operating in 5 markets in Ouagadougou. Objective and subjective indicators of food security were calculated, as well as several indices of resilience capacity. A simple logit model and ordered logit model were used for the socioeconomic analysis. Three main results emerge. First, COVID-19 has increased the likelihood of households being food insecure due to their lower food consumption scores. Second, estimates show that COVID-19 has reduced households' incomes by increasing their likelihood of entering poverty. Finally, at all levels of analysis, households with adaptive capacity were able to adjust to the shock, but social security was not a mitigating factor. Implications in terms of economic policies are discussed.

COVID‐19 y trabajo informal: evidencia de once ciudades

Se presentan las conclusiones de un estudio dirigido por la red Mujeres en Empleo Informal: Globalizando y Organizando (WIEGO), en el que se investigan las repercusiones de la crisis de la COVID‐19 en diferentes grupos de personas trabajadoras informales y en sus hogares en términos de empleo, ingresos, alimentación y hambre, cuidado y otras responsabilidades domésticas, así como las estrategias de afrontamiento de estas personas. Se comparan los roles de los gobiernos y de las organizaciones de personas trabajadoras informales en la prestación de diversas ayudas. Basándose en las reivindicaciones de estas personas, se plantean principios rectores para mejorar su situación en el futuro.

The Digital Revolution in the Urban Water Cycle and Its Ethical–Political Implications: A Critical Perspective

The development and application of new forms of automation and monitoring, data mining, and the use of AI data sources and knowledge management tools in the water sector has been compared to a ‘digital revolution’. The state-of-the-art literature has analysed this transformation from predominantly technical and positive perspectives, emphasising the benefits of digitalisation in the water sector. Meanwhile, there is a conspicuous lack of critical literature on this topic. To bridge this gap, the paper advances a critical overview of the state-of-the art scholarship on water digitalisation, looking at the sociopolitical and ethical concerns these technologies generate. We did this by analysing relevant AI applications at each of the three levels of the UWC: technical, operational, and sociopolitical. By drawing on the precepts of urban political ecology, we propose a hydrosocial approach to the so-called ‘digital water ‘, which aims to overcome the one-sidedness of the technocratic and/or positive approaches to this issue. Thus, the contribution of this article is a new theoretical framework which can be operationalised in order to analyse the ethical–political implications of the deployment of AI in urban water management. From the overview of opportunities and concerns presented in this paper, it emerges that a hydrosocial approach to digital water management is timely and necessary. The proposed framework envisions AI as a force in the service of the human right to water, the implementation of which needs to be (1) critical, in that it takes into consideration gender, race, class, and other sources of discrimination and orients algorithms according to key principles and values; (2) democratic and participatory, i.e., it combines a concern for efficiency with sensitivity to issues of fairness or justice; and (3) interdisciplinary, meaning that it integrates social sciences and natural sciences from the outset in all applications.

COVID‐19 pandemic, vaccine nationalism and counterfeit products: Discourse and emerging research themes

Although “vaccine nationalism” and vaccine diplomacy have thus far typified the COVID‐19 vaccine rollouts around the globe, there remain limited scholarly insights on global vaccine distribution strategies. This research note (RN) examines the global vaccine distribution strategies and implications for public policy and governments. In conceptualizing the global vaccine distribution strategies into three competing perspectives (i.e., “vaccine nationalism,” vaccine diplomacy, and global initiative), this article highlights the divergent effects of different approaches in terms of ushering elements of nationalism and ethnocentrism. By contextualizing the discourse on the COVID‐19 pandemic into the three competing perspectives and highlighting the role of pharmaceutical companies and COVID‐19 vaccine passport, the study also offers pathways for further examination of the subject incorporating the contextual conditions.

Progression of the Pathway for Public Health Care during the COVID-19 Outbreak at District Health Office

Public health activities under district health offices (DHOs) play a major role in Malaysia's fight against COVID-19. This article aims to describe and illustrate the public health activity pathway in combating the COVID-19 pandemic, and a team of public health workers who are familiar with DHO work settings was created in April 2020 for that purpose. Review of documents and the Ministry of Health's updates was carried out, followed by a series of discussions with stakeholders. Based on the steps in the outbreak investigation tasks, the flow of activities from January to May 2020 was listed in line with the phases of the country's National Movement Control Order 2020. Results show that the activities can be classified into three different sections-namely, the main action areas, category of cases, and level of care. The main process flow of activities comprised the case management and support activities. Case management flow was split into tasks for patients under investigation and persons under surveillance, while the support services existed throughout the phases. The pathways illustrate that the progression of the pandemic translated directly to changes in the pattern of activities, with additional subgroups of activities in accordance with all imposed guidelines.

Effect of COVID-19 on Household Food Insecurity and Poverty: Evidence from Ghana

Following the outbreak of COVID-19 and its heavy toll on the global community and humanity, a fierce debate on the pandemic and Sustainable Development Goals (SDGs) performance nexus has emerged. While the literature on this subject remains highly contested, evidence within the Ghanaian contest is sparse. Thus, we present micro-level evidence on how COVID-19 poses a threat to hunger and poverty as SDGs in Ghana. Precisely, we examined the effect of COVID-19 on households' food insecurity and poverty and further analysed gender and locational sub-samples for differential effects. Data on 3905 households were obtained via concurrent online survey and telephone interviews. The results indicate that, on several occasions, a significant number of the sampled households (57.76%) did not get enough food to eat due to the pandemic. The proportion of households that went on several times without clean water for home use and access medicines/medical treatments were 50.52% and 52.22%, respectively. About 60.72% of the sampled households affirmed that, on several times, they did not have enough income due to the pandemic. At the same time, the share of households that suffered food insecurity due to the pandemic was 69.04%. Instrumenting for COVID-19 using distance to the affected communities, we find that a standard deviation increase in COVID-19 is associated with a rise of 0.232 and 0.289 standard deviations in poverty and food insecurity, respectively. Our results are robust to alternative estimation approaches to addressing the endogeneity of COVID-19 and other sensitivity checks. We conclude that Ghana would need to develop a new spectrum of gender- and location-sensitive policies that engender social inclusion as a conduit to expediate the attainment of zero poverty and hunger.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11205-021-02766-9.

The pandemic and the problem of compliance with safety measures: The case of Egypt

Analysing data from a nationally representative sample of 3442 interviews conducted in Egypt in 2020, this study examines the influence of four sets of factors in predicting compliance with the advice of healthcare professionals to combat the spread of COVID-19: demographics, knowledge and values, fear of the disease and denial, and the pandemic as a foreign invasion. The findings show that a higher likelihood of compliance is linked to socioeconomic status, awareness of the pandemic, reliance on a plurality of information sources, adherence to liberal values, and fear of the disease, but being male, young, employed, religious, fatalistic, and in denial of the severity of the pandemic lower this likelihood - all consistent with the results reported in the literature. In addition, this study highlights the link between compliance and such attributes of nationalism as national identity, national pride, the perception of the pandemic as a national event, and the willingness to sacrifice one's human right to combat the spread of the disease. Drawing on these factors, this paper suggests building societal consensus around the theme of national unity against the microparasitic invasion is the key to an effective strategy to combat the spread of the virus.

COVID-19-related attitudes, risk perceptions, preventive behaviours and economic impact in sub-Saharan African countries: implementing a longitudinal phone-based survey protocol in rural Senegalese households

INTRODUCTION

Rural areas are considered safe havens against the increased spread of COVID-19 and associated restrictive measures, especially in contexts where public authorities are not in a position to systematically and substantially ease COVID-19-induced economic shocks. In the current sub-Saharan Africa context, still marked by uncertainty surrounding the spread of COVID-19, we present the protocol of an ongoing longitudinal study aimed at investigating COVID-19-related attitudes, risks perceptions, preventive behaviours and economic impact in rural areas in Senegal.

METHODS AND ANALYSIS

A prospective randomised longitudinal study of 600 households located in three semiurban villages and nine randomly selected rural villages in the Niakhar area (located 135 km East of Dakar). Three ad hoc phone surveys are administered to 600 heads of households, their housewives in charge of managing the household and a relative living temporarily in the household, respectively. In addition to sharing identical sets of questions on several topics (risks perceptions, attitudes to curfew, attitudes to vaccines, beliefs about COVID-19 infection), the three separate survey questionnaires also include other topics (economic impact, local preventive strategies) whose related questions differ between questionnaires. As analysing evolutions is the study's primary focus, data on all the topics covered will be collected in three waves unless the spread of COVID-19 by mid-2021 justifies extending data collection. The present article presents the study protocol and details about the implementation of the first wave of data collection which started in July 2020. The decision to wait before presenting the protocol was based on the unprecedented context the COVID-19 pandemic.

ETHICS AND DISSEMINATION

The survey's protocol was approved by the Senegalese National Ethical Committee for Research in Health (131/MSAS/CNERS/Sec) and received authorisation from both the Senegalese Ministry of Health (619/MSAS/DPRS/DR) and the French Commission on Information Technology and Liberties (CNIL 2220771).

Reported health and social consequences of the COVID-19 pandemic on vulnerable populations and implemented solutions in six West African countries: A media content analysis

Coronavirus has spread worldwide with over 140 million cases and resulting in more than 3 million deaths between November 2019 to April 2021, threatening the socio-economic and psychosocial stability of many families and communities. There has been limited research to understand the consequences of COVID-19 on vulnerable populations in West Africa, and whether such consequences differ by countries’ previous experience with Ebola. Using a media analysis of leading online news sources, this study identified the populations particularly vulnerable to the threats of the COVID-19 pandemic, described the consequences of COVID-19 experienced by these populations, and reported on the solutions to address them. All articles from the selected news sources published between January 1 and June 30, 2020 on 6 West African countries were imported into Dedoose. A total of 4,388 news articles were coded for excerpts on vulnerable populations, only 285 excerpts of which mentioned the existing effects of COVID-19 on vulnerable populations or implemented solutions. News articles from countries with past experience with Ebola were more likely to mention the pandemic’s effects on vulnerable populations, especially on incarcerated people. Vulnerable groups were reported to have experienced a range of effects including economic disruptions, heightened domestic and sexual abuse, arbitrary arrests, health care inaccessibility, and educational challenges throughout the pandemic. With implications for the achievement of the Sustainable Development Goals (SDG) for 2030 in West Africa, these countries should consider and focus more strategic efforts on vulnerable populations to overcome their fight against the COVID-19 pandemic and to achieve the SDG for 2030.

Poverty and COVID-19 in Africa and Latin America

Since March 2020, governments have recommended or enacted lockdown policies to curb the spread of COVID-19. Yet, poorer segments of the population cannot afford to stay at home and must continue to work. In this paper, we test whether work-related mobility is effectively influenced by the local intensity of poverty. To do so, we exploit poverty data and Google mobility data for 242 regions of nine Latin American and African countries. We find that the drop in work-related mobility during the first lockdown period was indeed significantly lower in high-poverty regions compared to other regions. We also illustrate how higher poverty has induced a faster spread of the virus. The policy implication is that social protection measures in the form of food or cash trasfers must be complementary to physical distancing measures. Further research must evaluate how such transfers, when implemented, have attenuated the difference between poor and non-poor regions in terms of exposure to the virus.

Next City: Learning from Cities during COVID-19 to Tackle Climate Change

Fundamental principles of modern cities and urban planning are challenged during the COVID-19 pandemic, such as the advantages of large city size, high density, mass transport, free use of public space, unrestricted individual mobility in cities. These principles shaped the development of cities and metropolitan areas for more than a century, but currently, there are signs that they have turned from advantage to liability. Cities Public authorities and private organisations responded to the COVID-19 crisis with a variety of policies and business practices. These countermeasures codify a valuable experience and can offer lessons about how cities can tackle another grand challenge, this of climate change. Do the measures taken during the COVID-19 crisis represent a temporal adjustment to the current health crisis? Or do they open new ways towards a new type of urban development more effective in times of environmental and health crises? We address these questions through literature review and three case studies that review policies and practices for the transformation of city ecosystems mostly affected by the COVID-19 pandemic: (a) the central business district, (b) the transport ecosystem, and (c) the tourism–hospitality ecosystem. We assess whether the measures implemented in these ecosystems shape new policy and planning models for higher readiness of cities towards grand challenges, and how, based on this experience, cities should be organized to tackle the grand challenge of environmental sustainability and climate change.