Poverty and COVID-19 in Africa and Latin America

Bibliometric analysis of scientific production on university social responsibility in Latin America and the Caribbean

Objective: To evaluate the scientific production on university social responsibility (USR) from institutions in Latin America and the Caribbean. Methods: A bibliometric analysis was conducted on documents published in indexed journals in the Scopus database from its inception until April 2023. Eligible documents included those on USR describing experiences carried out by universities in Latin America and the Caribbean. The number of articles per author, average authors per article, average citations per article, and the number of documents with one or more author were described. Bibliometric indicators regarding authors per article, co-authors per article, and institutional collaboration were presented. Bibliometric networks were constructed based on bibliographic coupling analysis of documents by countries and term co-occurrence in titles and abstracts. Results: Of a total of 4075 documents retrieved from Scopus, 150 were included. Documents published between 1997 and 2023 were identified, with an average annual growth rate of 2.7%. A total of 439 authors were identified, 18 articles had a single author, and an average of 0.3 articles per author and a co-authorship index of 3.13 were found. The percentage of international collaborations was 30.7%. Brazil had the highest proportion of publications (26.4%), followed by Chile (17%) and Colombia (13.2%). Opción and Revista de Ciencias Sociales were the journals with the highest number of articles published (13 each). In the analysis of term co-occurrence, recent years showed an increase in the use of terms related to e-learning, information and communication technologies, virtual education, COVID-19, sustainable development goals, and URSULA (initiative on USR in institutions in Latin America and the Caribbean). Conclusions: A growth in scientific production on USR in Latin America and the Caribbean was identified. The interest in USR documents in recent years has been focused on COVID-19 and the challenges of virtual education and sustainable development.

Rural household vulnerability and COVID-19: Evidence from India

The coronavirus disease 2019 (COVID-19) pandemic has affected vulnerable households' livelihoods in developing countries. Using high-frequency phone survey data from the World Bank, we assess rural Indian households' vulnerability and poverty status during the pandemic. Results reveal that over three-fifths of Indian rural households are vulnerable to poverty in the context of COVID-19, despite India's evident progress in mitigating poverty in the pre-pandemic era. Poverty plays a major role in accounting for variations in household vulnerability; however, the impact of risks on household welfare is not negligible. On average, households with more members, older household heads, and more outmigrants are more vulnerable to poverty during the pandemic. The impacts of the gender of the household head, access to masks, consumption loans, and COVID-related information are nevertheless insignificant. Results stress the urgent necessity of deploying concerted interventions to strengthen household vulnerability in rural India.

Changing levels of income and multidimensional poverty among persons with disabilities in Colombia: A pseudo panel analysis

In Colombia, more than 4 per cent of the population lives with disability and high levels of income and multidimensional poverty have been recognised within this group. However, there is no information on how the levels of poverty have changed over time or whether households with members with disabilities are more likely to be chronically poorer than households without disabilities in the country. In addition, no evidence exists on the potential effect of the Covid-19 pandemic on the socioeconomic characteristics of persons with disability. This study aims to contribute to the literature on this topic by analysing a nationally representative survey (Quality of Life Survey) from 2018 to 2022 and studying the changes in the levels of income and multidimensional poverty of persons with disabilities and their household, and identifying whether any changes associated with the Covid-19 pandemic.

Preparing healthcare facilities in sub-Saharan Africa for future outbreaks: insights from a multi-country digital self-assessment of COVID-19 preparedness

BACKGROUND

Despite previous experience with epidemics, African healthcare systems were inadequately prepared and substantially impacted by the coronavirus disease 2019 (COVID-19) pandemic. Limited information about the level of COVID-19 preparedness of healthcare facilities in Africa hampers policy decision-making to fight future outbreaks in the region, while maintaining essential healthcare services running.

METHODS

Between May-November 2020, we performed a survey study with SafeCare4Covid - a free digital self-assessment application - to evaluate the COVID-19 preparedness of healthcare facilities in Africa following World Health Organization guidelines. The tool assessed (i) COVID-19-related capabilities with 31 questions; and (ii) availability of essential medical supplies with a 23-supplies checklist. Tailored quality improvement plans were provided after assessments. Information about facilities' location, type, and ownership was also collected.

RESULTS

Four hundred seventy-one facilities in 11 African countries completed the capability assessment; 412 also completed the supplies checklist. The average capability score on a scale of 0-100 (n=471) was 58.0 (interquartile range 40.0-76.0), and the average supplies score (n=412) was 61.6 (39.0-83.0). Both scores were significantly lower in rural (capability score, mean 53.6 [95%CI:50.3-57.0]/supplies score, 59.1 [55.5-62.8]) versus urban facilities (capability score, 65.2 [61.7-68.7]/supplies score, 70.7 [67.2-74.1]) (P<0.0001 for both comparisons). Likewise, lower scores were found for public versus private clinics, and for primary healthcare centres versus hospitals. Guidelines for triage and isolation, clinical management of COVID-19, staff mental support, and contact tracing forms were largely missing. Handwashing stations were partially equipped in 33% of facilities. The most missing medical supply was COVID-19 specimen collection material (71%), while 43% of facilities did not have N95/FFP2 respirators and 19% lacked medical masks.

CONCLUSIONS

A large proportion of public and private African facilities providing basic healthcare in rural areas, lacked fundamental COVID-19-related capabilities and life-saving personal protective equipment. Decentralization of epidemic preparedness efforts in these settings is warranted to protect healthcare workers and patients alike in future epidemics. Digital tools are of great value to timely measure and improve epidemic preparedness of healthcare facilities, inform decision-making, create a more stakeholder-broad approach and increase health-system resilience for future disease outbreaks.

Structural competency in pre-health and health professional learning: A scoping review

Structural competency training provides guidance to healthcare providers on recognizing and addressing structural factors leading to health inequities. To inform the evidence-based progression of structural competency curriculum development, this study was designed to map the current state of the literature on structural competency training with pre-health students, healthcare professional students, and/or healthcare professionals. We performed a scoping review and identified peer-reviewed, primary research articles assessing structural competency training interventions. The category of learners, timing of the structural competency training, types of teaching and learning activities used, instruments used to measure training outcomes, and evaluation criteria were examined. Eleven (n = 11) articles met inclusion criteria, addressing all training levels, and largely focused on medical education. Active learning strategies and researcher-developed instruments to measure training outcomes were most used. Evaluation criteria largely focused on trainees' affective reactions, utility assessments, and direct measure of the trainee learning. We suggest designing interprofessional structural competency education with an emphasis on active learning strategies and standardized training curricula. Evaluation instruments integrated at different points in the health professional learning trajectory are important for evidence-based progression in curriculum development focused on achieving structural competency.

Reduced incidence of respiratory, gastrointestinal and malaria infections among children during the COVID-19 pandemic in Western Kenya: An analysis of facility-based and weekly diaries data

Background

Epidemics can cause significant disruptions of essential health care services. This was evident in West-Africa during the 2014-2016 Ebola outbreak, raising concerns that COVID-19 would have similar devastating consequences for the continent. Indeed, official facility-based records show a reduction in health care visits after the onset of COVID-19 in Kenya. Our question is whether this observed reduction was caused by lower access to health care or by reduced incidence of communicable diseases resulting from reduced mobility and social contacts.

Methods

We analysed monthly facility-based data from 2018 to 2020, and weekly health diaries data digitally collected by trained fieldworkers between February and November 2020 from 342 households, including 1974 individuals, in Kisumu and Kakamega Counties, Kenya. Diaries data was collected as part of an ongoing longitudinal study of a digital health insurance scheme (Kakamega), and universal health coverage implementation (Kisumu). We assessed the weekly incidence of self-reported medical symptoms, formal and informal health-seeking behaviour, and foregone care in the diaries and compared it with facility-based records. Linear probability regressions with household fixed-effects were performed to compare the weekly incidence of health outcomes before and after COVID-19.

Results

Facility-based data showed a decrease in health care utilization for respiratory infections, enteric illnesses, and malaria, after start of COVID-19 measures in Kenya in March 2020. The weekly diaries confirmed this decrease in respiratory and enteric symptoms, and malaria / fever, mainly in the paediatric population. In terms of health care seeking behaviour, our diaries data find a temporary shift in consultations from health care centres to pharmacists / chemists / medicine vendors for a few weeks during the pandemic, but no increase in foregone care. According to the diaries, for adults the incidence of communicable diseases/symptoms rebounded after COVID-19 mobility restrictions were lifted, while for children the effects persisted.

Conclusions

COVID-19-related containment measures in Western Kenya were accompanied by a decline in respiratory infections, enteric illnesses, and malaria / fever mainly in children. Data from a population-based survey and facility-based records aligned regarding this finding despite the temporary shift to non-facility-based consultations and confirmed that the drop in utilization of health care services was not due to decreased accessibility, but rather to a lower incidence of these infections.

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.

Metro travel and perceived COVID-19 infection risks: A case study of Hong Kong

The COVID-19 pandemic has exerted unprecedented impacts on travel behaviors because of people's increased health precautions and the presence of various COVID-19 containment measures. However, little research has explored whether and how people changed their travel with respect to their perceived local infection risks across space and time. In this article, we relate elasticity and resilience thinking to the changes in metro travel and perceived infection risks at the station or community level over time. Using empirical data from Hong Kong, we measure a metro station's elasticity as the ratio of changes in its average trip length to the COVID-19 cases' footprints around that station. We regard those footprints as a proxy for people's perceived infection risks when making trips to that station. To explore influencing factors on travel in the ups and downs of perceived infection risks, we classify stations based on their elasticity values and examine the association between stations' elasticities and characteristics of stations and their served communities. The findings show that stations varied in elasticity values across space and different surges of the local pandemic. The elasticity of stations can be predicted by socio-demographics and physical attributes of station areas. Stations serving a larger percentage of population with higher education degrees and certain occupations observed more pronounced trip length decrease for the same level of perceived infection risks. The number of parking spaces and retail facilities significantly explained variations in stations' elasticity. The results provide references on crisis management and resilience improvement amid and post COVID-19.

How has the sustainability of countries changed after COVID-19? Evidence from the pandemics' first year

The Covid-19 crisis has caused several social-related issues; the sanitary is, perhaps, the most significant one. Lockdowns and vaccination were implemented to fight the Covid-19 virus. From a sustainability perspective, Covid-19 has been considered a meaningful crisis driver that has affected nations' economies and social and natural capitals. The literature presents clues that effects appear to be different among countries. Recognizing its importance as public policies for sustainability, this study aims to assess how the sustainability of countries has changed after Covid-19, focusing on countries' economic power that reflects their capacity to face the crisis. A sample of 89 countries is considered, and 2019-2020 are set as base years for data gathering, which covers the first year of the Covid-19 crisis. Sustainability is conceptually supported and represented by a 3-D cube. The natural environment is expressed by the ecological footprint (EF) method, the economic capital by the gross domestic product (GDP), and the social capital by the happiness index. Results show that sustainability of economies was negatively affected after first year of Covid-19 crisis, but in different magnitudes, according to nations' economic power. While the sustainability of the wealthiest economies was slightly changed during 2019-2020 but maintained within the named 'useful-order' world (environmentally unsustainable, productive, and happy), the poorest economies pushed about 169 million people into the worst performance, reaching the 'ineffective' world (environmentally unsustainable, unproductive, and unhappy). Numbers highlight the inequalities of sustainability performance among countries, according to their capacity to face the Covid-19 crisis. The shield of the richest evaluated countries comprising 5 % of the world population is more powerful than the shield of the poorest evaluated countries carrying 67 % of the world population. Results claims for efforts to make different policies and provide economic support differently for countries, since although we are all under the same storm, but in different boats.

The COVID-19 Pandemic, Social Ties, and Psychosocial Well-Being of Middle-Aged Women in Rural Africa

The study contributes to the understanding of the societal impact of the coronavirus disease 2019 pandemic in the Global South by examining longer term implications of pandemic-induced disruptions and deprivations for social ties and psychosocial well-being. Using data from a survey of middle-aged women in rural Mozambique, the author finds a negative association between the pandemic-triggered household economic decline and perceived changes in the quality of relations with marital partners, non-coresident children, and relatives, but not with generally more distant actors, such as coreligionists and neighbors. In turn, multivariable analyses detect a positive association of changes in the quality of family and kin ties with participants' life satisfaction, regardless of other factors. Yet women's expectations for changes in their household living conditions in the near future show a significant association only with changes in the quality of relations with marital partners. The author situates these findings within the context of women's enduring vulnerabilities in low-income patriarchal settings.

The Impact of Conditional Cash Transfers on Poverty, Inequality, and Employment During COVID-19: A Case Study from Brazil

The policy responses to the COVID-19 pandemic varied widely between countries. Understanding how effective these responses were is important to improve preparedness for future crises. This paper investigates how one of largest scale conditional cash transfer COVID relief policies in the world-the Brazilian Emergency Aid (EA)-impacted poverty, inequality, and the labor market amidst the public health crisis. We use fixed-effects estimators to analyze the impact of the EA on labor force participation, unemployment, poverty, and income at the household level. We find that inequality, measured by per capita household income, reduced to a historical low and was accompanied by substantial poverty declines-even as compared to pre-pandemic levels. Furthermore, our results suggest that the policy has effectively targeted those in most need-temporarily reducing historical racial inequalities-while not incentivizing reductions in labor force participation. Absent the policy, adverse shocks would have been significant and are likely to occur once the transfer is interrupted. We also observe that the policy was not enough to curb the spread of the virus, suggesting that cash transfers alone are insufficient to protect citizens.

Economic analysis through alternative data and big data techniques: what do they tell about Brazil?

Alternative data are now widely used in economic analyses worldwide but still infrequent in studies on the Brazilian economy. This research demonstrates how alternative data extracted from Google Trends and Google Mobility contribute to innovative economic analysis. First, it demonstrates that the search for the future on the internet is correlated (R = 0.62) with the average household income in Brazilian states. The three Brazilian states with the most people looking for the future on the internet have an average household income 1.6 times higher than people from states that do not have this behavior. The search for the future represents 10.9% of the economic development potential of the states, while the proportion of people with university degrees, scientific publications, and researchers represents another 60.4%. The reduction in mobility in retail/recreation locations averaged 34.28% in Brazil, Ecuador, Paraguay, and Uruguay. This group of countries had COVID-19 infection and death rates 1.25 and 1.74 times higher than in countries that reduced their mobility in retail/recreation locations by 45.03%. The impact of reduced mobility in retail/recreation locations on the unemployment rate, gross domestic product degrowth, and inflation in countries such as Brazil was 1.1, 2.2, and 2.6 times lower than in countries that reduced mobility more of people. The research contributions are associated with identifying new indicators extracted from alternative data and their application to carry out innovative economic analyses.

COVID-19 outbreak and rural household food security in the Western Democratic Republic of the Congo

Although global assessments of the initial impacts of the coronavirus disease (COVID-19) have focused on income, jobs, and health conditions, this study constitutes one of the first studies that assessed the impact of COVID-19 on food security in DRC and established the short-term implications of the COVID-19 outbreak on rural households' food security in DRC. In addition, the study recommendations contributed to shaping government interventions toward the pandemic in the Country. The study used data from four western provinces of the country on 1339 households. Our results show that 80 % of households experienced an increase in food prices, 61 % a noticeable decrease in the availability of food, and 54 % a decrease in their dietary diversity. Due to changes in food availability, dietary diversity, and food accessibility imposed by the COVID-19 outbreak, >70 % of households experienced either a decrease in the consumption of meat, milk, fish, and cereals or an increase in their consumption of traditional vegetables. In addition, COVID-19 significantly affected food security dimensions in larger households, households with a greater number of members aged 35 years and above, households headed by women, households where members participate in associations or cooperatives, households that depend on crop sales as the major source of income, and in poorer households. These findings highlight the significant implications of the COVID-19 outbreak on household food security in western DRC and underscore the need for emergency interventions to strengthen the resilience of rural people and accelerate their recovery and other long-term measures toward sustainable and inclusive development.

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.

COVID19 in Latin America: informal settlements and the politics of urbicide

Informal settlements in Latin America express pandemic idiosyncrasies, calling global attention to historical problems related to a specific urbanization pattern. This article stresses COVID19 implications in the main urban planning canon: the notion of densification as an urban solution. Traditionally invisible social groups and territories acquire relevance, but now as a source of biological risk. Urban density appears as a contradictory trigger point, outlining new debates about informal settlements and their metrics. Evidence shows that trends in health discourse are striving to legitimize and enhance "urbicides" in this scenario, already underway through State action or inaction.

Knowledge acquisition and precautionary behaviors for individual resilience to the COVID-19 pandemic: A study of rural Latin America

The concept of resilience gains prominence as human society faces more frequent and impactful shocks and disturbances. This study seeks to investigate how rural populations build resilience amid the COVID-19 pandemic. A simple theoretical model is presented to illustrate the determinants of knowledge acquisition and precautionary behaviors among rural residents. Based on a High Frequency Phone Survey of 10,583 Latin American adults, this study found that rural residents were less capable of using informal channels (e.g., the internet) to collect COVID-19 information. Younger generations were generally less likely to adopt precautionary behaviors than the elderly. The age disparity, however, was relatively minor for rural populations. Costly preventive measures such as staying at home are less affordable for rural residents. Meanwhile, confidence in government ensures better compliance to ensure public health guidelines. We argue that internet skills, prosociality, and political confidence are necessary to build rural residents' resilience during the pandemic.

COVID-19 in Latin America and the Caribbean: Two years of the pandemic

Worldwide, nations have struggled during the coronavirus disease 2019 (COVID-19) pandemic. However, Latin America and the Caribbean faced an unmatched catastrophic toll. As of March 2022, the region has reported approximately 15% of cases and 28% of deaths worldwide. Considering the relatively late arrival of SARS-CoV-2, several factors in the region were determinants of the humanitarian crisis that ensued. Pandemic unpreparedness, fragile healthcare systems, forthright inequalities, and poor governmental support facilitated the spread of the virus throughout the region. Moreover, reliance on repurposed and ineffective drugs such as hydroxychloroquine and ivermectin-to treat or prevent COVID-19-was publicised through misinformation and created a false sense of security and poor adherence to social distancing measures. While there were hopes that herd immunity could be achieved after the region's disastrous first peak, the emergence of the Gamma, Lambda, and Mu variants made this unattainable. This review explores how Latin America and the Caribbean fared during the first 2 years of the pandemic, and how, despite all the challenges, the region became a global leader in COVID-19 vaccination, with 63% of its population fully vaccinated.

Twenty-first century bioarchaeology: Taking stock and moving forward

This article presents outcomes from a Workshop entitled "Bioarchaeology: Taking Stock and Moving Forward," which was held at Arizona State University (ASU) on March 6-8, 2020. Funded by the National Science Foundation (NSF), the School of Human Evolution and Social Change (ASU), and the Center for Bioarchaeological Research (CBR, ASU), the Workshop's overall goal was to explore reasons why research proposals submitted by bioarchaeologists, both graduate students and established scholars, fared disproportionately poorly within recent NSF Anthropology Program competitions and to offer advice for increasing success. Therefore, this Workshop comprised 43 international scholars and four advanced graduate students with a history of successful grant acquisition, primarily from the United States. Ultimately, we focused on two related aims: (1) best practices for improving research designs and training and (2) evaluating topics of contemporary significance that reverberate through history and beyond as promising trajectories for bioarchaeological research. Among the former were contextual grounding, research question/hypothesis generation, statistical procedures appropriate for small samples and mixed qualitative/quantitative data, the salience of Bayesian methods, and training program content. Topical foci included ethics, social inequality, identity (including intersectionality), climate change, migration, violence, epidemic disease, adaptability/plasticity, the osteological paradox, and the developmental origins of health and disease. Given the profound changes required globally to address decolonization in the 21st century, this concern also entered many formal and informal discussions.

Predicting COVID-19 Infections in Eswatini Using the Maximum Likelihood Estimation Method

COVID-19 country spikes have been reported at varying temporal scales as a result of differences in the disease-driving factors. Factors affecting case load and mortality rates have varied between countries and regions. We investigated the association between socio-economic, weather, demographic and health variables with the reported cases of COVID-19 in Eswatini using the maximum likelihood estimation method for count data. A generalized Poisson regression (GPR) model was fitted with the data comprising 15 covariates to predict COVID-19 risk in the whole of Eswatini. The results show that the variables that were key determinants in the spread of the disease were those that included the proportion of elderly above 55 years at 98% (95% CI: 97–99%) and the proportion of youth below the age of 35 years at 8% (95% CI: 1.7–38%) with a pseudo R-square of 0.72. However, in the early phase of the virus when cases were fewer, results from the Poisson regression showed that household size, household density and poverty index were associated with reported COVID-19 cases in the country. We then produced a disease-risk map of predicted COVID-19 in Eswatini using variables that were selected by the regression model at a 5% significance level. The map could be used by the country to plan and prioritize health interventions against COVID-19. The identified areas of high risk may be further investigated to find out the risk amplifiers and assess what could be done to prevent them.

Effects of a community-driven water, sanitation, and hygiene program on Covid-19 symptoms, vaccine acceptance, and non-Covid illnesses: a cluster-randomized controlled trial in rural Democratic Republic of Congo

OBJECTIVE

The government of the Democratic Republic of Congo responded to Covid-19 with policy measures such as business and school closures and distribution of vaccines, which rely on citizen compliance. In other settings, prior experience with effective government programs has increased compliance with public health measures. We study the effect of a national water, sanitation, and hygiene program on compliance with COVID-19 policies.

METHODS

Prior to the COVID-19 pandemic, 332 communities were randomly assigned to the Villages et Ecoles Assainis program or control. After COVID-19 reached DRC, individuals who owned phones (590/1312; 45%) were surveyed by phone three times between May 2020-August 2021. Primary outcomes were COVID symptoms, non-COVID illness symptoms, child health, psychological well-being, and vaccine acceptance. Secondary outcomes included COVID-19 preventive behavior and knowledge, and perceptions of governmental performance, including COVID response. All outcomes were self-reported. Outcomes were compared between treatment and control villages using linear models.

RESULTS

The VEA program did not affect respondents' COVID symptoms (-0.11, 95% CI -0.55, 0.33), non-COVID illnesses (-0.01, 95% CI -0.05, 0.03), child health (0.07, 95% CI -0.19, 0.33), psychological well-being (-0.05, 95% CI -0.35, 0.24), or vaccine acceptance (-0.04, 95% CI -0.19, 0.10). There was no effect on village-level COVID-19 preventive behavior (0.02, 95% CI -0.17, 0.22), COVID-19 knowledge (0.16, 95% CI -0.08, 0.39), or trust in institutions.

CONCLUSIONS

Although the VEA program increased access to improved water and sanitation, it did not increase trust in government. Accordingly, there was no evidence of increased compliance with COVID policies, and no reduction in illness.

Movement under state and non-state authorities during COVID-19: Evidence from Lebanon

COVID-19 has presented governing authorities with challenging decisions that have required them to consider the tradeoffs between movement restriction and economic activity. We propose that non-state armed groups may make different decisions than state governments in response to these challenges. Drawing upon the case of Hezbollah in Lebanon, we investigate whether movement levels differed between areas with Hezbollah private governance in comparison to other areas of Lebanon. Using Google COVID-19 mobility data and a difference in differences model, we show that following the first COVID-related death in Lebanon, movement in districts with private Hezbollah governance decreased significantly less than in other districts. We present a number of potential reasons for this disparity, arguing that the most probable explanation is the relatively high level of economic assistance that Hezbollah provided to people living in areas under Hezbollah's authority, which led to comparatively lesser rates of movement decline.

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COVID19 presented health incentives for governments to reduce population movement.

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Governments are not the only actors providing governance services.

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Hezbollah provides forms of private governance services in parts of Lebanon.

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Movement reduction levels are lower in Hezbollah areas of Lebanon.

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Subnational governance types may affect population responses to health crises.

An overview of effects of COVID-19 on mobility and lifestyle: 18 months since the outbreak

The outbreak of SARS-COV-2 has led to the COVID-19 pandemic in March 2020 and caused over 4.5 million deaths worldwide by September 2021. Besides the public health crisis, COVID-19 affected the global economy and development significantly. It also led to changes in people's mobility and lifestyle during the COVID-19 pandemic. In addition to short-term changes, the drastic transformation of the world may account for the potentially disruptive long-term impacts. Recognizing the adverse effects of the COVID-19 pandemic is crucial in mitigating the negative behavioral changes that directly relate to people's psychological and social well-being. It is important to stress that citizens and governments face an uncertain situation since nobody knows exactly how the viruses and cures will develop. Better understanding uncertainties and evaluating behavioral changes contribute to addressing the future of urban development, public transportation, and behavioral strategies to tackle COVID-19 negative consequences. The major sources of impacts on short-term (route, departure time, mode, teleshopping, and teleworking) and medium and long-term (car ownership, work location, choice of job, and residential location) mobility decisions are mostly reviewed and discussed in this paper.

Digital health systems strengthening in Africa for rapid response to COVID-19

The COVID-19 pandemic has painfully exposed the constraints of fragile health systems in low- and middle-income countries, where global containment measures largely set by high-income countries resulted in disproportionate collateral damage. In Africa, a shift is urgently needed from emergency response to structural health systems strengthening efforts, which requires coordinated interventions to increase access, efficiency, quality, transparency, equity, and flexibility of health services. We postulate that rapid digitalization of health interventions is a key way forward to increase resilience of African health systems to epidemic challenges. In this paper we describe how PharmAccess' ongoing digital health system interventions in Africa were rapidly customized to respond to COVID-19. We describe how we developed: a COVID-19 App for healthcare providers used by more than 1,000 healthcare facilities in 15 African countries from May-November 2020; digital loans to support private healthcare providers with USD 20 million disbursed to healthcare facilities impacted by COVID-19 in Kenya; a customized Dutch mobile COVID-19 triage App with 4,500 users in Ghana; digital diaries to track COVID-19 impacts on household expenditures and healthcare utilization; a public-private partnership for real-time assessment of COVID-19 diagnostics in West-Kenya; and an expanded mobile phone-based maternal and child-care bundle to include COVID-19 adapted services. We also discuss the challenges we faced, the lessons learned, the impact of these interventions on the local healthcare system, and the implications of our findings for policy-making. Digital interventions bring efficiency due to their flexibility and timeliness, allowing co-creation, targeting, and rapid policy decisions through bottom-up approaches. COVID-19 digital innovations allowed for cross-pollinating the interests of patients, providers, payers, and policy-makers in challenging times, showing how such approaches can pave the way to universal health coverage and resilient healthcare systems in Africa.

COVID-19 and heterogeneous vulnerabilities in the Peruvian labor market: implications for social inequalities and for gender gaps

Using quarterly data from the 2020 Peruvian National Household Survey (ENAHO), this paper estimates the differentiated impacts of the COVID-19 pandemic on a set of labor market indicators, such as labor participation, occupational categories, informality, and number of hours worked. The impacts are calculated from an individual perspective (effects on the activities of the heads of household and their spouses, distinguishing them according to sex) and also from a joint strategy perspective among the partners. The results indicate that the intersectionalities of vulnerability considered (rural/urban area, and those contained in the type of households and in the situation of single-parenting or two-parenting of household heads and their spouses) determine that women, who live in rural areas, have children and do not have a partner were the most affected by the global health crisis.

Who Lost Most Wages and Household Income during the COVID‐19 Pandemic in Poor Rural China?

China managed to eliminate all extreme poverty in rural areas in 2020. Poor households, however, may risk falling back into poverty due to the COVID‐19. This paper examines the impacts of the pandemic on wages and household incomes among different groups in poor areas of rural China. Using a unique dataset from five poverty‐stricken counties, we found that the pandemic has had large negative effects on wage income for migrant workers and workers in manufacturing, the private sector, and small enterprises. Compared with households relying on wage income, households relying on small businesses have suffered much more from the pandemic, whereas households depending on farming or transfer payments have been less affected. Although poor and ethnic minority households lost significant amounts of wage income due to the pandemic, they did not lose more household income than nonpoor and nonminority households. We conclude that support from the government has kept vulnerable households from suffering more than other households from the effects of COVID‐19. Our findings suggest that the government can play a strong role in alleviating the negative impacts of the COVID‐19.