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Dzinamarira T, Iradukunda PG, Saramba E, Gashema P, Moyo E, Mangezi W, Musuka G. COVID-19 and mental health services in Sub-Saharan Africa: A critical literature review. Compr Psychiatry 2024; 131:152465. [PMID: 38387168 DOI: 10.1016/j.comppsych.2024.152465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/07/2024] [Accepted: 02/16/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has wrought a profound impact on mental health in Sub- Saharan Africa, exacerbating existing disparities and rendering individuals undergoing treatment particularly susceptible. This comprehensive critical review delves into the scope, nature, and extent of COVID-19 impact on mental health services in Sub- Saharan Africa, while concurrently elucidating pivotal lessons and exemplary practices learnt from periods of lockdown. METHODS The methodology was guided by Jesson & Laccy's guide on how to conduct critical literature reviews. Articles were comprehensively sought through two academic databases (PubMed and Google Scholar), complemented by targeted searches on the WHO website and official public health websites of relevant Sub-Saharan African countries. RESULTS The investigation reveals a surge in mental health challenges, notably marked by a significant escalation in anxiety, depression, and post-traumatic stress disorder. Disruptions to care services, financial hardships, and the pervasive effects of social isolation further compound this escalation. The pre-existing inequalities in access to and quality of care were accentuated during this crisis, with marginalized groups encountering heightened impediments to essential services. In navigating this unprecedented challenge, communities emerged as integral agents in establishing supportive networks and implementing culturally sensitive interventions. Technology, such as telemedicine and online resources, played a pivotal role in bridging access gaps, particularly in remote areas. The synthesis of best practices for supporting mental health patients during lockdowns encompasses targeted interventions for vulnerable groups, including adolescents and pregnant women. Empowering communities through economic support and mental health literacy programs was identified as crucial. The integration of technology, such as the development of robust telemedicine frameworks, virtual training in curricula, and the utilization of digital platforms for interventions and public messaging, emerged as a cornerstone in addressing access disparities. Community engagement and resilience-building strategies gained prominence, emphasizing the necessity of collaboration between healthcare providers and communities. Promotion of peer support groups, home-based care, and the preservation of traditional healing practices were underscored as essential components. CONCLUSION The study underscores the need to adapt and optimize mental health services during emergencies. This entails prioritizing mental health within emergency response frameworks, exploring alternative service delivery methods, and fortifying data collection and research efforts.
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Affiliation(s)
- Tafadzwa Dzinamarira
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.
| | | | - Eric Saramba
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | - Enos Moyo
- Department of Public Health Medicine, University of KwaZulu Natal, Durban, South Africa
| | - Walter Mangezi
- Department of Mental Health, University of Zimbabwe, Harare, Zimbabwe
| | - Godfrey Musuka
- International Initiative for Impact Evaluation, Harare, Zimbabwe
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Kim AW. Psychosocial stress, adult suicidal ideation, and the mediating effect of poor sleep quality during the COVID-19 pandemic in South Africa. Am J Hum Biol 2024; 36:e24038. [PMID: 38174783 DOI: 10.1002/ajhb.24038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/28/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES South Africa instituted one of the world's strictest lockdowns during the COVID-19 pandemic, which generated heightened conditions of psychosocial stress and posed widespread mental health risks. Despite the elevated burdens of suicidal behaviors and risk of psychiatric disease in the country, few studies have examined the impacts of psychosocial stress from the pandemic on suicidal ideation in South Africa. This study examined the association between psychosocial stress experienced under the COVID-19 pandemic and adult suicidal ideation, as well as degree to which sleep quality and duration mediated this relationship. METHODS An online survey assessed experiences of COVID-19 psychosocial stress, sleep quality and duration, and suicidal ideation in a sample of 189 South African adults during the second and third waves of the COVID-19 pandemic. A causal inference framework for mediation analysis was used to assess the degree to which sleep quality and duration explained the association between COVID-19 psychosocial stress and suicidal ideation. RESULTS Suicidal ideation was reported in 21% of adults. Adults described having moderate sleep quality and an average of 6.9 hours of sleep per night. COVID-19 psychosocial stress significantly predicted adult suicidal ideation in fully adjusted models. Sleep quality, but not sleep duration, significantly mediated the association between COVID-19 psychosocial stress and suicidal ideation, accounting for 25.9% of the total effect. CONCLUSIONS Poor sleep quality may play an important role in exacerbating the alarming stress-induced mental health effects of the COVID-19 pandemic. Further research is necessary to understand the underlying sleep dynamics and associated psychological and neurobiological processes that perpetuate adult suicidal ideation.
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Affiliation(s)
- Andrew Wooyoung Kim
- Department of Anthropology, University of California, Berkeley, California, USA
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Kim AW, Said Mohamed R, Norris SA, Naicker S, Richter LM, Kuzawa CW. Childhood adversity during the post-apartheid transition and COVID-19 stress independently predict adult PTSD risk in urban South Africa: A biocultural analysis of the stress sensitization hypothesis. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2023; 182:620-631. [PMID: 37283092 PMCID: PMC10700668 DOI: 10.1002/ajpa.24791] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 04/28/2023] [Accepted: 05/24/2023] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The COVID-19 pandemic in South Africa introduced new societal adversities and mental health threats in a country where one in three individuals are expected to develop a psychiatric condition sometime in their life. Scientists have suggested that psychosocial stress and trauma during childhood may increase one's vulnerability to the mental health consequences of future stressors-a process known as stress sensitization. This prospective analysis assessed whether childhood adversity experienced among South African children across the first 18 years of life, coinciding with the post-apartheid transition, exacerbates the mental health impacts of psychosocial stress experienced during the 2019 coronavirus (COVID-19) pandemic (ca. 2020-2021). MATERIALS AND METHODS Data came from 88 adults who participated in a follow-up study of a longitudinal birth cohort study in Soweto, South Africa. Childhood adversity and COVID-19 psychosocial stress were assessed as primary predictors of adult PTSD risk, and an interaction term between childhood adversity and COVID-19 stress was calculated to evaluate the potential effect of stress sensitization. RESULTS Fifty-six percent of adults exhibited moderate-to-severe PTSD symptoms. Greater childhood adversity and higher COVID-19 psychosocial stress independently predicted worse post-traumatic stress disorder symptoms in adults. Adults who reported greater childhood adversity exhibited non-significantly worse PTSD symptoms from COVID-19 psychosocial stress. DISCUSSION These results highlight the deleterious mental health effects of both childhood trauma and COVID-19 psychosocial stress in our sample and emphasize the need for greater and more accessible mental health support as the pandemic progresses in South Africa.
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Affiliation(s)
- Andrew Wooyoung Kim
- Department of Anthropology, University of California, Berkeley, Berkeley, California, USA
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Rihlat Said Mohamed
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
- Global Health Research Institute, School of Human Development and Health, University of Southampton, Southampton, UK
| | - Sara Naicker
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Linda M Richter
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Christopher W Kuzawa
- Department of Anthropology, Northwestern University, Evanston, Illinois, USA
- Institute for Policy Research, Northwestern University, Evanston, Illinois, USA
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Haffejee F, Maharajh R, Sibiya MN. Exploring the Lived Experiences of Vulnerable Females from a Low-Resource Setting during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7040. [PMID: 37998271 PMCID: PMC10671480 DOI: 10.3390/ijerph20227040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/20/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023]
Abstract
The onset of the Coronavirus disease 2019 (COVID-19) pandemic has affected the mental health and well-being of women in vulnerable settings. Currently, there is limited evidence that explores the wellness of elderly women under the associated restrictions. This study explores the lived experiences of elderly women in a vulnerable community in Durban, South Africa. A face-to-face, in-depth qualitative approach was implemented to interview 12 women aged 50 years and over. Thematic analysis was used to analyse the data. The findings suggest that social interactions, the effect of a high death rate, and financial strain predominantly affect stress and anxiety levels. Despite the women being in receipt of pensions and/or other grants, their supplementary income was reduced. This, together with the additional expenses incurred during the lockdown, resulted in anxiety over finances. The lack of social interaction, with limits on visiting family and other loved ones when they were ill, along with the limit on the number of people attending the funerals of loved ones were also stressful. This study also reports on the resulting coping mechanisms, which included using hobbies such as baking and sewing as a means of self-care. Religious beliefs also relieved stress while home remedies were used as preventative measures during the lockdown restrictions due to COVID-19.
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Affiliation(s)
- Firoza Haffejee
- Department of Basic Medical Sciences, Durban University of Technology, Durban 4000, South Africa;
| | - Rivesh Maharajh
- Department of Basic Medical Sciences, Durban University of Technology, Durban 4000, South Africa;
| | - Maureen Nokuthula Sibiya
- Division of Research, Innovation and Engagement, Mangosuthu University of Technology, Umlazi 4031, South Africa;
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Agadjanian V. The COVID-19 Pandemic, Social Ties, and Psychosocial Well-Being of Middle-Aged Women in Rural Africa. SOCIUS : SOCIOLOGICAL RESEARCH FOR A DYNAMIC WORLD 2023; 9:23780231231171868. [PMID: 37234471 PMCID: PMC10201067 DOI: 10.1177/23780231231171868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
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.
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Mayers PM, Olckers L, Prinsloo EL, Raine J, Zweigenthal V. Reflections of volunteer counselors working remotely during the COVID-19 pandemic-Implications for policy and practice. J Nurs Scholarsh 2023; 55:239-252. [PMID: 36510097 PMCID: PMC9877706 DOI: 10.1111/jnu.12859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE We reflect on our experience of running a remote volunteer counseling service, known as the Counseling Collective, to support patients and their families during the second wave of the COVID-19 pandemic in Cape Town, South Africa, and the learning and implications for practice and policy regarding the effective utilization of volunteers during a crisis or disaster context. BACKGROUND The Beta SARS-Co-2 variant dominated the second COVID-19 wave which gained momentum in December 2020, as public sector health teams prepared to deescalate services over the South African summer season. The ferocity with which the wave hit the city soon made it clear that volunteers would be needed to assist with counseling services as the Beta variant caused serious disease, resulting in a significant upswing in hospitalisations and deaths. METHODS Four counselors and a colleague with oversight responsibilities of the volunteers reflected on the service we provided. This was done with the benefit of hindsight a year after the activities of the Counseling Collective were wrapped up. LESSONS LEARNED Virtual volunteers are a largely untapped resource in the South African health care system. Much is to be gained by using this underutilized resource to deliver patient-centred services, especially in times of crisis. CONCLUSION Networks of retired and self-employed health professionals, particularly nurses,-skilled volunteers-are a valuable resource and can be deployed for critical work using their versatile skillsets, in public health emergencies. Telephonic consultations are a useful modality for providing quality care and need to be built into the business of health services. Skills to conduct such consultations and for the provision of palliative care services need to be mainstreamed into the skillsets of health professionals. POLICY AND CLINICAL RELEVANCE Public health disaster plans should include a blueprint for the rapid recruitment and deployment of volunteer counselors to assist permanent staff in providing crucial patient-centred care.
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Affiliation(s)
- Pat M. Mayers
- University of Western CapeCape TownSouth Africa
- University of Cape TownCape TownSouth Africa
| | | | | | - Joy Raine
- Private PracticeCape TownSouth Africa
| | - Virginia Zweigenthal
- School of Public Health and Family MedicineUniversity of Cape TownCape TownSouth Africa
- Western Cape Department of HealthCape TownSouth Africa
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Holm-Hadulla RM, Mayer CH, Wendler H, Kremer TL, Kotera Y, Herpertz SC. Fear, depression, and well-being during COVID-19 in German and South African students: A cross-cultural comparison. Front Psychol 2022; 13:920125. [PMID: 36405127 PMCID: PMC9671164 DOI: 10.3389/fpsyg.2022.920125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 09/07/2022] [Indexed: 11/06/2022] Open
Abstract
Various studies have shown a decrease in well-being and an increase in mental health problems during the COVID-19 pandemic; however, only a few studies have explored fear, depression, and well-being cross-culturally during this time. Accordingly, we present the results of a cross-cultural study that (1) compares these mental health scores for German and South African students, (2) compares the correlations among them, and (3) identifies COVID-19 fear, well-being, and depression predictors. German and South African societies differ from each other socio-culturally, politically, and economically. Their university systems also differ to a large extent. University students in both countries completed the Fear of COVID-19 Scale, the World Health Organization-Five Well-Being Index (WHO-5), and the Patient Health Questionnaire-9 (PHQ-9). Welch's t-test, correlation, and multiple regression analyses were performed. (1) German students were found to have statistically lower levels of COVID-19 fear and depression, but lower levels of general well-being than South African students. (2) In both samples, fear of COVID-19 was negatively correlated with well-being and positively associated with female gender and depression. (3) Additionally, female gender, depression, and lower well-being were identified as predictors of COVID-19 fear in both samples. The findings indicate that the fear of COVID-19 is associated with and varies according to gender, depression, and well-being across cultures, and that the difference in the intensity of fear between German and South African students may be partly explained by cultural and contextual differences. These findings can create a deeper understanding of the pandemic's impact on student communities and may be used by mental health practitioners and researchers to develop and apply culture-specific interventions.
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Affiliation(s)
| | - Claude-Hélène Mayer
- Department of Industrial Psychology and People Management, University of Johannesburg, Johannesburg, South Africa
| | - Hannes Wendler
- Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
- Department of Philosophy, University of Cologne, Cologne, Germany
| | - Thomas L. Kremer
- Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
- Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Yasuhiro Kotera
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Sabine C. Herpertz
- Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
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Fisher DA, Miller TR, Grube JW, Ringwalt CL, Achoki T, Ngwato TP, Shilakoe L, Mkhondo P. Locked Down: Economic and Health Effects of COVID-19 Response on Residents of a South African Township. GLOBAL SOCIAL WELFARE : RESEARCH, POLICY & PRACTICE 2022:1-13. [PMID: 35967248 PMCID: PMC9361952 DOI: 10.1007/s40609-022-00230-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 06/15/2023]
Abstract
Background Little research has examined how pandemics affect residents in under-resourced communities. This study investigated how COVID-19 and lockdown policies affected residents of Alexandra, one of Johannesburg, South Africa's lowest-income townships. Methods We conducted a telephone survey May 11-22, 2020, while the lockdown and alcohol ban were in effect, of a spatially stratified sample of 353 adult Alexandra residents drawn randomly from voter registration, credit card application, and prior studies' sampling frames. We examined economic consequences; health experiences, including COVID-19 exposure and mental health symptoms; alcohol use; and personal experiences with violence. Results Respondents were aged 18 to 89 and 47% female. About 70% of those employed before the lockdown were no longer working. Over half of households lost at least one source of income. About 50% of respondents reported stockpiling food. A majority reported price rises and declines in availability of food. Smaller percentages reported such changes for other items. Over 80% reported stress or anxiety, or depression due to the pandemic. The prevalence of past-week alcohol use fell from over 50% before the lockdown to less than 10% during the lockdown. Self-reported physical violence victimization increased. Discussion COVID-19 and the lockdown disrupted Alexandra residents' lives through unemployment, lost income, mental health problems, and increased violence. The differences between these outcomes and those in more advantaged communities deserve investigation. Research should also seek to identify tailored responses to effectively address the challenges of marginalized communities that often have limited resources to deal with pandemics and policies to contain them.
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Affiliation(s)
- Deborah A. Fisher
- Pacific Institute for Research and Evaluation, 4061 Powder Mill Road, Suite 350, Beltsville, MD 20705-3113 USA
| | - Ted R. Miller
- Pacific Institute for Research and Evaluation, 4061 Powder Mill Road, Suite 350, Beltsville, MD 20705-3113 USA
- Curtin University School of Public Health, Curtin University, Kent St, Bentley, WA 400 Australia
| | - Joel W. Grube
- Pacific Institute for Research and Evaluation, 2150 Shattuck Ave., Suite 601, Berkeley, CA 94704 USA
| | - Christopher L. Ringwalt
- Pacific Institute for Research and Evaluation, 101 Conner Drive, Suite 200, Chapel Hill, NC 27514-7038 USA
| | - Tom Achoki
- AB InBev Foundation, 1440 G Street NW, DC Washington, DC, 20005 United States
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Tara Polzer Ngwato
- Social Surveys Africa, 2 Upper Park Drive, Forest Town, Johannesburg, 2193 South Africa
| | - Lebogang Shilakoe
- Social Surveys Africa, 2 Upper Park Drive, Forest Town, Johannesburg, 2193 South Africa
| | - Penelope Mkhondo
- Social Surveys Africa, 2 Upper Park Drive, Forest Town, Johannesburg, 2193 South Africa
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Duby Z, Bunce B, Fowler C, Bergh K, Jonas K, Dietrich JJ, Govindasamy D, Kuo C, Mathews C. Intersections between COVID-19 and socio-economic mental health stressors in the lives of South African adolescent girls and young women. Child Adolesc Psychiatry Ment Health 2022; 16:23. [PMID: 35346316 PMCID: PMC8959551 DOI: 10.1186/s13034-022-00457-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 03/14/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND In contexts where poverty and mental health stressors already interact to negatively impact the most vulnerable populations, COVID-19 is likely to have worsened these impacts. Before the COVID-19 pandemic, adolescent girls and young women (AGYW) in South Africa already faced intersecting mental health stressors and vulnerabilities. It is critical to understand how additional challenges brought on by COVID-19 have intersected with existing vulnerabilities and mental health risks AGYW faced, particularly given the intersections between psychological distress and increased risk behaviours that impact sexual and reproductive health. We aimed to examine socio-economic and mental health impacts of COVID-19 on South African AGYW in order to understand how additional challenges brought on by COVID-19 have intersected with existing challenges, compounding AGYW vulnerabilities. METHODS Using qualitative and quantitative methods, framed by the syndemic theory, we examined the intersections between mental health and the COVID-19 epidemic amongst AGYW in six districts of South Africa characterised by high rates of HIV, teenage pregnancy and socio-economic hardship. Between November 2020 and March 2021 we conducted a cross-sectional telephone survey with 515 AGYW, and in-depth interviews with 50 AGYW, aged 15 to 24 years. RESULTS Our findings reveal how COVID-19 restrictions led to increased experiences of stress and anxiety. Poor mental health was compounded by strained family relationships, increased fear of domestic violence, household unemployment, economic stress and food insecurity. Respondents described feelings of boredom, frustration, isolation, loneliness, fear and hopelessness. However, despite the multitude of challenges, some AGYW articulated emotional resilience, describing ways in which they coped and retained hope. CONCLUSION Various psycho-social risk factors already disproportionally affect the mental health of AGYW in these communities; the COVID-19 pandemic intersects with these pre-existing social and environmental factors. Understanding strategies AGYW have used to positively cope with the uncertainty of COVID-19 amongst an array of pre-existing mental health stressors, is key in informing efforts to respond to their needs. Multisectoral interventions are needed to address the drivers of poor mental health among AGYW, and bolster healthy coping mechanisms; interventions seeking to mitigate the mental health impacts on this vulnerable population need to be responsive to the unpredictable pandemic environment.
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Affiliation(s)
- Zoe Duby
- Health Systems Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Tygerberg, Cape Town, South Africa
- Division of Social and Behavioural Sciences in the School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Brittany Bunce
- Institute for Global Sustainable Development, University of Sheffield, Sheffield, UK
| | - Chantal Fowler
- Division of Social and Behavioural Sciences in the School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Kate Bergh
- Health Systems Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Tygerberg, Cape Town, South Africa
| | - Kim Jonas
- Health Systems Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Tygerberg, Cape Town, South Africa
| | - Janan Janine Dietrich
- Perinatal HIV Research Unit (PHRU) and African Social Sciences Unit of Research and Evaluation (ASSURE), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Darshini Govindasamy
- Health Systems Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Tygerberg, Cape Town, South Africa
| | - Caroline Kuo
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI USA
| | - Catherine Mathews
- Health Systems Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Tygerberg, Cape Town, South Africa
- Division of Social and Behavioural Sciences in the School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Did COVID-19-Related Alcohol Sales Restrictions Reduce Alcohol Consumption? Findings from a National Online Survey in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042422. [PMID: 35206607 PMCID: PMC8878112 DOI: 10.3390/ijerph19042422] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/22/2022] [Accepted: 01/29/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND South Africa has a high prevalence of heavy episodic drinking (HED). Due to the high levels of alcohol misuse and violence, public hospital intensive care units were often overrun during the COVID-19 pandemic. This research investigated alcohol intake behaviour change during differing levels of lockdown restrictions, which included bans on alcohol sales. METHODS A self-reported Facebook survey ran from July to November 2020. The questions included socio-demographics, income, alcohol intake, purchasing behaviour, and reasoning. Chi-square tests/Fisher's exact test for categorical data, Student's t-test for normal continuous data, and the Mann-Whitney U test for non-normal data were applied. Multiple logistic regression was run for HED versus moderate drinkers. RESULTS A total of 798 participants took part in the survey, of which 68.4% were female. Nearly 50% of participants fell into the HED category and the majority bought alcohol illegally during restrictions. HED respondents who drank more alcohol than usual during restrictions reported that they felt stressed, needed to relax, and were bored. CONCLUSIONS Policies intended to increase the pricing of alcohol may have the potential to reduce alcohol intake. Reducing stress and anxiety may be key to curtailing HED during emergency situations.
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