1
|
Taruvinga T, Chingono RS, Olaru ID, Masiye K, Madanhire C, Munhenzva S, Sibanda S, Mafuva L, O’Sullivan N, Osman AY, Deane K, Brandson T, Munyanyi M, Makoni AC, Ngwenya S, Webb K, Chinyanga TT, Ferrand RA, Dixon J, Kranzer K, McCoy D. Understanding the impact of the COVID-19 pandemic and its control measures on women and children: A Zimbabwe case study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.03.24308400. [PMID: 38883725 PMCID: PMC11177921 DOI: 10.1101/2024.06.03.24308400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
COVID-19 presented countries with unprecedented health policy challenges. For low-income countries in particular, policymakers had to contend with both the direct threats posed by COVID-19 as well as the social, educational, and economic harms associated with lockdown and other infection prevention and control measures. We present a holistic and contextualised case study of the direct and indirect impacts of COVID-19 on women and children, with some assessment of their uneven distribution across socio-economic, age and gender groups. We used different types of primary and secondary data from multiple sources to produce a holistic descriptive analysis. Primary data included: qualitative data obtained from 28 in-depth interviews of key informants, six focus group discussions; and 40 household interviews. We also extracted data from government reports and announcements, the District Health Information Software version 2 (DHIS2), newspaper articles and social media, as well as from published research articles. Our findings show that the direct and indirect adverse impacts of COVID-19 were compounded by many years of severe political economic challenges, and consequent deterioration of the healthcare system. The indirect effects of the pandemic had the most severe impacts on the poorest segment of society and widened age and gender inequalities. The pandemic and its accompanying infection prevention and control measures negatively affected health service delivery and uptake. The management of COVID-19 presented enormous challenges to policymakers and public health specialists. These included managing the greatest tension between direct and indirect harms; short-term and long-term effects; and the unequal distribution of harms across different segments of society.
Collapse
Affiliation(s)
- Tinotenda Taruvinga
- The Health Research Unit Zimbabwe (THRU-ZIM), Biomedical Research & Training Institute (BRTI), Harare, Zimbabwe
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine (LSHTM), London, UK
| | - Rudo S. Chingono
- The Health Research Unit Zimbabwe (THRU-ZIM), Biomedical Research & Training Institute (BRTI), Harare, Zimbabwe
| | - Ioana D. Olaru
- The Health Research Unit Zimbabwe (THRU-ZIM), Biomedical Research & Training Institute (BRTI), Harare, Zimbabwe
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Kenneth Masiye
- Organisation for Public Health Interventions and Development (OPHID) Harare, Zimbabwe
| | - Claudius Madanhire
- The Health Research Unit Zimbabwe (THRU-ZIM), Biomedical Research & Training Institute (BRTI), Harare, Zimbabwe
- Organisation for Public Health Interventions and Development (OPHID) Harare, Zimbabwe
| | - Sharon Munhenzva
- The Health Research Unit Zimbabwe (THRU-ZIM), Biomedical Research & Training Institute (BRTI), Harare, Zimbabwe
- Organisation for Public Health Interventions and Development (OPHID) Harare, Zimbabwe
| | - Sibusisiwe Sibanda
- The Health Research Unit Zimbabwe (THRU-ZIM), Biomedical Research & Training Institute (BRTI), Harare, Zimbabwe
- Organisation for Public Health Interventions and Development (OPHID) Harare, Zimbabwe
| | - Lyton Mafuva
- The Health Research Unit Zimbabwe (THRU-ZIM), Biomedical Research & Training Institute (BRTI), Harare, Zimbabwe
- Organisation for Public Health Interventions and Development (OPHID) Harare, Zimbabwe
| | - Natasha O’Sullivan
- Queen Mary University of London (QMUL), London, UK
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Abdinasir Y. Osman
- Queen Mary University of London (QMUL), London, UK
- Pathobiology and Population Science, Royal Veterinary College, London, UK
- Ministry of Health, Mogadishu, Somalia
| | - Kevin Deane
- Queen Mary University of London (QMUL), London, UK
| | - Tsitsi Brandson
- The Health Research Unit Zimbabwe (THRU-ZIM), Biomedical Research & Training Institute (BRTI), Harare, Zimbabwe
| | | | | | - Solwayo Ngwenya
- Mpilo Central Hospital, Bulawayo, Zimbabwe
- National University of Science and Technology (NUST), Bulawayo, Zimbabwe
| | - Karren Webb
- Organisation for Public Health Interventions and Development (OPHID) Harare, Zimbabwe
| | | | - Rashida A. Ferrand
- The Health Research Unit Zimbabwe (THRU-ZIM), Biomedical Research & Training Institute (BRTI), Harare, Zimbabwe
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Justin Dixon
- The Health Research Unit Zimbabwe (THRU-ZIM), Biomedical Research & Training Institute (BRTI), Harare, Zimbabwe
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine (LSHTM), London, UK
| | - Katharina Kranzer
- The Health Research Unit Zimbabwe (THRU-ZIM), Biomedical Research & Training Institute (BRTI), Harare, Zimbabwe
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich
| | - David McCoy
- Queen Mary University of London (QMUL), London, UK
- United Nations University, Shibuya, Tokyo, Japan
| |
Collapse
|
2
|
Militao EMA, Uthman OA, Salvador EM, Vinberg S, Macassa G. Food Insecurity and Associated Factors among Households in Maputo City. Nutrients 2023; 15:nu15102372. [PMID: 37242255 DOI: 10.3390/nu15102372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
Food insecurity (FI) is a global concern and is one of the main causes of malnutrition in low- and middle-income countries. In Mozambique, the burden of FI and how various factors contribute to FI is not well known. This study aimed to investigate the prevalence of FI and its associated factors in southern Mozambique. Data from 1842 household heads in Maputo City were analyzed in a cross-sectional design. Food insecurity was measured using a modified version of the US Department of Agriculture Household Food Security scale, and its association with socio-demographic factors was assessed through multiple regressions. Altogether, 79% of the households were food insecure; of these, 16.6% had mild FI, 28.1% moderate and 34.4% severe FI. The study revealed that low-income households, those with less educated heads, and those engaged in informal work were significantly more prone to FI. Likewise, dietary diversity and the number of meals were also significant predictors of FI. These findings suggest the need for decent work and job creation, which calls for joint efforts from government, the private sector, and international institutions. Furthermore, these key drivers should be considered in the development of public health policies and programs designed to alleviate household FI and malnutrition in Mozambique.
Collapse
Affiliation(s)
- Elias M A Militao
- Department of Health Sciences, Faculty of Humanities, Mid Sweden University, Holmgatan 10, 851 70 Sundsvall, Sweden
- Department of Public Health and Sports Science, Faculty of Occupational and Health Sciences, University of Gävle, Kungsbacksvägen 47, 801 76 Gävle, Sweden
- Department of Biological Sciences, Faculty of Science, Eduardo Mondlane University, 3453 Julius Nyerere Avenue, Maputo 257, Mozambique
| | - Olalekan A Uthman
- Warwick Centre for Global Health, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- Department of Global Health, Division of Epidemiology and Biostatistics, Faculty of Health Sciences, Stellenbosch University, Francie van Zijl Drive, Cape Town 7505, South Africa
| | - Elsa M Salvador
- Department of Biological Sciences, Faculty of Science, Eduardo Mondlane University, 3453 Julius Nyerere Avenue, Maputo 257, Mozambique
| | - Stig Vinberg
- Department of Health Sciences, Faculty of Humanities, Mid Sweden University, Holmgatan 10, 851 70 Sundsvall, Sweden
| | - Gloria Macassa
- Department of Health Sciences, Faculty of Humanities, Mid Sweden University, Holmgatan 10, 851 70 Sundsvall, Sweden
- Department of Public Health and Sports Science, Faculty of Occupational and Health Sciences, University of Gävle, Kungsbacksvägen 47, 801 76 Gävle, Sweden
- EPI Unit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal
| |
Collapse
|
3
|
Militao EMA, Salvador EM, Uthman OA, Vinberg S, Macassa G. Food Insecurity and Health Outcomes Other than Malnutrition in Southern Africa: A Descriptive Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5082. [PMID: 35564477 PMCID: PMC9100282 DOI: 10.3390/ijerph19095082] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/14/2022] [Accepted: 04/19/2022] [Indexed: 12/15/2022]
Abstract
Food insecurity (FI) is one of the major causes of malnutrition and is associated with a range of negative health outcomes in low and middle-income countries. The burden of FI in southern Africa is unknown, although FI continues to be a major public health problem across sub-Saharan Africa as a whole. Therefore, this review sought to identify empirical studies that related FI to health outcomes among adults in southern Africa. Altogether, 14 publications using diverse measures of FI were reviewed. The majority of the studies measured FI using modified versions of the United States Department of Agriculture Household Food Security Survey Module. A wide range in prevalence and severity of FI was reported (18-91%), depending on the measurement tool and population under investigation. Furthermore, FI was mostly associated with hypertension, diabetes, anxiety, depression and increased risk of human immunodeficiency virus (HIV) acquisition. Based on the findings, future research is needed, especially in countries with as yet no empirical studies on the subject, to identify and standardize measures of FI suitable for the southern African context and to inform public health policies and appropriate interventions aiming to alleviate FI and potentially improve health outcomes in the region.
Collapse
Affiliation(s)
- Elias M. A. Militao
- Department of Health Sciences, Faculty of Humanities, Mid Sweden University, Holmgatan 10, 851 70 Sundsvall, Sweden; (S.V.); (G.M.)
- Department of Public Health and Sports Science, Faculty of Occupational and Health Sciences, University of Gävle, Kungsbacksvägen 47, 801 76 Gävle, Sweden
- Department of Biological Sciences, Faculty of Science, Eduardo Mondlane University, 3453 Julius Nyerere Avenue, Maputo 257, Mozambique;
| | - Elsa M. Salvador
- Department of Biological Sciences, Faculty of Science, Eduardo Mondlane University, 3453 Julius Nyerere Avenue, Maputo 257, Mozambique;
| | - Olalekan A. Uthman
- Warwick Centre for Global Health, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK;
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
| | - Stig Vinberg
- Department of Health Sciences, Faculty of Humanities, Mid Sweden University, Holmgatan 10, 851 70 Sundsvall, Sweden; (S.V.); (G.M.)
| | - Gloria Macassa
- Department of Health Sciences, Faculty of Humanities, Mid Sweden University, Holmgatan 10, 851 70 Sundsvall, Sweden; (S.V.); (G.M.)
- Department of Public Health and Sports Science, Faculty of Occupational and Health Sciences, University of Gävle, Kungsbacksvägen 47, 801 76 Gävle, Sweden
- EPI Unit, Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal
| |
Collapse
|