COVID-19 Pandemic Worsening Gender Inequalities for Women and Girls in Sub-Saharan Africa

Vaccine inequity: a threat to Africa's recovery from COVID-19

BACKGROUND

Vaccine inequity is a reality facing the Sub-Saharan Africa region as vaccine nationalism from high-income countries (HICs) leads to limited access to the lifesaving vaccines needed to end the pandemic. In Africa, a significant portion of the population has yet to be vaccinated against Covid-19; however, the barriers to accessing such vaccines, including capacity challenges, still persist despite the implementation of the COVAX facility meant to support the lower- and middle-income countries (LMICs) to boost vaccination.

METHODS

This study involved a systemic narrative review where literature search was conducted using the NCBI's PMC and BMC databases based on defined keywords. Three authors were involved in the literature search and consensus was applied to settle disagreements and validate the findings.

RESULTS

In this systematic narrative review, we report that vaccine nationalism remains a challenge for LMICs as HICs still hoard vaccines and even bypass COVAX to procure doses directly from the manufacturers. Factors that promote vaccine hesitancy in Africa include misinformation regarding the Covid-19 vaccine, a lack of trust in politicians and the pharmaceutical industry, and concerns about vaccine safety and efficacy. The policies implemented to enhance vaccine coverage in Africa, such as mandates, community engagement, and partnerships, all seek to promote equity of vaccination and ending Covid-19.

CONCLUSION

Covid-19 vaccine inequity persists and contributes to prolonged pandemic in LMICs. In response, African governments have taken certain measures to enhance vaccine uptake but more needs to be done to address resistance to vaccines.

Vulnerability of migrant women during disasters: a scoping review of the literature

BACKGROUND

Disasters have an unequal impact on the population because of differences in conditions of vulnerability, exposure, and capacity. Migrants and women are among the groups that are at greater risk for and disproportionately affected by disasters. However, despite the large body of evidence that analyzes their vulnerability separately, disaster research that targets migrant women is scant. The aim of this scoping review was to analyze the published scientific literature concerning the vulnerability of migrant women and the consequent negative impact they experience during disasters.

METHODS

A literature search was conducted on December 15th, 2021 on Pubmed, Scopus, and Web of Science databases. No time filter was applied to the search. Information regarding the article's main characteristics and design, migrant women and their migration experience, as well as about the type of disaster was collected. The factors responsible for the vulnerability of migrant women and the negative outcomes experienced during a disaster were extracted and inductively clustered in main themes reflecting several vulnerability pathways. The review followed the Joanna Briggs Institute methodology for scoping reviews and relied on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).

RESULTS

After full text review, 14 articles met the inclusion criteria. All of them adopted a qualitative methodology and focused on COVID-19. The pandemic negatively affected migrant women, by triggering numerous drivers that increased their level of exposure and vulnerability. Overall, six vulnerability factors have been identified: legal status, poverty conditions, pre-existing health conditions, limited agency, gender inequality and language and cultural barriers. These resulted in nine impacts: worsening of mental health status, poor access to care, worsening of physical health conditions, fraud, exacerbation of poverty, gender-based violence, jeopardization of educational path, and unfulfillment of their religious needs.

CONCLUSIONS

This review provided an analysis of the vulnerability factors of migrant women and the pathways leading to negative outcomes during a disaster. Overall, the COVID-19 pandemic demonstrated that health equity is a goal that is still far to reach. The post-pandemic era should constitute the momentum for thoroughly addressing the social determinants of health that systematically marginalize the most vulnerable groups.

Subjective social status and well-being of adolescents and young adults in Ghanaian schools: conditional process analysis

BACKGROUND

With the growing concern and interest in the mental health and well-being of adolescents and young adults (AYAs) including those in schools, many studies have explored the bivariate relationship between subjective social status (SSS) and AYAs' subjective well-being (SWB). Acknowledging the spurious nature of this relationship, we assessed the relationship between SSS and SWB of AYAs in schools within Northern Ghana, focusing on the conditional indirect effect of monetary resource (MR) and sense of coherence (SoC).

METHODS

We utilised a cross-sectional descriptive design to survey 1096 senior high school students from two regions in Ghana's Northern zone through a stratified sampling method. A questionnaire consisting of a number of calibrated standardized measures was used for the data collection. The data were processed using SPSS and PROCESS Macro and analysed using Hayes' conditional process analysis.

RESULTS

The results revealed that students' MR significantly moderated the relationships between SSS and SoC as well as SSS and SWB. A significant moderated mediation effect of MR and SoC on the relationship between SSS and SWB was found. Particularly, AYAs who reported higher levels of MRl, SSS and SoC reported a better SWB.

CONCLUSION

The findings underscore the relevance of providing sufficient financial support for students in secondary schools in Ghana; thus, highlighting the sheer relevance of economic capital as a leading factor for better well-being. The findings also place much emphasis on building students' personal coping mechanisms as a key variable in explaining how the students' SSS and MR translate into having positive mental health outcomes.

The Place of Academia and Industry in the Adoption and Adaptation of Education Technologies (ICT) in the African Education Sector for a post COVID-19 Recovery

The COVID-19 pandemic disrupted livelihoods at different fronts and at varying degrees globally. The global education sector was one of the key sectors that bore the heaviest brunt, particularly in the teaching and learning delivery modes. For instance, digital educational technologies became vital methods for teaching and learning. In responses, a number of initiatives were adopted by countries to lend insight on how to cope with the emergent challenges, as well as how to alleviate the challenges brought about by the pandemic for a post-COVID-19 recovery and growth. In this paper, we explore the contribution of industry and academia on post-COVID-19 recovery and growth, with a special focus on education technologies (ICT)’s adoption and promotion of entrepreneurial efforts in Africa. To attain the paper's objective, we used a scoping review approach to obtain crucial literature from credible and relevant databases to demonstrate and deliver a succinct, stronger, and clear and clarified findings on the areas of focus. Additionally, we visited websites of certain international organizations that supported sub-Saharan Africa (SSA) countries in respond to the COVID-19 pandemic, specifically focusing on responses targeting the education sector. The findings highlighted in this paper reveals that both academia and industry have a significant contribution to building back better efforts for a post-COVID-19 recovery and growth. Such efforts operate within the realms of adoption and adaptation of technology in the education sector, and increased emphasis on involvement in entrepreneurship practices. The paper also offers salient recommendations on how to better improve academia and industry's involvement for a post-COVID-19 recovery and growth efforts.

Validation of the WHO-5 Well-Being Scale among Adolescents in Ghana: Evidence-Based Assessment of the Internal and External Structure of the Measure

The WHO-5 well-being measure happens to be one of the most renowned measures of subjective well-being across the globe. Although the instrument has been calibrated in different countries, its psychometric properties and applicability in Africa, especially in Ghana, are not known. In this study, the WHO-5 well-being scale was validated among adolescents in Ghana by assessing the validity evidence of the measure based on the internal and external structure. In particular, the study examined the (1) dimensionality of the WHO-5 well-being scale, (2) quality of the items (including the scale functioning) for the measure, and (3) criterion validity of the well-being measure. Using a survey approach, 997 adolescents were recruited in secondary schools across the northern belt of Ghana. The study found a one-factor structure of the scale, which supports the factor solution of the original measure. The items were found to be of high quality, except for one item. The WHO-5 well-being measure was found to have sufficient evidence regarding convergent and divergent validity. The outcome of this validation study provides support for the validity and reliability of the WHO-5 well-being scale's utility and use among adolescents in Ghana. The study encourages further validation studies to be conducted in Ghana to widen the reproducibility of the WHO-5 well-being measure.

"Even if I'm undetectable, I just feel like I would die": a qualitative study to understand the psychological and socioeconomic impacts of the COVID-19 pandemic on women living with HIV (WLWH) in Chicago, IL

BACKGROUND

The COVID-19 pandemic has affected the health and well-being of people worldwide, yet few studies have qualitatively examined its cumulative effects on ciswomen living with HIV (WLWH). We aimed to explore how the pandemic has impacted WLWH, including challenges related to HIV care, employment, finances, and childcare. We also investigated how HIV status and different psychosocial stressors affected their mental health.

METHODS

We performed 25 semi-structured qualitative interviews with WLWH regarding the ways in which COVID-19 impacted their social determinants of health and physical well-being during the pandemic. 19 WLWH who received care at the University of Chicago Medicine (UCM) and 6 women who received care at Howard Brown Health, a federally qualified health center (FQHC) in Chicago, were interviewed remotely from June 2020 to April 2021. All interviews were audio recorded and transcribed. Interviews were thematically analyzed for commonalities regarding HIV-specific and general experiences of WLWH during the pandemic.

RESULTS

The majority of participants reported COVID-19 impacted their HIV care, such as appointment cancellations and difficulties adhering to antiretroviral therapy. In addition to HIV care obstacles, almost all participants described perceived heightened vulnerability to or fear of COVID-19. The pandemic also affected the socioeconomic well-being of participants, with reported financial strains and employment disruptions. Some mothers took on additional childcare responsibilities, such as homeschooling. Increased mental health concerns and negative psychological effects from the social isolation associated with the pandemic were also experienced by most participants.

CONCLUSIONS

We gained invaluable insight into how WLWH were challenged by and adapted to the COVID-19 pandemic, including its destabilizing effects on their HIV care and mental health. Women described how they undertook additional childcare responsibilities during the pandemic and how their HIV status compounded their concerns (e.g., perceived heightened vulnerability to COVID-19). Strategies to better support WLWH in maintaining their overall health throughout the pandemic include childcare assistance, access to affordable mental health services, support groups, and education from HIV care providers. These findings have significant implications for examining future health crises through the perspective of potential gender inequalities.

Intimate Partner Violence in the COVID-19 Era: A Health, Psychological, Forensic and Legal Perspective

This commentary aims to provide a multidisciplinary framework on intimate partner violence (IPV) during the COVID-19 pandemic (with a specific focus on the most predominant form of gender-based violence, i.e., male violence towards women), commenting on the multiple negative consequences of the pandemic on gender violence and providing elements of effective practice. We searched literature for reports/studies on the issue of IPV during the COVID-19 pandemic, focusing on health, psychological, forensic, and legal aspects. The combined effects of lockdowns, isolation at home with abusive partners, quarantine, and economic worries/loss of a job could significantly facilitate violence against women and, at the same time, diminish women's chances to seek for help, with a strong negative impact on their life. The continued offer of clinical, psychological, forensic, and legal services for survivors of violence, despite the modifications to the provision of these services due to the new needs related to the COVID-19 pandemic, appears of utmost importance. All actions to support survivors of IPV are expected to be multidisciplinary, including the involvement of social and/or legal services and health systems, and woman-centred. Implementing these measures in the COVID-19 era appears challenging but is of primary importance.

Adolescent Sexual and Reproductive Health During the COVID-19 Pandemic: A Mini Review

This mini review explores the impact of the COVID-19 pandemic on adolescent sexual and reproductive health. We conducted a rapid review of the literature across three databases, with a particular focus on the African continent. Few studies have specifically focused on adolescents in Africa and this paper contributes to this paucity of research. Findings revealed the unintended consequences of the pandemic. Studies across several countries showed that the respective lockdown measures restricted adolescents' access to sexual and reproductive health services. The literature also showed increases in adolescent pregnancies during the lockdown, along with increases in reports of sexual violence against adolescents. We conclude this paper by offering recommendations to address these unintended consequences and potentially improve adolescent sexual and reproductive health in African communities.