‘A tale of two paradoxes in response to COVID-19’: Public health system and socio-economic implications of the pandemic in South Africa and Zimbabwe.

Chitsamatanga, Bellita Banda; Malinga, Wayne

doi:10.1080/23311886.2020.1869368

Cited by 26 publications

(24 citation statements)

References 25 publications

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“…Of all African countries, South Africa has had the highest number of COVID-19 cases (34% of all cases on the continent), and accounts for 43% of all reported COVID-19-related deaths on the continent (South Africa’s COVID-19 related deaths are estimated to be around 300,000 1 ) [ 6 ]. The country’s under-resourced public health system, already overburdened by infectious and chronic diseases, was characterised by constrained access to mental health care services even prior to the pandemic [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Intersections between COVID-19 and socio-economic mental health stressors in the lives of South African adolescent girls and young women

Duby

Bunce

Fowler

et al. 2022

Child Adolesc Psychiatry Ment Health

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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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Section: Introductionmentioning

confidence: 99%

Intersections between COVID-19 and socio-economic mental health stressors in the lives of South African adolescent girls and young women

Duby

Bunce

Fowler

et al. 2022

Child Adolesc Psychiatry Ment Health

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show abstract

“…More than two thirds of Zimbabwe's population is rural and facilities had no spare capacity to meet demand for treatment of covid or testing, "leaving the rural vulnerable and deprived populations lack[ing] access to medical services" and leading the World Health Organization to warn of "the imminent effects of the 'silent' spread of this virus in countries such as Zimbabwe." 18 When covid arrived, the government intervened on an emergency basis. "All public [health] institutions owned by either the central government or a local government were taken over [by the central government] for the purposes of managing the pandemic," said Edwin Sibanda, director of the Bulawayo Health Services Department.…”

Section: Zimbabwementioning

confidence: 99%

“…Rural studies researchers Bellita Banda Chitsamatanga and Wayne Malinga describe Zimbabwe’s healthcare as a system on the brink of collapse, only surviving for the past two decades because of international aid. More than two thirds of Zimbabwe’s population is rural and facilities had no spare capacity to meet demand for treatment of covid or testing, “leaving the rural vulnerable and deprived populations lack[ing] access to medical services” and leading the World Health Organization to warn of “the imminent effects of the ‘silent’ spread of this virus in countries such as Zimbabwe.”18…”

Section: Zimbabwementioning

confidence: 99%

How covid-19 has exposed the weaknesses in rural healthcare: Video 1

Rothbart

Karáth²,

Ndhlovu³

2022

BMJ

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“…Challenges: Health systems challenges in Zimbabwe include a shortage of medicines, health care personnel, and infrastructure; suboptimal surveillance; and inadequate data management (Banda Chitsamatanga et al, 2021;Chung et al, 2020;Global Fund, 2020). Supply chain management in Zimbabwe is partially effective, with weaknesses in available storage for health products, and in transportation (Global Fund, 2020;Makurumidze et al, 2020a).…”

Section: Health Systemsmentioning

confidence: 99%

Malaria, HIV and TB in Zimbabwe: Epidemiology, Disease Control Challenges and Interventions

Haider¹

2022

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Zimbabwe is a lower-middle income country in southern Africa with a population of approximately 15 million. Malaria, HIV and tuberculosis (TB) remain important public health concerns in the country, despite significant progress over the past two decades. Malaria incidence has declined markedly between 2003 and 2019 (by 81% from 2003 to 2015), but has risen since, particularly during the Covid-19 pandemic (Gwitira et al., 2020; Tapera, 2019). Zimbabwe is one of 22 high burden countries for HIV (Chimwaza et al., 2021). While HIV prevalence has declined from 27.2% in 1998 to 11.9% in 2020, Zimbabwe has the fifth highest HIV prevalence in sub-Saharan Africa (UNAIDS, 2020; UNDP, 2020b). Zimbabwe is among the 14 high burden countries for TB, multi-drug resistant TB and TB-HIV coinfection (UNDP, 2020c). TB case incidence and mortality have declined by over 60% between 2011 and 2018, however, TB mortality remains high, at 15% among notified TB clients (Global Fund, 2020; UNDP, 2020b). This rapid literature review highlights key aspects of the epidemiology of malaria, HIV and TB in Zimbabwe and challenges in prevention, detection and treatment; and surveys select interventions that seek to address these challenges. It has not been possible to provide a comprehensive and dedicated review of the many interventions in Zimbabwe in this report. The Covid-19 pandemic is addressed as a key control challenge for malaria, HIV and TB – with various Covid-19 related issues sign-posted throughout the report. Covid-19 mitigation measures have affected the delivery and utilisation of HIV, TB, and malaria services: the largest effect is projected to result from interruption of antiretroviral therapy (ART); decline in TB case detection; and interruption of preventive indoor residual spraying (IRS) and long-lasting insecticidal net (LLIN) distribution campaigns, respectively (Amimo et al., 2020).

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‘A tale of two paradoxes in response to COVID-19’: Public health system and socio-economic implications of the pandemic in South Africa and Zimbabwe.

Cited by 26 publications

References 25 publications

Intersections between COVID-19 and socio-economic mental health stressors in the lives of South African adolescent girls and young women

Intersections between COVID-19 and socio-economic mental health stressors in the lives of South African adolescent girls and young women

How covid-19 has exposed the weaknesses in rural healthcare: Video 1

Malaria, HIV and TB in Zimbabwe: Epidemiology, Disease Control Challenges and Interventions

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