Disruptions in Livelihoods, Healthcare Access and Health Outcomes in West Africa During Emerging Infectious Disease Outbreaks

Abstract

Background: Outbreaks of infectious diseases like Ebola virus disease, Lassa fever, and COVID-19 have severely strained infrastructural systems and social services across West Africa. We investigated the disruptions caused by emerging outbreaks on access to healthcare, health outcomes, and livelihoods in West Africa. Method: A mixed-methods approach was utilized, conducting extensive studies in Nigeria, Sierra Leone, Guinea, and Liberia through structured questionnaires, in-depth interviews with key informants, and focus group discussions. Using a device-to-cloud system guided by GIS for randomized sampling across the four nations, this technique allowed us to comprehensively analyze implications across imposed lifestyle changes on health and wellbeing due to disrupted healthcare. Results: Our findings indicate drastic shifts in food consumption patterns and healthcare access. In Guinea, self-reported Once Daily meals astonishingly surged from 148 to 775 individuals (p<0.001), with analogous substantial increases observed in Liberia and Sierra Leone. Nigeria exhibited a varied response, with notable rises both in Once Daily and Twice Daily meal frequencies (p<0.001), reflecting broad dietary adaptations out of necessity. Additionally, there was a significant decrease in consumption of traditional protein sources like bushmeat, beef, and mutton, mainly because of disrupted supply chains and heightened concerns over food insecurity. Conversely, fish consumption slightly fell possibly due to its perceived safety or accessibility amidst the outbreak. Healthcare services faced severe disruptions, particularly acute in Sierra Leone and Liberia compared to Guinea and Nigeria. The interruption of services drastically impacted everything from immunization rates to mental health, with a rise in reported anxiety and depression alongside public dissatisfaction towards the healthcare disruptions. Conclusion: This study demonstrates the dramatic effects of infectious disease outbreaks on health access and diets in West Africa. The research calls for integrating health initiatives with social protection to strengthen the resilience of societies to meet all types of health challenges. It is imperative districts establish robust health systems and social security mechanisms to counter future public health crises.