Unintended Socio-Economic and Health Consequences of COVID-19 among Slum Dwellers in Kampala, Uganda

Abstract

BackgroundTo reduce the spread of COVID-19, several countries in Africa instituted countrywide lockdowns and other public health measures. Whereas lockdowns contributed to the control of the pandemic, there were concerns about the unintended consequences of these measures especially in the most vulnerable populations. We assessed unintended socio-economic and health consequences due to the COVID-19 pandemic and the mitigation measures in slums in Kampala to inform the on-going and future pandemic response strategies.MethodsThis was a mixed methods cross-sectional study conducted in Bwaise I and Bwaise III slums of Kawempe division, Kampala Uganda from October to December 2020. We used systematic sampling to randomly select 425 household heads for the face-to-face quantitative interviews. We also conducted six focus group discussions (FGDs) with slum dwellers and used photovoice among eight Community Health Workers (CHWs) to document unintended socio-economic and health consequences. Quantitative data were imported into STATA version 14.0 for analysis, while qualitative data were analysed thematically using NVivo version 12. Modified Poisson regression analysis was conducted to establish factors associated with impact on access to food.ResultsMost respondents reported limited access to food (71.1%; 302/425); disruption in education (77.1%; 270/350); drop in daily income and wages (86.1%; 329/382) and loss of employment (63.1; 125/198). Twenty five percent of the respondents (25.4%; 86/338) reported domestic violence as one of the challenges. Seven themes emerged from the qualitative findings on the impact of COVID-19 including: limited access to food; negative impact on children’s rights (child labour and early pregnancies) and education; poor housing and lack of accommodation; negative social behaviours; negative impact on family and child care; reduced income and employment; and negative impact on health and access to health care services. Conclusion The slum dwellers of Bwaise I and Bwaise III experienced several negative socio-economic consequences of COVID-19 and its prevention measures that severely affected their wellbeing. Children experienced severe consequences such as child labour and early pregnancies among the girls. Response activities should be contextualised to different settings and protocols to protect the vulnerable groups in the community such as children and women should be developed and mainstreamed in response activities.

COVID-19 Knowledge, Attitudes and Practices and Vaccine Acceptability in Rural Western Kenya and an Urban Informal Settlement in Nairobi, Kenya, May 2021: A Cross-sectional Survey

“…The young people may also assume that they will have mild disease in case of infection [32]. The informal settlement dwellers, who largely depend on informal employment for a living, have been more economically affected by the mitigation measures against the pandemic [33,34]. Informal settlements have historically had inadequate access to essential services such as water, healthcare, and sanitation [35].…”

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“…Greater Kampala residents and workers faced multiple challenges during the two lockdowns, including limited access to food, drops in daily income, loss of employment and an increase in domestic violence. 39 Uganda's lockdowns were stringent and, whilst deemed necessary to contain the spread of COVID-19, these measures have presented extreme difficulties for Kampala's urban poor. Reportedly, the legacy of these lockdowns is increasing demotivation among the urban populace to continue following COVID-19 preventive measures.…”

Water, sanitation, hygiene practices, health and nutritional status among children before and during the COVID-19 pandemic: longitudinal evidence from remote areas of Dailekh and Achham districts in Nepal

“…Second, children's learning and their mental health are directly affected by the closure of schools [35,[38][39][40]. Children living in remote areas and in low-income households lack access to internet learning resources and do not have equitable access to distance learning [19,41]. Lastly, the repeated lockdowns throughout the country resulted in widespread unemployment and major impacts on the parental involvement in economic activity leading to food insecurities that could have further compromised child health by reducing access to sufficient and balanced nutrition [11].…”