Unintended socio-economic and health consequences of COVID-19 among slum dwellers in Kampala, Uganda

Abstract

Background To 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 among slum dwellers in Kampala to inform the on-going and future pandemic response strategies. Methods This 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. Results Most 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 teenage 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 and health consequences of COVID-19 and its prevention measures that severely affected their wellbeing. Children experienced severe consequences such as child labour and teenage 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.

The COVID-19 pandemic in the African continent

“…In another study, the majority of women in Kenya and Burkina Faso did not change their contraceptive status and were in fact more likely to adopt a method if the status changed (25 and 13%, respectively). Discontinuation was lower at 6 and 5%, respectively [ 205 ]. In Cameroon and DRC, several RMNCAAH in 2020 were comparable to 2019 and some where even higher, perhaps due to the service adaptations implemented with a focus on sustaining these services [ 198 ].…”

Housing-related challenges during COVID-19 pandemic among urban poor in low- and middle-income countries: A systematic review and gap analysis

“…With the increase in population, the stigma of catching the infection increased inside and beyond the home. This increased domestic violence, a problem regardless of gender, as working family heads were forced to remain at home (33)(34)(35). Frequently, women in urban slums experience violence (36).…”

Perceived stress of adolescents during the COVID-19 lockdown: Bayesian multilevel modeling of the Czech HBSC lockdown survey

“…These countries deal with similar post-lockdown problems in adolescents as the European countries. However, there are countries with socioeconomically disadvantaged regions (e.g., in India, Bangladesh, Jordan, Peru, Ethiopia, or Uganda), where school closures severely disrupted lives of young people in plentiful aspects beyond higher level of stress and mental health concerns ( Patra and Patro, 2020 ; Jones N. et al, 2021 ; Favara et al, 2022 ; Nuwematsiko et al, 2022 ). After the schools were closed, numerous adolescents started working to provide for their families, with only a small chance of returning to school ever again ( Patra and Patro, 2020 ; Jones N. et al, 2021 ; Favara et al, 2022 ; Nuwematsiko et al, 2022 ).…”