TY - JOUR
T1 - The wealth gradient and the effect of COVID-19 restrictions on income loss, food insecurity and health care access in four sub-Saharan African geographies
AU - Gummerson, Elizabeth
AU - Cardona, Carolina
AU - Anglewicz, Philip
AU - Zachary, Blake
AU - Guiella, Georges
AU - Radloff, Scott
N1 - Funding Information:
This work and all authors’ work on this (EG, CC, BZ, PA, GG and SR) was supported by the Bill & Melinda Gates Foundation 009639. (gatesfoundation.org) Under the grant conditions of the Foundation, a Creative Commons Attribution 4.0 Generic License has already been assigned to the Author Accepted Manuscript version that might arise from this submission. The funders of the study had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript. The authors would like to thank the participants in the PMA survey, as well as the PMA research teams at our partners institutions L’Institut Superieur des Sciences de la Population, L’Universite Joseph Ki-Zerbo de Ouagadougou; Ecole de Sante Publique Universite de Kinshasa; International Center for Reproductive Health, Kenya; Center for Research Evaluation and Resources Development, Nigeria; and University of Ibadan, Nigeria.
Publisher Copyright:
© 2021 Gummerson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2021/12
Y1 - 2021/12
N2 - Introduction While there has been considerable analysis of the health and economic effects of COVID-19 in the Global North, representative data on the distribution and depth of social and economic impacts in Africa has been more limited. Methods We analyze household data collected prior to the COVID-19 pandemic and during the first wave of COVID in four African countries. We evaluate the short-term changes to household economic status and assess women’s access to health care during the first wave of COVID-19 in nationally representative samples of women aged 15–49 in Kenya and Burkina Faso, and in sub-nationally representative samples of women aged 15–49 in Kinshasa, Democratic Republic of Congo and Lagos, Nigeria. We examine prevalence and distribution of household income loss, food insecurity, and access to health care during the COVID-19 lockdowns across residence and pre-pandemic wealth categories. We then regress pre-pandemic individual and household sociodemographic characteristics on the three outcomes. Results In three out of four samples, over 90% of women reported partial or complete loss of household income since the beginning of the coronavirus restrictions. Prevalence of food insecurity ranged from 17.0% (95% CI 13.6–20.9) to 39.8% (95% CI 36.0–43.7), and the majority of women in food insecure households reported increases in food insecurity during the COVID-19 restriction period. In contrast, we did not find significant barriers to accessing health care during COVID restrictions. Between 78•3% and 94•0% of women who needed health care were able successfully access it. When we examined pre-pandemic sociodemographic correlates of the outcomes, we found that the income shock of COVID-19 was substantial and distributed similarly across wealth groups, but food insecurity was concentrated among poorer households. Contrary to a-priori expectations, we find little evidence of women experiencing barriers to health care, but there is significant need for food support.
AB - Introduction While there has been considerable analysis of the health and economic effects of COVID-19 in the Global North, representative data on the distribution and depth of social and economic impacts in Africa has been more limited. Methods We analyze household data collected prior to the COVID-19 pandemic and during the first wave of COVID in four African countries. We evaluate the short-term changes to household economic status and assess women’s access to health care during the first wave of COVID-19 in nationally representative samples of women aged 15–49 in Kenya and Burkina Faso, and in sub-nationally representative samples of women aged 15–49 in Kinshasa, Democratic Republic of Congo and Lagos, Nigeria. We examine prevalence and distribution of household income loss, food insecurity, and access to health care during the COVID-19 lockdowns across residence and pre-pandemic wealth categories. We then regress pre-pandemic individual and household sociodemographic characteristics on the three outcomes. Results In three out of four samples, over 90% of women reported partial or complete loss of household income since the beginning of the coronavirus restrictions. Prevalence of food insecurity ranged from 17.0% (95% CI 13.6–20.9) to 39.8% (95% CI 36.0–43.7), and the majority of women in food insecure households reported increases in food insecurity during the COVID-19 restriction period. In contrast, we did not find significant barriers to accessing health care during COVID restrictions. Between 78•3% and 94•0% of women who needed health care were able successfully access it. When we examined pre-pandemic sociodemographic correlates of the outcomes, we found that the income shock of COVID-19 was substantial and distributed similarly across wealth groups, but food insecurity was concentrated among poorer households. Contrary to a-priori expectations, we find little evidence of women experiencing barriers to health care, but there is significant need for food support.
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U2 - 10.1371/journal.pone.0260823
DO - 10.1371/journal.pone.0260823
M3 - Article
C2 - 34910752
AN - SCOPUS:85122084554
SN - 1932-6203
VL - 16
JO - PloS one
JF - PloS one
IS - 12 December
M1 - e0260823
ER -