The Institute for Global Health and Development
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/9
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Item “Since the market is closed, there is no more money, there is nothing we can do”: Voices of adolescent girls in Burkina Faso and Sierra Leone on poverty and COVID-19(Elsevier, 2023-10-26) Lanau, Alba; Grieve, Tigist; Tengbeh, Angus F.; Enria, Luisa; Wayack-Pambé, MadeleineThe COVID-19 pandemic is expected to widen inequalities and hamper the SDG commitments of gender equality and poverty reduction. In Africa, it is feared that the social consequences of the pandemic will undo the progress in gender equality achieved over the last two decades. Through in-depth qualitative telephone interviews with 37 adolescent girls in Burkina Faso and Sierra Leone this paper sheds light on the economic consequences of the pandemic on girls. Adolescent girls' experience of the pandemic is strongly mediated by their household configuration, resources and geographical context. Our data identifies three groups: i) sheltered from the economic impact of the pandemic, ii) coping or adjusting, and iii) severely affected. We also identify a fourth group of girls, found only in Burkina Faso, whose lives have been affected by conflict and who perceive the impact of the pandemic to be minor compared to enduring violence and trauma. Our analysis shows the unequal impact of COVID-19 and the measures implemented to contain it is likely to increase economic inequality, particularly in areas with longer-lasting restrictions, as coping mechanisms erode over time. Furthermore, the pandemic is likely to accelerate marriages and the end of schooling thus increasing gender inequality. Such effects are also mediated by resources girls have access to. We argue that achieving the Sustainable Development Goals (SDG) ideals requires innovative, appropriate and sustainable solutions with the combined effort of governments and the development community that respond to the lived experiences of adolescent girls. Finally, necessary attention to the consequences of the pandemic should not detract from addressing ongoing issues affecting adolescent girls, including poverty and conflict.Item Community stressors and coping mechanisms in accessing the health system during a double crisis: a qualitative case study from Yangon Region, Myanmar(BioMed Central, 2023-03-06) Kyaw, Hnin Kalyar; Than, Kyu Kyu; Diaconu, Karin; Witter, SophieBackground: Due to the COVID-19 pandemic and political crisis, Myanmar’s health system has suspended routine services while struggling to respond to the pandemic. Many people who need continuous care, like pregnant women and people with chronic illnesses, have been facing challenges in seeking and receiving essential health services. This study explored community health seeking practices and coping mechanisms, including their views on health system stressors. Methods: This was a cross-sectional qualitative study based on 12 in-depth-interviews with pregnant people and persons with pre-existing chronic health conditions in Yangon. Sampling was purposive, convenience-based and snowball sampling was also used. The 3-delays framework was used to understand how persons were interacting with and accessing health care services; community and health system stressors and coping mechanisms in relation to COVID-19 were also identified. Results: Findings showed that Yangon region was the hardest hit with both the pandemic and political crisis and its health system was greatly affected. People were unable to access essential health services on time. The health facilities were not available to see patients, with serious shortages in human resources, medicines and equipment, resulting in interruption of essential routine services. The prices of medicines and consultation fees, and transportation costs, increased during this period. Limited options for accessing care were available due to travel restrictions and curfews. It became challenging to receive quality care because of unavailable public facilities and private hospitals being costly. Despite these challenges, the Myanmar people and health system have shown resilience. Cohesive and organized family support structures and extended and deep social networks played an important role in accessing health care. At times of emergency, people relied on community-based social organizations for transportation and accessing essential medicines. The health system also showed resilience through establishing new service provision options, such as teleconsultations, mobile clinics, and sharing medical advice through social media. Conclusions: This is the first study in Myanmar to explore peoples’ perceptions on COVID-19, the health system and their healthcare experiences during political crisis. Although there is no easy way to cope with this dual hardship, the people and the health system, even in a fragile and shock-prone setting like Myanmar, stayed resilient by developing alternative pathways for seeking and providing health services.Item Social determinants and mental health needs of Palestine refugees and UNRWA responses in Gaza during the COVID-19 pandemic: a qualitative assessment(BioMed Central, 2022-12-08) Jamal, Zeina; ElKhatib, Zoheir; AlBaik, Shatha; Horino, Masako; Waleed, Mohammed; Fawaz, Farah; Loffreda, Giulia; Seita, Akihiro; Witter, Sophie; Diaconu, KarinBackground: Due to pre-existing difficulties, refugees are especially susceptible to the negative effects of the pandemic; nonetheless, the pandemic’s effect on this group is still unclear. The purpose of this study was to determine the effects of the COVID-19 pandemic on the mental health of Palestine refugees in Gaza by identifying the role of social determinants. During the pandemic, the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) enacted a number of policies and measures. The purpose of this research was to assess their efficacy and acceptability. Methods: This qualitative study took place between August and November 2020. Twenty-nine key-informant interviews were conducted remotely with UNRWA Headquarters, field and clinical staff in Gaza and with community members, aged ≥18 years and residing in Rafah and Jabalia camps. We sought informed consent verbally or via email. Data was coded based on the framework for social determinants of mental health. Results: Interview results indicated that the relationship might be unidirectional, with COVID-19 causing the degradation of living conditions and vice versa, with living conditions exacerbating the COVID-19 situation by facilitating virus transmission. In other instances, the association between mental health determinants and COVID-19 might be bidirectional. In terms of experiencing violence and anxieties, women, children, and daily-paid employees were significantly more disadvantaged than other groups in the community. UNRWA modified its service delivery techniques in order to continue providing essential services. In general, UNRWA’s strategies throughout the pandemic were deemed beneficial, but insufficient to meet the needs of Gazans. Conclusion: The pandemic highlights the need to go beyond disease treatment and prevention to address social determinants to improve refugees’ health and reduce their susceptibility to future shocks. UNRWA has rapidly implemented telemedicine and mental telehealth services, making it imperative to assess the efficacy of these novel approaches to provide care at a distance. A long-term option may be to employ a hybrid strategy, which combines online and in-person therapy.Item Refugees, political bounding and the pandemic: Material effects and experiences of categorisations amongst refugees in Scotland(Routledge, 2022-04-25) Burns, Nicola; Mulvey, Gareth; Piacentini, Teresa; Vidal, Nicole L.Scholars are increasingly interested in and concerned with both the way various migrant populations are categorised, and the lived impacts of that categorisation. In this article, we examine how categorisation was experienced by people at various stages of the refugee journey during the biggest public health crisis for generations. We argue, using original interview data, that the way refugees are categorised, or politically bound, has material impacts on the way they experience their lives, and that this was evident in extremis during the Covid-19 lockdown in Scotland. As populations attempted to traverse public health messaging, this is shown to interact with longstanding state proclivities to control, marginalise and stratify. Consequently, how people experienced and managed the request to ‘stay home and save lives’ varied markedly by where they were in their refugee journey and how they arrived in the UK.