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Purpose: As Covid-19 became a pandemic, numerous people were forced to stay at home, leading to increased intimate partner violence (IPV) in many countries, particularly in developing and least-developed ones. This paper aims to highlight the IPV based on 15 different cases formed from the practical evidence of five developing countries. Design/methodology/approach: The authors interviewed 15 women from five countries who were the victims of IPV during the early periods of Covid-19 outbreak. Due to geographical remoteness, the authors conducted informal telephone interviews to collect the participants' personal experiences. The conversations were recorded with participants' permission; afterwards, the authors summarized participants' experiences into 15 different cases without revealing their original identities (instead, disguised names were used). Findings: It was revealed that the women were the primary victims of such violence, particularly from their intimate partners (husbands). In most cases, such IPV, as reported by the interviewees, originated or increased after the pandemic when they were forced to stay at home, losing their partners' jobs or income sources. Originality/value: The authors summarized the causes of IPV and put forward a few action recommendations based on the interviewees' practical experience and existing literature. This paper will open a new window for research investigations on IPV during emergencies such as Covid-19 outbreak. [ABSTRACT FROM AUTHOR]

Copyright of Urban Studies (Sage Publications, Ltd.) is the property of Sage Publications, Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper adopts Leiper's ([1990]. Tourist attraction systems. Annals of Tourism Research, 17(3), 367–384. https://doi.org/10.1016/0160-7383(90)90004-B) tourism system theory to examine the impact of COVID-19 on Kenya's tourism sector. The authors argue that tourism remains an important source of national revenue in Kenya and the severe negative effects of the pandemic as well as the resulting government measures to curb the spread of the disease threaten to undermine the gains made in recent years to revive the sector. The paper identifies that while much emphasis has been put on the impact of the disease on countries' national health systems and its epidemiology, few studies have been conducted to examine the relationship between COVID 19 and the tourism sector, especially in developing countries. The paper provides researchers and practitioners with an analysis of the impact of COVID-19 on the social and economic dimensions of tourism in Kenya and concludes with a set of recommendations that can shape Kenya's post-pandemic tourism sector recovery plans. [ABSTRACT FROM AUTHOR]

The onset of COVID-19 made governments and other education actors prioritize distance learning, particularly through education technologies (EdTechs). Most sub-Saharan African countries adopted and adapted this approach. This paper examines the extent of EdTechs' deployment in Kenya during the COVID-19 pandemic among marginalized and vulnerable populations. A cross-sectional study design was adopted for the study from which this paper drew its data, with both secondary and primary data utilized. The findings show that marginalized/vulnerable learner populations are still left out on EdTech supported learning. This article proposes salient recommendations that could help advance inclusive education discussion and related EdTechs' discourse. [ABSTRACT FROM AUTHOR]

This paper aims to deal with the impact of COVID-19 on the livelihoods of disadvantaged persons living in slums in Kenya. Months after the first case of COVID-19 was reported in Kenya in March 2020, most of the studies that have been carried out pertaining to its impact on slum dwellers have concentrated on narrowly defined concerns e.g. the impact of COVID-19 on youth, gender based violence and nutrition. It is thus difficult to get a clear global picture of the overall impact of COVID-19 on the livelihoods of slum dwellers in Kenya. This paper relies on information gathered during a comprehensive qualitative micro study covering numerous aspects of slum dwellers' livelihoods, as well as information that has been produced by the Ministry of Health, civil society organizations that work in specific slums, private research organizations as well as local and foreign media houses. The slums whose information is reported in this paper were selected to be indicative of the over 300 slums that are located in Nairobi and Mombasa, the two most important cities in Kenya. The analysis concludes that slum dwellers were potentially at a higher risk under the pressures of COVID-19 of deteriorating conditions with regard to the provision of health services, employment, gender-based violence, education and youth-related problems, and human rights violations, and offers several recommendations to the government. [ABSTRACT FROM AUTHOR]

This article analyses the intersection of response to Covid-19 and human rights in Nigeria and Kenya, as both countries illustrate two Covid-19 endemic and rapidly responding states to the Covid-19 pandemic. However, in Nigeria and Kenya, response to Covid-19 has to be understood in relation to their respective legal and policy frameworks and policy enforcement mechanisms. The paper notes that cases of police brutality, extortion and assault on civilians during Covid-19 pandemic raise the issue of insecurity and the whole question of human rights. The paper demonstrates that governments' emergency measures have serious implications for fundamental rights in Nigeria and Kenya, particularly those of perceived violators of the measures, the poor and vulnerable people, and women and girls. [ABSTRACT FROM AUTHOR]

Copyright of Cahiers Agriculture is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The COVID‐19 pandemic prompted social distancing, workplace closures, and restrictions on mobility and trade that had cascading effects on economic activity, food prices, and employment in low‐ and middle‐income countries. Using longitudinal data from Bangladesh, Kenya, and Nigeria covering a period from October 2020 to April 2021, the paper assesses whether knowledge of a person infected with COVID‐19 is associated with food insecurity, job loss and business closures, and coping strategies to smooth consumption. The likelihood of households to experience food insecurity at the extensive and intensive margins increased among those who knew an infected person in Bangladesh and Kenya. [ABSTRACT FROM AUTHOR]

The post-COVID-19 era has witnessed intensive engagements on latest datasets on COVID-19 experiences and the need for robust data systems to understand emerging policy pathways. There have also been extensive deliberations on how public organisations can deliver beyond immediate concerns with economic recovery and improved livelihoods. This paper draws insights from the Afrobarometer round 9 dataset on how different African governments' economies have been recovering from COVID-19 and how this has affected citizens' well-being in Kenya. The results show that despite the good recovery progress, the government has yet to stabilise high food prices, inflation, debts, job creation, etc. While national policy priorities may explain how this situation plays out, these challenges remain complex and linked to external factors that African governments may have little control over. [ABSTRACT FROM AUTHOR]

Essential Emergency and Critical Care (EECC) is a novel approach to the care of critically ill patients, focusing on first-tier, effective, low-cost, life-saving care and designed to be feasible even in low-resourced and low-staffed settings. This is distinct from advanced critical care, usually conducted in ICUs with specialised staff, facilities and technologies. This paper estimates the incremental cost of EECC and advanced critical care for the planning of care for critically ill patients in Tanzania and Kenya. The incremental costing took a health systems perspective. A normative approach based on the ingredients defined through the recently published global consensus on EECC was used. The setting was a district hospital in which the patient is provided with the definitive care typically provided at that level for their condition. Quantification of resource use was based on COVID-19 as a tracer condition using clinical expertise. Local prices were used where available, and all costs were converted to USD2020. The costs per patient day of EECC is estimated to be 1 USD, 11 USD and 33 USD in Tanzania and 2 USD, 14 USD and 37 USD in Kenya, for moderate, severe and critical COVID-19 patients respectively. The cost per patient day of advanced critical care is estimated to be 13 USD and 294 USD in Tanzania and USD 17 USD and 345 USD in Kenya for severe and critical COVID-19 patients, respectively. EECC is a novel approach for providing the essential care to all critically ill patients. The low costs and lower tech approach inherent in delivering EECC mean that EECC could be provided to many and suggests that prioritizing EECC over ACC may be a rational approach when resources are limited. [ABSTRACT FROM AUTHOR]

Informal settlements have been identified as locations both where the spread of COVID-19 has generally been slower than within the Global North and measures to restrain the pandemic have further intensified local peoples' marginality as income decreases without welfare or financial safety nets. In this paper, qualitative fieldwork is detailed which commenced in Korogocho, an informal settlement in Nairobi, Kenya, immediately prior to national COVID-19 restrictions. This March 2020, pre-COVID phase of the fieldwork focused on a community-based project and the basis for resilience in transforming local lives. During the next 12 months of the pandemic fieldwork continued, exploring experiences and reactions to restraining policies. These findings reinforce concerns about the impact of COVID-19 related restrictions on marginalised peoples' income, food security, health, safety and gender-based violence. How the local people reacted to these effects highlights their creative resilience and adaptability. The paper concludes by examining the impact of, and responses to, the controlling measures on the social relationships and cohesion that underpins the community resilience. [ABSTRACT FROM AUTHOR]

The global spread of the coronavirus pandemic has particularly dramatic consequences for the lives of migrants and refugees living in already marginalised and restricted conditions, whose ongoing crisis is at risk of being overlooked. But refugees are not only extremely vulnerable and at risk of infection, as several reports show, quickly develop their own protection measures like the production of hygienic products, the publication of their situation and calls for action and help. Therefore, this paper aims to research the effects of the coronavirus crisis on refugees in camp settings with a special ethnographic focus on how refugees actively deal with this crisis and if they, through already developed resilience, are capable of adapting to the restrictions as well as inventing strategies to cope with the difficult situation. To account for the variety of refugee camps as well as the different living conditions due to their locality, history and national asylum politics, we will look at three different locations, namely refugee asylum homes in Germany, hotspots on the Greek islands as well as one refugee camp in Kenya. The main questions will be how, under structurally and institutionally framed conditions of power and victimisation in refugee camps, forms of agency are established, made possible or limited. The goal is to show which strategies refugees apply to cope with the enhanced restrictions and exclusion, how they act to protect themselves and others from the virus and how they present and reflect their situation during the coronavirus pandemic. Finally, this discussion offers a new perspective to consider refugees not only as vulnerable victims, but also as actively engaged individuals. [ABSTRACT FROM AUTHOR]

Most countries worldwide during the COVID-19 pandemic adopted online learning as a means for mitigating the challenges facing face-to-face classroom education. The adoption of remote learning is largely informed by the decisions reached by individual country experts in pursuant to health guidelines of social distancing by the World Health Organization. Further, the United Nations Educational, Scientific and Cultural Organization (UNESCO) suggested recommendations to countries to implement to ensure that learning remains uninterrupted during the COVID-19 period. The paper analyzes critically the Kenyan situation in implementing and adhering to the UNESCO recommendations to enhance learning in all levels of education. Also, it evaluated the challenges faced and possible remedies in form of recommendations for future actions. The paper is largely based on library research to draw practical implications for both education research and policy. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Development Research is the property of Palgrave Macmillan Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Solicited diaries in audio, written and online forms are increasingly used in qualitative data collection. However, most studies using this approach are set in high-income, high-literacy country settings. This paper discusses the opportunities and challenges of this approach in a low-income, low-resource, low-literacy setting. We used solicited audio-recorded diaries to explore the financial lives of low-income women in Kenya during the COVID-19 pandemic. We enrolled 24 women to submit diary entries every day for seven days. We found that the audio-recorded diaries worked well with low-income women in Kenya, which has high penetration of cell phone ownership. The diaries provided textured, detailed insights into participants' day-to-day challenges, fluctuations, and coping strategies while relying less on recall. Nevertheless, the approach required two pilots to perfect, which may be challenging when research resources and time are limited. This study provides timely evidence on the use of audio-recorded solicited diaries in low-income settings. [ABSTRACT FROM AUTHOR]

This study aims to examine the impact of COVID-19 and sustainable ecommerce in Hungary and Kenya. COVID-19 has devastated the global economy, resulting in financial and job losses. Routine changes in spending have moved the focus from non-essential to essential items, due to the impact of COVID-19, the associated economic meltdown, and the deterioration of people's physical and mental health. However, e-commerce can be a better option to stop the spread of COVID-19 due to its real benefits and usefulness in solving the challenges faced. The methodology used in this paper is the collection of primary data from an online survey questionnaire, and secondary data from several databases, e.g., the World Health Organisation (WHO) and Johns Hopkins Centre websites. The results show the negative impact of COVID-19 on society and the economy, as well as the positive and significant effects of the growth of e-commerce during COVID-19, where most of the goods being purchased are medical supplies: masks, medicines, and food. This has been made possibleby the rise of e-commerce platforms as a link in sustainable e-commerce after the significant disruption to the worldwide supply chain due to total lockdown. E-commerce has shown growth during the COVID-19 pandemic period as a sustainable platform. In conclusion, this study proposes policies that support e-commerce in developing countries during and after COVID-19. Furthermore, theoretical, and managerial implications are proposed in the study. It is high time to warn businesses to adopt information and communications technology (ICT) to flourish and thrive during times of financial and economic hardship, such as the use of e-commerce with the right policies enacted to support sustainable e-commerce. [ABSTRACT FROM AUTHOR]

Evidence shows that those with non-communicable diseases (NCDs) are at higher risk for serious illness and mortality from COVID-19. In Kenya, about 50% of the COVID-19 patients who have died had an NCD. We sought to describe the challenges faced in accessing NCD medicines in Kenya during the pandemic, through a descriptive narrative informed by key stakeholders engaged in NCD service delivery and decision-making. Access to NCD medicines was affected at three levels, service delivery, health facility information systems and the medicines supply chain to health facilities. In response to these gaps, the Ministry of Health released clear directives and interim guidelines for continuity of NCD service delivery. However, implementation of guidelines was not apparent from conversations with county officials or from assessment of county services by the Ministry. Rather, heterogeneity was observed in counties' responsiveness to patient needs, where 5 out of 13 counties used mHealth technologies, while 5 had no established system to reach patients. COVID-19 amplified gaps that already existed in the system—particularly around lack of robust supply chains and sub-optimal health information systems. This descriptive paper will be useful to policy makers to provide a summary of the key challenges faced in accessing NCD medicines, identify gaps in medicines delivery, and make case for establishment of a more equitable health system to meet the needs of lower-income NCD patients. [ABSTRACT FROM AUTHOR]

Introduction: over one third of total Disability-Adjusted-Life-Years lost in Kenya are due to noncommunicable diseases (NCD). In response, the Government declared significant commitment towards improving NCD care. The COVID-19 pandemic increased the burden on the already overstretched health systems in Kenya. The aims of this study are to assess whether health care providers perceived NCD care to be optimal during the pandemic and explore how to improve responses to future emergencies. Methods: this cross-sectional online survey included healthcare personnel with non-clinical roles (public health workers and policy-makers) and those delivering health care (doctors and nurses). Respondents were recruited between May and September 2021 by random sampling, completed by snowball sampling. Results: among 236 participants (42% in clinical, 58% in non-clinical roles) there was an overall consensus between respondents on NCD care being disrupted and compromised during the pandemic in Kenya. Detracted supplies, funding, and technical resources affected the continuity of NCDs' response, despite government efforts. Respondents agreed that the enhanced personnel capacity and competencies to manage COVID-19 patients were positive, but noted a lack of guidance for redirecting care for chronic diseases, and advocated for digital innovation as a solution. Conclusion: this paper explores the perceptions of key stakeholders involved in the management of NCDs in Kenya to improve planning for future emergency responses. Gaps were identified in health system response and preparedness capacity during the pandemic including the perceived need to strengthen NCD services, with solutions offered to guide resilience efforts to protect the health system from disruption. [ABSTRACT FROM AUTHOR]

Pandemics are associated with exponential mortality rates, creating heavy burdens on communities. The high death rates affect how societies traditionally conduct funerary practices as governments impose regulations on the preparation of bodies and the conduct of the funerals to stem the transmission of the virus. In societies associated with deeply entrenched customary funerary practices, such limitative measures attract defiance. The tensions between public health objectives and funerary traditions have played out in a number of societies resulting in litigation. At the core of the disputes is whether the right to manifest religion or belief can be upheld, and relatedly, whether the dead have rights to dignified burials irrespective of pandemics. During the COVID-19 pandemic, some courts had to grapple with these difficult questions. In this paper, I take a jurisprudential excursion on some disputes in Kenya, India and Sri Lanka to assess the adjudication of conflicts which arose from COVID-19 pandemic deaths. [ABSTRACT FROM AUTHOR]

COVID-19 remains an income shock of significant economic consequence to many households across the world. The situation among refugees can be pathetic due to their inherent economic deprivations and vulnerability to income shocks. This paper analyzed the dynamics of poverty among refugees in Kenya during the COVID-19 pandemic and determined their correlates. The data were the first to fifth waves of the COVID-19 Rapid Response Phone Surveys that were conducted among refugees. The data were analysed with heteroscedasticity consistent Ordered Probit model. The results showed that with only 8.14% of the refugees never entering poverty within the survey periods, majority of the refugees were transiently (46.27%) and chronically (45.59%) poor. The error variance differed across household sizes, and heteroscedasticity was properly corrected. Movement from never being poor to chronic poverty was significantly promoted by urban residence, household size, educational levels, and camp of residence (Kakuma, Dadaab and Kalobeyei), while asset disposal income, amount of credit, remittance, and other gifts reduced it. It was concluded that efforts to reduce poverty vulnerability among refugees should among others address maternal fertility and promotion of policies to allow formally educated refugees to be gainfully engaged in the Kenyan labour markets. [ABSTRACT FROM AUTHOR]

Introduction: The first case of COVID-19 in Kenya was reported on March 13, 2020, prompting the collection of baseline data during the initial spread of the disease. Subsequently, the Kenyan government implemented non-pharmaceutical interventions (NPIs) on April 9, 2020, to mitigate disease transmission over a two-month period. These measures were later gradually relaxed starting from June 9, 2020. Methods: We applied a deterministic mathematical model to simulate the dynamics of COVID-19 transmission in Kenya. Using baseline data, we estimated transmission and recovery rates and proposed a mathematical model of how NPIs affect disease transmission rates. The model extends to interventions that yield an increase in disease transmission, unlike previous models that were limited to a decrease in transmission. We computed the mitigation and relaxation fractions and hence deduced the impact of the interventions. Results: The mitigation measures imposed from April 9, 2020, reduced the disease transmission by 43.7% from the baseline level, while the relaxation from June 9, 2020, increased the transmission by 32% over the mitigation level. Without intervention, the model predicts that infections would have peaked at 30% by late May 2020. However, due to the combined effect of mitigation and relaxation, the epidemic peaked at 13% infection in mid-July 2020. Discussion: The model's projections closely align with observed data, providing valuable insights for planning. Ongoing research aims to refine the model to capture sub-waves and spikes, as well as simulate multiple waves of infection. These efforts will enhance our understanding of COVID-19 dynamics and inform effective public health strategies. The estimated basic reproduction number = 2.76, consistent with previous findings, underscores the validity of our model and its relevance in predicting disease transmission dynamics. [ABSTRACT FROM AUTHOR]

Background: In 2020, healthcare providers were expected to provide care to individuals with coronavirus disease 2019 (COVID-19), putting them at risk of acquiring COVID-19. The possibility of acquiring poorly understood infectious diseases while providing care may have an impact on the mental health of providers. We conducted a study to explore the effects of COVID-19 on the mental health of healthcare providers. Methods: Between April and August 2021, we conducted in-depth interviews with 60 healthcare providers in the infectious disease unit (IDU) and other units of the hospital (non-IDU). The healthcare providers completed an online self-administered survey form with demographic data (age, sex, average income, and known contact with a COVID-19 patient). We used semi-structured interview guides to understand the healthcare providers' lived experiences of stress, anxiety, depression, and their associated factors. We transcribed the interviews verbatim and coded and analyzed the transcripts to derive thematic concepts related to mental health experiences. Results: The healthcare providers had a median age of 37 years [IQR 20.0–58.0], and 56.7% were female, 30.0% nurses, 18.3% medical doctors, and 11.7% laboratory technologists. The healthcare providers reported increased stress during the pandemic, attributed to the high demand for patient care, changes in social life, and fear of COVID-19 infection. They also reported experiences of anxiety and depression as a result of limited knowledge at the beginning of the pandemic and the perception that "COVID-19 resulted in death". Testing positive for COVID-19, high exposure to COVID-19 risks, and the death of patients and colleagues reportedly affected the healthcare providers' mental health. Additionally, the healthcare providers reported mental health support through debriefing meetings, peer-to-peer support, and psychological counseling, with privacy and confidentiality concerns. Conclusions: Healthcare providers faced mental health issues such as stress and anxiety while taking care of COVID-19 patients. An effective mental health response requires institutional practices that address context-specific challenges such as privacy and confidentiality. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper investigates the effects of the coronavirus disease 2019 (COVID-19) pandemic on financial institutions and on consumers' adoption of Financial Technology (FinTech) for payments. This paper documents the following findings in Kenya. (1) The COVID-19 pandemic accelerated the adoption and increased the payment concentration of FinTech. We document an approximately 54% increase in mobile banking transactions, a 19.56% increase in mobile banking agents, and a 14.56% increase in the number of mobile banking accounts. (2) The use of all types of electronic payment cards declined significantly during the pandemic. (3) The pandemic magnified interbank contagion and liquidity risks and reduced both domestic and international electronic fund transfers via both the Real-Gross Settlement System and the Automated Clearing House. Overall, our results indicate that FinTech not only partially alleviated the negative impact of the COVID-19 pandemic during Q1 of 2021 but also accelerated consumers' adoption of FinTech and digital onboarding, especially in Q3 and Q4 of 2022. • The COVID-19 pandemic has accelerated the adoption of FinTech. • The use of mobile banking has significantly increased during the pandemic. • The use of electronic payment cards has significantly declined during the pandemic. • The pandemic has reduced domestic and international electronic funds transfer. [ABSTRACT FROM AUTHOR]

This paper introduces a methodology to explore pedestrian accessibility in informal settlements. This methodology is applied to pandemic intervention sites in Nairobi's Kibera area for 3.5 months (14 April to 31 July 2020) during the COVID-19 pandemic. Freely available transportation network data and open-source GIS software are utilised. Isochrones, areas of equal travel time, are calculated to assess pedestrian accessibility (walk times) from 30,231 Kibera structures to 138 COVID-19 stationary intervention sites. These sites aid in virus control, resource distribution, and COVID-related medical support. Travel times are determined considering different terrain slopes. Unequal access to intervention sites is observed due to indirect routes. Shortest walks (up to 21.5 min) are to handwashing and food distribution points, while longer walks (up to 61.5 min) are to interventions with fewer sites or localised clustering, such as baby product distribution. This simple accessibility analysis helps identify service gaps during crises, aiding planning authorities and communities. Our methodology offers insight into travel patterns in slums and has wider applicability to assess the relationships between transport infrastructure provision and resilience in informal settlements. [ABSTRACT FROM AUTHOR]

Food price shocks exacerbated by the COVID-19 pandemic have the potential to threaten food security, especially among low-income households. The aim of this study was to assess the effect of COVID-19 on food prices and the coping strategies of households in Malava and Lurambi Sub-Counties of Kakamega County, Kenya. The researchers adopted a descriptive survey design for this study. A semistructured questionnaire was developed using KoBo Collect and synchronized to the Open Data Kit (ODK) server and used to collect data from a sample size of 200 households. Data was analyzed using Statistical Package for Social Sciences Version 26 to generate descriptive statistics. Results reveal that food prices significantly affected households as they depended on the market for food supply, with nutritious food items such as meat, vegetables, milk, and fruits exposed to significant food price shocks arising from COVID-19. Coping strategies included a reduced number of meals per day, reduced dietary diversity, and lower expenditure on health and education, calling for State and County Government interventions to provide food relief and transfer payments for vulnerable households. [ABSTRACT FROM AUTHOR]

Background : Health system shocks are increasing. The COVID-19 pandemic resulted in global disruptions to health systems, including maternal and newborn healthcare seeking and provision. Yet evidence on mitigation strategies to protect newborn service delivery is limited. We sought to understand what mitigation strategies were employed to protect small and sick newborn care (SSNC) across 65 facilities Kenya, Malawi, Nigeria and Tanzania, implementing with the NEST360 Alliance, and if any could be maintained post-pandemic. Methods: We used qualitative methods (in-depth interviews n=132, focus group discussions n=15) with purposively sampled neonatal health systems actors in Kenya, Malawi, Nigeria and Tanzania. Data were collected from September 2021 - August 2022. Topic guides were co-developed with key stakeholders and used to gain a detailed understanding of approaches to protect SSNC during the COVID-19 pandemic. Questions explored policy development, collaboration and investments, organisation of care, human resources, and technology and device innovations. Interviews were conducted by experienced qualitative researchers and data were collected until saturation was reached. Interviews were digitally recorded and transcribed verbatim. A common coding framework was developed, and data were coded via NVivo and analysed using a thematic framework approach. Findings: We identified two pathways via which SSNC was strengthened. The first pathway, COVID-19 specific responses with secondary benefit to SSNC included: rapid policy development and adaptation, new and collaborative funding partnerships, improved oxygen systems, strengthened infection prevention and control practices. The second pathway, health system mitigation strategies during the pandemic, included: enhanced information systems, human resource adaptations, service delivery innovations, e.g., telemedicine, community engagement and more emphasis on planned preventive maintenance of devices. Chronic system weaknesses were also identified that limited the sustainability and institutionalisation of actions to protect SSNC. Conclusion: Innovations to protect SSNC in response to the COVID-19 pandemic should be maintained to support resilience and high-quality routine SSNC delivery. In particular, allocation of resources to sustain high quality and resilient care practices and address remaining gaps for SSNC is critical. [ABSTRACT FROM AUTHOR]

Street artists around the world have been prominent in depicting issues concerning COVID-19, but the role of street art in public-making during the pandemic is unexplored. Despite burgeoning street art scenes in many African countries since the early 2000s, African street art is relatively neglected in critical street art scholarship. In response, this paper examines street art created during the pandemic in East African countries, principally Uganda, Kenya, Rwanda, and Tanzania, and explores the ways in which it is engaged in highly distinctive forms of public-making. Drawing primarily on qualitative online interviews with East African artists creating street art, and image analysis using online search tools, the paper argues that street art in urban areas is attempting to create knowledgeable publics through countering disinformation about the pandemic, to responsiblize publics through public health messaging and, through community activism, to build resilient publics. The paper concludes that street art is potentially an important tool in tackling the COVID-19 pandemic in East African countries due to the proximity, and mutual constitution of, creative practices and publics, which emerge from the embedding of street art within the social spaces of cities and everyday experiences of the pandemic. [ABSTRACT FROM AUTHOR]

The mortality impact of COVID-19 in Africa remains controversial because most countries lack vital registration. We analysed excess mortality in Kilifi Health and Demographic Surveillance System, Kenya, using 9 years of baseline data. SARS-CoV-2 seroprevalence studies suggest most adults here were infected before May 2022. During 5 waves of COVID-19 (April 2020-May 2022) an overall excess mortality of 4.8% (95% PI 1.2%, 9.4%) concealed a significant excess (11.6%, 95% PI 5.9%, 18.9%) among older adults (≥ 65 years) and a deficit among children aged 1–14 years (−7.7%, 95% PI −20.9%, 6.9%). The excess mortality rate for January 2020-December 2021, age-standardised to the Kenyan population, was 27.4/100,000 person-years (95% CI 23.2-31.6). In Coastal Kenya, excess mortality during the pandemic was substantially lower than in most high-income countries but the significant excess mortality in older adults emphasizes the value of achieving high vaccine coverage in this risk group. SARS-CoV-2-associated mortality estimates for sub-Saharan Africa are uncertain due to lack of comprehensive surveillance systems. Here, the authors analyse data from a detailed surveillance system in Kilifi, Kenya and find that excess mortality rates were relatively low, except for older adults. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had a negative effect on children's mental health worldwide. Existing studies suggest that children with greater levels of hope are more likely to be resilient in the face of disaster. While social support at the family and community level is proposed as an important factor in sustaining and fostering hope, the children of underprivileged households in developing countries tend to lack this support. We investigate whether development projects run by international NGOs are able to fill this gap and help children to remain hopeful during the pandemic. Using original survey data from 834 children in adolescence (aged between 10 and 18) in Kenya and Zambia, we show that children participating in Good Neighbors' child sponsorship programs and community development projects exhibit higher scores on the Children's Hope Scale than do non-participating children. These projects appear to foster hope by providing emotional and informational support. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic resulted in disruptions to routine HIV services for youth living with HIV (YLH), provoking rapid adaptation to mitigate interruptions in care. The Adolescent Transition to Adult Care for HIV-infected adolescents (ATTACH) study (NCT03574129) was a hybrid I cluster randomized trial testing the effectiveness of a healthcare worker (HCW)-delivered disclosure and transition intervention — the Adolescent Transition Package (ATP). During the pandemic, HCWs leveraged phone delivery of the ATP and were supported to make adaptations. We characterized real-time, provider-driven adaptations made to support phone delivery of the ATP. Methods: We conducted continuous quality improvement (CQI) meetings with HCWs involved in phone delivery of the ATP at 10 intervention sites. CQI meetings used plan-do-study-act (PDSA) cycles and were audio-recorded. Adaptations were coded by two-independent coders using the Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies (FRAME-IS). Adaptation testing outcomes (adopt, retest, or abandon) and provider experience implementing the adaptations were also recorded. We summarized adaptation characteristics, provider experience, and outcomes. Results: We identified 72 adaptations, 32 were unique. Overall, adaptations included modification to context (53%, n = 38), content (49%, n = 35), and evaluation processes (13%, n = 9). Context adaptations primarily featured changes to personnel, format, and setting, while content and evaluation adaptations were frequently achieved by simple additions, repetition, and tailoring/refining of the phone delivery strategy. Nine adaptations involved abandoning, then returning to phone delivery. HCWs sought to increase reach, improve fidelity, and intervention fit within their context. Most adaptations (96%, n = 69) were perceived to increase the feasibility of phone delivery when compared to before the changes were introduced, and HCWs felt 83% (n = 60) of adaptations made phone delivery easier. Most adaptations were either incorporated into routine workflows (47%) or tested again (47%). Conclusion: Adaptation of phone delivery was a feasible and effective way of addressing challenges with continuity of care for YLH during the COVID-19 pandemic. Adaptations were primarily context adaptions. While FRAME-IS was apt for characterizing adaptations, more use cases are needed to explore the range of its utility. Trial registration: Trial registered on ClinicalTrial.gov as NCT03574129. [ABSTRACT FROM AUTHOR]

Healthcare workers (HCWs) were a priority group for COVID-19 vaccination. Adopting the World Health Organization's 3C and the expanded 5C vaccine hesitancy models, we assessed the factors associated with COVID-19 vaccine acceptability among HCWs in Kenya. In a mixed methods study, respondents were from eight selected counties across the country. An online survey (n = 746), key informant interviews (n = 18) and focus group discussions (n = 3) were conducted. The data were analyzed concurrently. Quantitative data showed that all the 3C antecedents were strong predictors of vaccine acceptability. The association of vaccine acceptability was strongest with convenience (aOR 20.13, 95% CI 9.01–44.96), then complacency (aOR 10.15, 95% CI 4.63–22.21) and confidence (aOR 6.37, 95% CI 2.90–14.02). Marital status was a significant independent factor associated with vaccine acceptability (aOR 2.70, 95% CI 1.20–6.08). Qualitatively, convenience presented as the no-cost availability of vaccines at the health facilities, whereas non-complacency manifested from the first-hand observed experience of COVID cases, and the need to protect oneself and family members. Confidence was mainly attributed to increased knowledge, resulting from multiple training sessions and trust in regulatory authorities. Other social factors including workplace pressure, religion and misinformation had a role in influencing HCW vaccination decisions. In the background of a pandemic, the 3C model is a strong predictor of vaccine acceptability, and making the vaccines easily available and convenient to HCWs significantly impacts their uptake. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore 232 service providers' and policymakers' experiences of supporting children's well-being during the pandemic, across sectors, in 22 countries – including Kenya, the Philippines, South Africa, India, Scotland, Sweden, Canada and the USA, in the last quarter of 2020. Design/methodology/approach: A smartphone survey delivered via a custom-built app containing mostly open-ended questions was used. Respondents were recruited via professional networks, newsletters and social media. Qualitative content analysis was used. Findings: The findings reveal numerous system-level challenges to supporting children's well-being, particularly virus containment measures, resource deficiencies and inadequate governance and stakeholder coordination. Those challenges compounded preexisting inequalities and poorly affected the quality, effectiveness and reach of services. As a result, children's rights to an adequate standard of living; protection from violence; education; play; and right to be heard were impinged upon. Concurrently, the findings illustrate a range of adaptive and innovative practices in humanitarian and subsistence support; child protection; capacity-building; advocacy; digitalisation; and psychosocial and educational support. Respondents identified several priority areas – increasing service capacity and equity; expanding technology use; mobilising cross-sectoral partnerships; involving children in decision-making; and ensuring more effective child protection mechanisms. Practical implications: This study seeks to inform resilience-enabling policies and practices that foster equity, child and community empowerment and organisational resilience and innovation, particularly in anticipation of future crises. Originality/value: Using a novel approach to gather in-the-moment insights remotely, this study offers a unique international and multi-sectoral perspective, particularly from low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Background Coronavirus disease 2019 (COVID-19), declared a global pandemic by the World Health Organization (WHO), is a severe acute respiratory disease. The Kenyan Ministry of Health (MoH) put in place measures that included mandatory face masking, hand and cough hygiene and social and physical distancing to reduce disease transmission and increase prevention efforts. The primary objective of this study was to determine how sociodemographic characteristics affect knowledge and practice of the above measures. Methods A cross-sectional study was conducted to assess water, sanitation and hygiene practices for the prevention and control of COVID-19 in Kilifi and Mombasa Counties, Kenya. Data collection was accomplished through a mobile data collection tool. Principal component analysis was used to create a wealth index using data on asset ownership and housing characteristics. Bloom cut-off points of 80–100%, 60–79% and ≤59% were used to determine knowledge and practice. Results Of the 612 households, 339 (55.4%) were from Kilifi County and 273 (44.6%) were from Mombasa County. A total of 431 (70.4%) were female and the mean age of the household members was 38.2±14.8 y. Almost all (99.2%) respondents were aware of COVID-19, with 60% knowing prevention, symptoms and persons at a higher risk of contracting the virus. Females had the highest knowledge of COVID-19 and were likely to practice prevention and control measures, unlike males. Age was significant (p<0.05) with knowledge and practice. Conclusions The sociodemographic characteristics of populations play a key role in behavioural aspects as far as prevention and control of COVID-19 are concerned. There is a need for partnerships between the MoH and county governments to put in place a multisectoral community approach to advance feasible behavioural interventions among targeted populations towards combating the spread of COVID-19. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 global pandemic exposed mental health gaps that have been salient among adolescents and young people. The glaring gaps include lack of information, undefined referral systems, and inadequate human resources for mental health. We aimed to develop a digital webbased platform to support young people's mental health and psychosocial needs during the COVID-19 pandemic. Methods: we adopted a mixed methods action research approach to design and pilot a digital mental health intervention for young people during the pandemic. We piloted the platform between Oct 2020 and July 2021, and recruited a sample of 150 young people through the community gathering spaces in three informal settlements in Nairobi City County using a convenient sampling method. Results: overall, participants reported that information provided to them via the platform was pertinent and beneficial, and that the self-assessments improved their mental health and psychosocial awareness and signposted them to available support and services. The support services consisted of informative weekly bulk emails and short motivational messages related to mental health, with a total of, 1343 short messages distributed through the short message service (SMS). Moreover, more than half the participants completed online self-assessments and participated in 19 online sessions. Conclusion: findings from this pilot study demonstrate that digital mental health systems are feasible and have the potential to improve access to mental health and psychosocial services. This is especially crucial during times of public health crisis, such as the COVID-19 pandemic. The realization of such systems requires swift multistakeholder partnership approach and investment. [ABSTRACT FROM AUTHOR]

Sexual and gender-based violence (SGBV), and particularly intimate partner violence (IPV), has spiked dramatically during the COVID-19 pandemic. At the same time, the pandemic is impacting and interrupting SGBV and IPV services of all kinds. This paper focuses on the impact of the COVID-19 pandemic on clinical care and forensic medical documentation for SGBV survivors, including an analysis of the response in the UK and Kenya, and provides recommendations for safe implementation of these services during the pandemic. [ABSTRACT FROM AUTHOR]

Background: Tungiasis is a neglected tropical skin disease caused by the sand flea Tunga penetrans. Female fleas penetrate the skin, particularly at the feet, and cause severe inflammation. This study aimed to characterize disease burden in two highly affected regions in Kenya, to test the use of thermography to detect tungiasis-associated inflammation and to create a new two-level classification of disease severity suitable for mapping, targeting, and monitoring interventions. Methods: From February 2020 to April 2021, 3532 pupils age 8–14 years were quasi-randomly selected in 35 public primary schools and examined for tungiasis and associated symptoms. Of the infected pupils, 266 were quasi-randomly selected and their households visited, where an additional 1138 family members were examined. Inflammation was assessed using infra-red thermography. A Clinical score was created combining the number of locations on the feet with acute and chronic symptoms and infra-red hotspots. Results: The overall prevalence of tungiasis among all the school pupils who were randomly selected during survey rounds 1 and 3 was 9.3% [95% confidence interval (CI): 8.4–10.3]. Based on mixed effects logistic models, the odds of infection with tungiasis among school pupils was three times higher in Kwale (coastal Kenya) than in Siaya [western Kenya; adjusted odds ratio (aOR) = 0.36, 95% CI: 0.18–0.74]; three times higher in males than in females (aOR = 3.0, 95% CI: 2.32–3.91) and three times lower among pupils sleeping in a house with a concrete floor (aOR = 0.32, 95% CI: 0.24–0.44). The odds of finding an infected person among the household population during surveys before the COVID-19 pandemic was a third (aOR = 0.32, 95% CI: 0.19–0.53) of that when schools were closed due to COVID-19 restrictions and approximately half (aOR = 0.44, 95% CI: 0.29–0.68) in surveys done after school re-opening (round 3). Infection intensity was positively correlated with inflammation as measured by thermography (Spearman's rho = 0.68, P < 0.001) and with the clinical score (rho = 0.86, P < 0.001). Based on the two-level classification, severe cases were associated with a threefold higher level of pain (OR = 2.99, 95% CI: 2.02–4.43) and itching (OR = 3.31, 95% CI: 2.24–4.89) than mild cases. Conclusions: Thermography was a valuable addition for assessing morbidity and the proposed two-level classification of disease severity clearly separated patients with mild and severe impacts. The burden of tungiasis was considerably higher in households surveyed during COVID-19 restrictions suggesting underlying risks are found in the home environment more than in school. [ABSTRACT FROM AUTHOR]

This implementation research study sought to examine the impact of the COVID‐19 pandemic on adolescent nutrition practices and related behaviors in Nairobi and Uasin Gishu Counties, Kenya. Eight focus group discussions (FGDs) were conducted with adolescents 10–19 years of age, in‐depth interviews with 10 health facility providers, and a combination of FGDs (n‐4) and key informant interviews with government stakeholder and implementing partners (n = 9). During the pandemic, adolescents tended to avoid commonly consumed junk foods, in favor of "immune boosting, protective" foods. Widespread unemployment and reductions in parental income rendered some food items such as meat, eggs, and fruits unaffordable for families of adolescents. Adolescents relayed experiences of skipping meals and reducing the amount and variety of foods consumed. Adolescents also described employing strategies such as working in the informal sector and selling personal items to support families financially, in response to rising food insecurity. School closures mandated during the pandemic likely contributed to reductions in overall physical activity. To improve the diets of adolescents, programs should build on the healthy mindset brought on by the pandemic, while strengthening, targeting, and improving access to social protection measures and agricultural initiatives for vulnerable families with adolescents to cushion them from rising food insecurity as an effect of COVID‐19. Building practical adolescent life skills to encourage healthy nutrition actions will also be key to building forward from the COVID‐19 pandemic in Kenya. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic overstretched health systems in developed and developing nations. Like other African nations, Kenya has a frail health system, making responding to the pandemic a problem. Recent studies during COVID-19 have shown that Kenya's health systems were either strained to their maximum capability or worse in handling patients. Therefore, citizens were advised not to go to the hospital unless necessary. This advice applies to all, including pregnant mothers. This article utilized the anthropological description of the healthcare system, viewed as a cultural system attached to particular provisions of social institutions and forms of social connections. It is a social and cultural system in origin, structure, function, and significance. In every society, healthcare systems are forms of social reality in which they embody specific social roles and relationships between these roles. There is a dearth of information on how healthcare providers experienced the effects of COVID-19 on Kenya's healthcare system, which this study addresses for those in Coastal Kenya. This rapid qualitative study utilized data from sixteen purposefully selected healthcare providers in charge of various departments in Kilifi County of Coastal Kenya. We utilized thematic analysis and textual description to present our findings. It emerged that there was a diversion in resources allocated for maternal health programs, health facilities were temporarily shut down due to inadequate resources and equipment for health workers, there was a lack of preparation by health workers, there was a reduced flow of pregnant mothers and missing scheduled appointments for ante- and postnatal clinics, maternal mortality increased, and mothers resorted to traditional midwives for deliveries. These findings show that maternal health services were negatively affected. Thus, the government needs to institute alternative measures for continued access to maternal health services during pandemics. We recommend expanding and supporting the existing community midwifery model (CMM). For instance, incorporating community health workers (CHWs) and other local health institutions in the community, such as traditional birth attendants (TBAs), and creating midwifery centers managed by trained midwives in communities. [ABSTRACT FROM AUTHOR]

Background Epidemics can cause significant disruptions of essential health care services. This was evident in West-Africa during the 2014-2016 Ebola outbreak, raising concerns that COVID-19 would have similar devastating consequences for the continent. Indeed, official facility-based records show a reduction in health care visits after the onset of COVID-19 in Kenya. Our question is whether this observed reduction was caused by lower access to health care or by reduced incidence of communicable diseases resulting from reduced mobility and social contacts. Methods We analysed monthly facility-based data from 2018 to 2020, and weekly health diaries data digitally collected by trained filedworkers between February and November 2020 from 342 households, including 1974 individuals, in Kisumu and Kakamega Counties, Kenya. Diaries data was collected as part of an ongoing longitudinal study of a digital health insurance scheme (Kakamega), and universal health coverage implementation (Kisumu). We assessed the weekly incidence of self-reported medical symptoms, formal and informal health-seeking behaviour, and foregone care in the diaries and compared it with facility-based records. Linear probability regressions with household fixed-effects were performed to compare the weekly incidence of health outcomes before and after COVID-19. Results Facility-based data showed a decrease in health care utilization for respiratory infections, enteric illnesses, and malaria, after start of COVID-19 measures in Kenya in March 2020. The weekly diaries confirmed this decrease in respiratory and enteric symptoms, and malaria / fever, mainly in the paediatric population. In terms of health care seeking behaviour, our diaries data find a temporary shift in consultations from health care centres to pharmacists / chemists / medicine vendors for a few weeks during the pandemic, but no increase in foregone care. According to the diaries, for adults the incidence of communicable diseases/symptoms rebounded after COVID-19 mobility restrictions were lifted, while for children the effects persisted. Conclusions COVID-19-related containment measures in Western Kenya were accompanied by a decline in respiratory infections, enteric illnesses, and malaria / fever mainly in children. Data from a population-based survey and facility-based records aligned regarding this finding despite the temporary shift to non-facility-based consultations and confirmed that the drop in utilization of health care services was not due to decreased accessibility, but rather to a lower incidence of these infections. [ABSTRACT FROM AUTHOR]

SUMMARY: In this narrative, I offer a lightly fictionalized version of my experience returning to Kenya from the United States to conduct fieldwork from late 2020 through mid‐2021, a period when the COVID‐19 pandemic was ravaging globally. My narrative reveals how local people draw on their knowledge of the corrupt police system to resist COVID‐19 restrictions as they navigate and make meaning of their day‐to‐day lives during the pandemic and how the police use the mask mandate and curfew to take bribes from people who defy these restrictions. The story also brings into question the extent to which native ethnographers can re‐immerse themselves into the everyday lives of their home communities while balancing the many intersecting factors that inform their positionality. [ABSTRACT FROM AUTHOR]

Growing evidence documents the effects of the COVID-19 pandemic on adolescents in East and Southern Africa. We present and explore the longitudinal health and development-related priorities and challenges of adolescent advisors in South Africa and Kenya, including prior to, and during the COVID-19 pandemic. Findings were co-generated with adolescent advisors in the Eastern Cape Province of South Africa (n=15, ages 18–22 in 2019) and Kisumu, Kenya (n=16, ages 10–14 in 2020). Prior to COVID-19, adolescent advisors engaged in a participatory exercise to share and explore their health and development-related priorities and challenges in 2019 and 2020. During the COVID-19 pandemic in 2020 and 2021, members of the same groups shared their experiences, challenges and coping strategies in semi-structured telephone interviews (Eastern Cape: n=14, aged 19–23; Kisumu n=12, aged 11–16) and group-based remote participatory social media activities (n=27 activities with n=12 advisors, Eastern Cape). We thematically analysed COVID-19 activities, considering them alongside pre-pandemic priorities and challenges. Many of the health and development-related priorities and challenges identified prior to COVID-19 remained issues of concern during COVID-19. These included education; victimization and violence; teenage pregnancy; substance use; household tension, conflict and inadequate family and caregiver support; health and medication concerns (South Africa) and water and food shortages (Kenya). Other issues such as financial insecurity, mental health, and crime were strong themes that emerged during COVID-19, which were not directly reported as priorities prior. Although almost all of adolescent advisors' most pressing pandemic-related challenges were also priorities for them prior to COVID-19, these issues were often discussed as new, and caused by the onset of COVID-19. While demonstrating how COVID-19 has exacerbated pre-existing vulnerabilities, we also suggest that the pandemic may have brought about a new way for adolescents to make sense of, and articulate pre-existing challenges. [ABSTRACT FROM AUTHOR]

The present study aimed to explore the drivers of early marriage and teenage pregnancy in Kenya and Uganda during COVID-19 lockdown period. A systematic review design was adopted. The major online databases utilized were PubMed, Google Scholar, Uganda and Kenya Ministry of Health repositories, ScienceDirect, and Scopus. Studies that were originating from Kenya and Uganda that were publicly available in electronic format published from March 2020 to March 2022 were used. The thematic analysis identified major concepts that were drivers to the present research problem which were as follows: (1) school closure and (2) loss of income by parents. The COVID-19 containment measures introduced in the two countries were noted as major contributing factors. During the pandemic, lockdown led to school closures which meant the teenagers being idle at home with an increased opportunity to indulge in sexual risk behaviors. Schools have been noted to be a safe place protecting this vulnerable population. However, with their prolonged closure, the teenagers were exposed to sexual predators. Parents lost income, and this might have contributed to early marriages and teenagers' dependency on their sexual partners. Based on the reviewed evidence, the present study furthers the advocacy for the reduction of early marriages and teenage pregnancy, especially in the current COVID-19 pandemic era. The study calls upon the governments to intensify efforts toward the present research problem as the COVID-19 pandemic is eroding the earlier gains made within the region. [ABSTRACT FROM AUTHOR]

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Following its outbreak in late 2019, the Coronavirus disease (COVID-19) has been reported to have had devastating human health, health systems, and socioeconomic impacts across the globe. Countries in the Global South are known to have been hit harder given the low level of resilience to crises amid high levels of poverty and limited social protection programmes. This includes countries in sub-Saharan Africa (SSA). Most of the existing studies on the COVID-19 pandemic in SSA, however, have focused on the puzzling nature of the considerably low rate at which the virus spread over the continent, the low level of hospitalisation, and the corresponding low morbidity rate. As such, little focus has been given to the social and economic effects of the pandemic in the local communities. Carried out in two rural communities in Kenya—Kilifi and Murang'a—the present study adopts a case study approach for an in-depth, real-life context and explores the socioeconomic (including land-related) effects of the COVID-19 pandemic on the vulnerable rural population and the social group of smallholder farmers. Outcomes of the study show that the local effects of the pandemic are context specific. The findings demonstrate that the pandemic has had far-reaching impact on access to and control over land for some households in the rural communities. It was also accompanied with other negative social and economic effects, including a notable rise in teenage pregnancy, intra-household conflicts, job losses, and businesses closures. Positively, it is also claimed to have contributed to food and nutrition security in some rural regions, following increased availability of nutritious food that could have, otherwise, been sold. [ABSTRACT FROM AUTHOR]

This study assesses the extent of COVID‐19‐related food insecurity in Kenya, Tanzania, and Namibia. Using the Household Food Insecurity Access Scale, we measure food insecurity in various dimensions and document several food access disruptions associated with the COVID‐19 pandemic between April and July 2020. Furthermore, we assess the association of COVID‐19 countermeasures with the adoption of various strategies in line with the coping strategies index. We rely on a unique phone survey that followed households who participated in an earlier field‐based survey. First, through Ordinary Least‐Squares and Probit regressions, we show a strong and statistically significant association between COVID‐19 countermeasures and food access disruptions and food insecurity in each of the three countries. We then use a multivariate probit regression model to understand the use of the various coping strategies, including reducing food intake, increasing food search, and relying more on less nutritious foods. We provide evidence on the complementarities and trade‐offs in using these coping strategies. COVID‐19 and related lockdown measures coincided with a deleterious increase in food insecurity in rural Africa. [ABSTRACT FROM AUTHOR]

The Covid-19 (acronym for the coronavirus disease of 2019) pandemic negatively affected the world economy akin to the global financial crisis of 2008, leading to the revival of the debate about neoliberal rationalities. Although many nations attempted to contain the pandemic through a public goods approach, the authors argue that these state interventions concealed neoliberalism by advancing its governmentalities. Further, they use Norman Fairclough's (1992) interdiscursivity to describe how in Kenya, The Standard newspaper's coverage of the government interventions was dialogical, euphemising neoliberalism through content that seemed to advocate state welfarism while advocating for the free market at the same time. The interdiscursive analysis was enriched by using Ernesto Laclau and Chantal Mouffe's (1985) concept of chains of equivalence and difference to explain the power relations behind the euphemisation of neoliberalism. The authors also argue that the invisible free-market mechanism becomes hegemonic when it takes over populist demands through the transformation of the chains of difference – the antagonism against neoliberalism – into chains of equivalence, the points of similarity between neoliberalism and people's welfare demands. For the current study, the authors selected articles on Covid-19 that appeared in the Standard, chiefly those written on policy issues and published during the early period of the pandemic. Two regular themes were analysed to illustrate the euphemisation of neoliberalism, namely, corruption watchdogism and unemployment narratives. The authors use interdiscursivity to illustrate how these two themes euphemise neoliberalism. [ABSTRACT FROM AUTHOR]

In low‐income settings, the informal economy is a practical alternative to work and employment for persons with disabilities. However, the COVID‐19 pandemic negatively affected the informal economy. This study aimed to explore the experiences of women with psychosocial disabilities in Kenya during the pandemic. We found that the pandemic worsened their experiences of work and employment, and they did not receive any social welfare or support from the government. Our findings suggest that pandemic management must adopt inclusive and context‐sensitive approaches that support persons with psychosocial disabilities. Social welfare and protection for persons with disabilities are relevant for socio‐economic empowerment and inclusion. [ABSTRACT FROM AUTHOR]

Background: Healthcare workers, including residents, are prone to various mental health disorders especially given the context of the COVID-19 pandemic. Residents, particularly, are already under undue stress due to their respective training program demands. Methods: This cross-sectional, online survey-based study from August to November 2020 collected demographic and mental health measurements from all residents at the Aga Khan University Hospital, Nairobi. The questionnaire investigated demographic variables, information regarding direct care of COVID-19 patients, prior history of mental health and mental health outcomes using the Patient Health Questionnaire, Generalized Anxiety Disorder scale, Insomnia Severity Index, Impact of Event Scale–Revised Questionnaire and Stanford Professional Fulfillment Index Questionnaire. Results: A total of 100 residents completed the survey (participation rate 77.5%). Participants were about equal in gender (women [53%]), with a median age of 31.28 years, and majority were single (66.7%). A total of 66 participants (66%) were directly engaged in COVID-19 care. Depression: 64.3%, anxiety: 51.5%, insomnia: 40.5%, distress: 35.4%, and burnout: 51.0% were reported in all participants. Statistical significance was found in median depression, professional fulfillment and interpersonal disengagement when comparing frontline resident directly involved in care of COVID-19 patient versus second line residents. Conclusion: Residents directly involved with caring for COVID-19 patients had statistically higher incidences of depression and interpersonal disengagement and lower professional fulfillment compared to second line residents. Keeping in mind the limited resources in sub-Saharan Africa, urgent and geographically specific strategies are needed to help combat mental health disorders in this specific population. [ABSTRACT FROM AUTHOR]