COVID-19 disruption in sub-Saharan Africa will have significant health consequences

Boston, MA – At the onset of the COVID-19 pandemic, many African leaders implemented preventive measures such as lockdowns, travel bans, border closures and school closings. While these efforts may have helped slow the spread of the virus on the continent and continue to be important for its containment, they have inadvertently disrupted livelihoods and food systems and restricted access to essential nutrition services, health and education. A new series of studies by researchers at Harvard TH Chan School of Public Health and colleagues from the Africa Research, Implementation Science and Education (ARISE) network reveals that these disruptions can have serious consequences for nutrition and health and exacerbate existing inequalities – key areas policymakers must grapple with as the pandemic continues.

All six studies will be published online in The American Journal of Tropical Medicine and Hygiene June 23, 2021.

Few studies have documented and quantified the direct and indirect health and socio-economic impacts of the pandemic in sub-Saharan Africa. As COVID-19 cases are on the rise in many African countries and access to vaccines lags, these new studies help fill knowledge gaps regarding the direct and indirect impacts of COVID-19 on various population groups in rural and urban areas, and in three countries in sub-Saharan Africa: Burkina Faso, Ethiopia and Nigeria. These sites were selected to take advantage of the partnerships and infrastructure of the ARISE network, which brings together 21 member institutions from nine countries in sub-Saharan Africa and researchers from the Harvard Chan School to advance training and research capacities in the region.

Researchers analyzed data from the ARISE multi-country surveys, which were conducted using mobile phone survey platforms from July to November 2020. Participants included 900 health workers, 1,797 adults and 1,795 adolescents. .

In addition to the immediate risk of infection and death from COVID-19, researchers found that the pandemic posed substantial indirect threats due to existing challenges around health infrastructure, food insecurity and high prevalence. other infectious diseases such as HIV.

The main findings of the studies detailed these threats:

  • COVID-19 restrictions have impacted food systems, leading to reported price increases for staple foods and grains, legumes (lentils, chickpeas and beans), fruits, vegetables and food of animal origin, and a reduction in the consumption of diversified and quality diets.
  • Schooling has been halted for most of the adolescents surveyed, many without access to distance education or through other formats at the height of the pandemic in 2020.
  • Health care providers reported that more than half (56%) of essential health care services – including child and maternal health and nutrition services, HIV treatment, and surgeries – were interrupted in due to COVID-19 restrictions.
  • Knowledge about COVID-19 was high among adults and health workers (although lower among nurses than doctors). However, among adults (excluding health workers) misconceptions about the transmission of COVID-19 were widespread and adherence to recommended prevention measures was low.
  • At least 18% of health care providers and 20% of adults reported mild or greater levels of psychological distress during the pandemic.

“Over the next few months, additional preventive measures may be needed to slow the spread of the virus in African countries,” said lead author and senior researcher Wafaie Fawzi, Richard Saltonstall professor of population sciences and professor of nutrition , epidemiology and global health. at Harvard Chan School. “Our findings highlight key areas that policy makers need to consider when designing interventions to reduce indirect risks to their populations.”

“These results indicate that the COVID-19 pandemic has had serious consequences for education, nutrition and food security in sub-Saharan Africa,” said Isabel Madzorera, senior author and postdoctoral researcher in the Department of Global Health and the people at Harvard. Chan School. “Interventions are needed to address the observed increases in food prices, the reduction in the quality and diversity of diets, and the educational opportunities lost, especially for poor and vulnerable households during this pandemic – and for prevent these challenges in future epidemics. ”

Elena Hemler, senior author and senior research project coordinator for the Nutrition and Global Health Program of the Department of Global and Population Health at Harvard Chan School, said: “These studies can inform and aid in the development of strategies. and evidence-based public policies. to mitigate the health, social and economic impacts of COVID-19 in these countries and beyond. ”

The ARISE network is planning a follow-up survey that will include additional sites in Ghana and Tanzania and questions regarding vaccines.

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Other Harvard Chan School authors included Till Bärnighausen, Phyllis Kanki, Michelle Korte, Josiemer Mattei, Dongqing Wang, and Tara Young. Other collaborating institutions involved in the first survey cycle include the Harvard Center for African Studies, Addis Continental Institute of Public Health (Ethiopia), Haramaya University (Ethiopia), Nouna Health Research Center (Burkina Faso), the University of Ouagadougou (Burkina Faso), and the University of Ibadan (Nigeria).

This work was supported by the Bill & Melinda Gates Foundation grant OPP1179606.

“Design and field methods of the COVID-19 rapid monitoring survey of the ARISE network”, Elena C. Hemler, Michelle L. Korte, Bruno Lankoande, Ourohiré Millogo, Nega Assefa, Angela Chukwu, Firehiwot Workneh, Amani Tinkasimile, Isaac Lyatuu, Abdramane Soura, Dongqing Wang, Isabel Madzorera, Said Vuai, Till Bärnighausen, Mary Mwanyika Sando, Japhet Killewo, Ayoade Oduola, Ali Sié, Yemane Berhane, Wafaie Fawzi, The American Journal of Tropical Medicine and Hygiene, online 23 June 2021.

“Reported Barriers to Health Care Access and Service Interruptions Caused by COVID-19 in Burkina Faso, Ethiopia and Nigeria: A Telephone Survey”, Nega Assefa, Ali Sié, Dongqing Wang, Michelle L. Korte, Elena C. Hemler, Yasir Y. Abdullahi, Bruno Lankoande, Ourohiré Millogo, Angela Chukwu, Firehiwot Workneh, Phyllis Kanki, Till Bärnighausen, Yemane Berhane, Wafaie Fawzi, Ayoade Oduola, The American Journal of Tropical Medicine and Hygiene, online 23 June 2021.

“COVID-19 Knowledge, Perception, Preventive Measures, Stigma and Mental Health Among Healthcare Workers in Three Sub-Saharan African Countries: A Telephone Survey”, Nega Assefa, Abdramane Soura, Elena C. Hemler, Michelle L. Korte, Dongqing Wang, Yasir Y. Abdullahi, Bruno Lankoande, Ourohiré Millogo, Angela Chukwu, Firehiwot Workneh, Ali Sié, Yemane Berhane, Till Bärnighausen, Ayoade Oduola, Wafaie Fawzi, The American Journal of Tropical Medicine and Hygiene, online 23 June 2021.

“Impact of COVID-19 on Nutrition, Food Security and Food Diversity and Quality in Burkina Faso, Ethiopia and Nigeria”, Isabel Madzorera, Abbas Ismail, Elena C. Hemler, Michelle L. Korte, Adedokun A. Olufemi, Dongqing Wang, Nega Assefa, Firehiwot Workneh, Bruno Lankoande, Ourohiré Millogo, Josiemer Mattei, Abdramane Soura, Yemane Berhane, Ali Sié, Ayoade Oduola, Wafaie Fawzi, The American Journal of Tropical Medicine and Hygiene, online 23 June 2021.

“The experience of the COVID-19 pandemic and adolescents in sub-Saharan Africa: a cross-national study using a telephone survey”, Dongqing Wang, Angela Chukwu, Ourohiré Millogo, Nega Assefa, Christabel James, Tara Young, Bruno Lankoande, Firehiwot Workneh, Elena C. Hemler, Michelle L. Korte, Josiemer Mattei, Abdramane Soura, Ali Sié, Ayoade Oduola, Yemane Berhane, Wafaie Fawzi, The American Journal of Tropical Medicine and Hygiene, online 23 June 2021.

“Knowledge and Practices Related to COVID-19 and Adult Mental Health in Sub-Saharan Africa”, Firehiwot Workneh, Dongqing Wang, Ourohiré Millogo, Alemayehu Worku, Angela Chukwu, Bruno Lankoande, Nega Assefa, Elena C. Hemler, Michelle L . Korte, Abdramane Soura, Ayoade Oduola, Ali Sié, Wafaie Fawzi, Yemane Berhane, The American Journal of Tropical Medicine and Hygiene, online 23 June 2021.

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The Harvard TH Chan School of Public Health brings together dedicated experts from many disciplines to educate new generations of global health leaders and produce powerful ideas that improve the lives and health of people everywhere. As a community of leading scientists, educators and students, we work together to bring innovative ideas from the lab to people’s lives – not only by making scientific breakthroughs, but also working to change individual behaviors, public policies and health care practices. Each year, more than 400 faculty members at Harvard Chan School teach more than 1,000 full-time students around the world and train thousands more through online courses and executive training. Founded in 1913 as the Harvard-MIT School of Health Officers, the school is recognized as the oldest public health professional training program in the United States.

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