Gendered economic, social and health effects of the COVID-19 pandemic and mitigation policies in Kenya: evidence from a prospective cohort survey in Nairobi informal settlements.
Gendered economic, social and health effects of the COVID-19 pandemic and mitigation policies in Kenya: evidence from a prospective cohort survey in Nairobi informal settlements.
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DOI：
10.1136/bmjopen-2020-042749
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发表时间：
2021-03-03
期刊：
影响因子：
2.9
通讯作者：
Ngo TD
中科院分区：
文献类型：
--
作者：
Pinchoff J;Austrian K;Rajshekhar N;Abuya T;Kangwana B;Ochako R;Tidwell JB;Mwanga D;Muluve E;Mbushi F;Nzioki M;Ngo TD
COVID-19可能会在人口密集的城市非正规住区迅速传播。肯尼亚迅速实施了缓解政策;我们评估了对妇女造成不成比例影响的经济、社会和健康相关伤害。2020年4月、5月和6月重复移动的电话调查的前瞻性纵向队列研究。2009家庭在内罗毕的五个非正规住区，从两个以前采访的队列抽样。其结果包括粮食不安全、家庭暴力的风险以及由于这一流行病而放弃必要的保健服务。构建了性别分层线性概率回归模型，以确定与这些结果相关的因素。到5月，更多的女性比男性报告了COVID-19缓解政策对他们生活的不利影响。与男性相比，女性不吃饭的可能性高出6个百分点（系数：0.055; 95% CI 0.016至0.094），而那些完全失去收入的人不吃饭的可能性比那些有工作的人高出15个百分点（系数：0.154; 95% CI 0.125至0.184）。与男子相比，妇女报告家庭暴力风险增加的可能性高8个百分点（系数：0.079; 95% CI 0.028至0.130），放弃必要医疗保健的可能性高6个百分点（系数：0.056; 95% CI 0.037至0.076）。这一流行病对妇女的生活产生了迅速和不成比例的影响。随着肯尼亚重新开放，政策制定者必须部署援助，以确保城市非正规住区的妇女能够重返工作岗位，并获得所需的医疗保健和服务，以免失去迄今为止在性别平等方面取得的进展。
COVID-19 may spread rapidly in densely populated urban informal settlements. Kenya swiftly implemented mitigation policies; we assess the economic, social and health-related harm disproportionately impacting women. A prospective longitudinal cohort study with repeated mobile phone surveys in April, May and June 2020. 2009 households across five informal settlements in Nairobi, sampled from two previously interviewed cohorts. Outcomes include food insecurity, risk of household violence and forgoing necessary health services due to the pandemic. Gender-stratified linear probability regression models were constructed to determine the factors associated with these outcomes. By May, more women than men reported adverse effects of COVID-19 mitigation policies on their lives. Women were 6 percentage points more likely to skip a meal versus men (coefficient: 0.055; 95% CI 0.016 to 0.094), and those who had completely lost their income were 15 percentage points more likely versus those employed (coefficient: 0.154; 95% CI 0.125 to 0.184) to skip a meal. Compared with men, women were 8 percentage points more likely to report increased risk of household violence (coefficient: 0.079; 95% CI 0.028 to 0.130) and 6 percentage points more likely to forgo necessary healthcare (coefficient: 0.056; 95% CI 0.037 to 0.076). The pandemic rapidly and disproportionately impacted the lives of women. As Kenya reopens, policymakers must deploy assistance to ensure women in urban informal settlements are able to return to work, and get healthcare and services they need to not lose progress on gender equity made to date.
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