Unintended consequences of implementing non-pharmaceutical interventions for the COVID-19 response in Africa: experiences from DRC, Nigeria, Senegal, and Uganda

Globalization and Health

Research

William Sambisa¹  Andrew Tusubira²  Steven Ndugwa Kabwama²  Rhoda K. Wanyenze³  Rawlance Ndejjo³  Susan Kizito³  Eniola A. Bamgboye⁴  Rotimi Felix Afolabi⁴  Mobolaji M. Salawu⁴  Magbagbeola David Dairo⁴  Olufunmilayo I. Fawole⁴  Segun Bello⁴  Ayo S. Adebowale⁴  Noel Namuhani⁵  Ziyada Babirye⁵  Suzanne N. Kiwanuka⁵  Manel Fall⁶  Thiané Gueye⁷  Youssoupha Ndiaye⁷  Mala Ali Mapatano⁸  Landry Egbende⁸  Marc Bosonkie⁸  Mamadou Makhtar Mbacké Leye⁹  Omar Bassoum⁹  Ndeye Mareme Sougou⁹  Ibrahima Seck⁹  Issakha Diallo^1,10 

[1] Bill and Melinda Gates Foundation, Seattle, USA;Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda;Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda;Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria;Department of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda;Epidemiology Department of Pasteur Institute of Dakar, Dakar, Senegal;Health Economics Unit of the Ministry of Health and Social Action, Dakar, Senegal;Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo;Preventive Medicine and Public Health Department within the Faculty of Medicine, Pharmacy and Dentistry, University Cheikh Anta Diop of Dakar, Dakar, Senegal;Public Health Department, Faculty of Health Sciences, University Amadou Hampaté Ba, Dakar, Senegal;

关键词: COVID-19;    Unintended Consequences;    NPI;    Stringency;    DRC;    Nigeria;    Senegal;    Uganda;   

DOI  :  10.1186/s12992-023-00937-6

 received in 2023-01-30, accepted in 2023-05-19,  发布年份 2023

来源: Springer

【 摘 要 】

IntroductionThe coronavirus (COVID 19) pandemic is one of the most terrifying disasters of the twenty-first century. The non-pharmaceutical interventions (NPIs) implemented to control the spread of the disease had numerous positive consequences. However, there were also unintended consequences—positively or negatively related to the nature of the interventions, the target, the level and duration of implementation. This article describes the unintended economic, Psychosocial and environmental consequences of NPIs in four African countries.MethodsWe conducted a mixed-methods study in the Democratic Republic of Congo (DRC), Nigeria, Senegal and Uganda. A comprehensive conceptual framework, supported by a clear theory of change was adopted to encompass both systemic and non-systemic interventions. The data collection approaches included: (i) review of literature; (ii) analysis of secondary data for selected indicators; and (ii) key informant interviews with policy makers, civil society, local leaders, and law enforcement staff. The results were synthesized around thematic areas.ResultsOver the first six to nine months of the pandemic, NPIs especially lockdowns, travel restrictions, curfews, school closures, and prohibition of mass gathering resulted into both positive and negative unintended consequences cutting across economic, psychological, and environmental platforms. DRC, Nigeria, and Uganda observed reduced crime rates and road traffic accidents, while Uganda also reported reduced air pollution. In addition, hygiene practices have improved through health promotion measures that have been promoted for the response to the pandemic. All countries experienced economic slowdown, job losses heavily impacting women and poor households, increased sexual and gender-based violence, teenage pregnancies, and early marriages, increased poor mental health conditions, increased waste generation with poor disposal, among others.ConclusionDespite achieving pandemic control, the stringent NPIs had several negative and few positive unintended consequences. Governments need to balance the negative and positive consequences of NPIs by anticipating and instituting measures that will support and protect vulnerable groups especially the poor, the elderly, women, and children. Noticeable efforts, including measures to avoid forced into marriage, increasing inequities, economic support to urban poor; those living with disabilities, migrant workers, and refugees, had been conducted to mitigate the negative effects of the NIPs.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

41116_2023_37_Article_IEq82.gif

41116_2023_37_Article_IEq80.gif

Fig. 3

41116_2023_37_Article_IEq74.gif

Fig. 2

41116_2023_37_Article_IEq64.gif

41116_2023_37_Article_IEq61.gif