ABSTRACT
To respond to the unintended consequences of prevention measures to reduce COVID-19 transmission, individuals and groups, including religious leaders, have collaborated to provide care to those negatively impacted by these measures. Amid these various efforts and interventions, there is a need to deepen our understanding of diverse expressions of care across various geographical and social contexts. To address this need, the objective of this study was to investigate how religious leaders in the Philippines practiced care for their communities by meeting emergency food needs amid the COVID-19 pandemic. Guided by an ethics of care theoretical orientation, we conducted 25 remote semi-structured interviews with Filipino religious leaders who partnered with a Philippines-based non-governmental organization (NGO) to mobilize essential food aid to their local communities. Through defining the efforts and activities of these religious leaders as care work, we found that religious leader experiences revolved around navigating care responsibilities, caring alongside others, and engaging holistically with the care work. Additionally, we observed how contextual factors such as the humanitarian settings where religious leaders worked, the partnership with an NGO, and the positionality of local religious leaders within their communities, fundamentally shaped the care work. This study expands our understanding of how care is practiced and experienced and also brings greater visibility to the experiences and efforts of local religious leaders in responding to humanitarian emergencies.
ABSTRACT
BACKGROUND: The presence of COVID-19 in low- and middle-income countries (LMICs) is raising important concerns about effective pandemic response and preparedness in the context of fragile health systems and the pervasiveness of misinformation. The objective of this study was to gain an understanding of how COVID-19 was perceived by households experiencing extreme poverty in the Philippines. METHODS: This study was conducted in partnership with International Care Ministries (ICM), a Philippine-based non-governmental organization (NGO) that runs a poverty-alleviation program called Transform targeted towards extreme low-income households. We integrated knowledge, attitudes, and practices (KAP) questions into ICM's cross-sectional program monitoring and evaluation systems from February 20 through March 13, 2020. Frequencies and proportions were calculated to describe the respondents' responses, and the Kruskal-Wallis test and binomial logistic regression were undertaken to determine the socio-demographic characteristics associated with COVID-19 KAPs. RESULTS: In total, 2224 respondents from 166 communities in rural, urban and coastal settings were surveyed. Although the survey was administered during the earlier stages of the pandemic, 94.0% of respondents had already heard of COVID-19. Traditional media sources such as television (85.5%) and radio (56.1%) were reported as the main sources of information about the virus. Coughing and sneezing were identified as a transmission route by 89.5% of respondents, while indirect hand contact was the least commonly identified transmission route, recognized by 72.6% of respondents. Handwashing was identified by 82.2% of respondents as a preventive measure against the virus, but social distancing and avoiding crowds were only identified by 32.4% and 40.6%, respectively. Handwashing was the most common preventive practice in response to COVID-19, adopted by 89.9% of respondents. A greater number of preventive measures were taken by those with more knowledge of potential transmission routes. CONCLUSIONS: There is a need for targeted health education as a response strategy to COVID-19 in low-income settings, and it is important that strategies are contextually relevant. Understanding KAPs among populations experiencing extreme poverty will be important as tailored guidance for public health response and communication strategies are developed for LMICs.