Protective Behaviors and Secondary Harms Resulting From Nonpharmaceutical Interventions During the COVID-19 Epidemic in South Africa: Multisite, Prospective Longitudinal Study.
JMIR Public Health Surveill
; 7(5): e26073, 2021 05 13.
Article
in English
| MEDLINE | ID: covidwho-1249617
Preprint
This scientific journal article is probably based on a previously available preprint. It has been identified through a machine matching algorithm, human confirmation is still pending.
See preprint
This scientific journal article is probably based on a previously available preprint. It has been identified through a machine matching algorithm, human confirmation is still pending.
See preprint
ABSTRACT
BACKGROUND:
In March 2020, South Africa implemented strict nonpharmaceutical interventions (NPIs) to contain the spread of COVID-19. Over the subsequent 5 months, NPI policies were eased in stages according to a national strategy. COVID-19 spread throughout the country heterogeneously; the disease reached rural areas by July and case numbers peaked from July to August. A second COVID-19 wave began in late 2020. Data on the impact of NPI policies on social and economic well-being and access to health care are limited.OBJECTIVE:
We aimed to determine how rural residents in three South African provinces changed their behaviors during the first COVID-19 epidemic wave.METHODS:
The South African Population Research Infrastructure Network nodes in the Mpumalanga (Agincourt), KwaZulu-Natal, (Africa Health Research Institute) and Limpopo (Dikgale-Mamabolo-Mothiba) provinces conducted up to 14 rounds of longitudinal telephone surveys among randomly sampled households from rural and periurban surveillance populations every 2-3 weeks. Interviews included questions on the following topics COVID-19-related knowledge and behaviors, the health and economic impacts of NPIs, and mental health. We analyzed how responses varied based on NPI stringency and household sociodemographics.RESULTS:
In total, 5120 households completed 23,095 interviews between April and December 2020. Respondents' self-reported satisfaction with their COVID-19-related knowledge and face mask use rapidly rose to 85% and 95%, respectively, by August. As selected NPIs were eased, the amount of travel increased, economic losses were reduced, and the prevalence of anxiety and depression symptoms fell. When the number of COVID-19 cases spiked at one node in July, the amount of travel dropped rapidly and the rate of missed daily medications doubled. Households where more adults received government-funded old-age pensions reported concerns about economic matters and medication access less often.CONCLUSIONS:
South Africans complied with stringent, COVID-19-related NPIs despite the threat of substantial social, economic, and health repercussions. Government-supported social welfare programs appeared to buffer interruptions in income and health care access during local outbreaks. Epidemic control policies must be balanced against the broader well-being of people in resource-limited settings and designed with parallel support systems when such policies threaten peoples' income and access to basic services.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Public Policy
/
Health Behavior
/
Epidemics
/
COVID-19
/
Health Services Accessibility
/
Income
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Topics:
Long Covid
Limits:
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
Africa
Language:
English
Journal:
JMIR Public Health Surveill
Year:
2021
Document Type:
Article
Affiliation country:
26073
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