Impact of COVID-19 public health restrictions on older people in Uganda: "hunger is really one of those problems brought by this COVID".

OBJECTIVES: To explore the impact of COVID-19 public health restrictions on the lives of older adults living in Uganda. DESIGN: Qualitative semi-structured interview study. SETTING: Participants' homes. PARTICIPANTS: Older adults living in Uganda (aged 60+). MEASUREMENTS: Older adults in Uganda were interviewed over the phone and asked about their lives before and since COVID-19, and how public health restrictions have affected their lives. Semi-structured interviews were audio-recorded, transcribed and translated into English. Transcripts were thematically analyzed and themes generated in discussion. RESULTS: In total, 30 older adults participated in the study. Five themes were identified: (1) economic impacts; (2) lack of access to basic necessities; (3) impact on healthcare utilization; (4) social impacts and (5) violent reinforcement of public health restrictions. COVID-19 public health restrictions had severe impacts on their lives, with many people having not enough food to eat due to lack of income, and being unable to pay their grandchildren's school fees. Steep rises in public transport fares and an overall avoidance of transport also resulted in a lack of access to healthcare services and difficulty in getting food. Restrictions were violently reinforced by security guards. CONCLUSIONS: Public health restrictions have a severe impact not only on older adults but also on the whole family in Uganda. Governmental strategies to contain the virus need to provide more support to enable people to get basic necessities and live as normal a life as possible.

COVID-19 Public Health Restrictions and Older Adults' Well-being in Uganda: Psychological Impacts and Coping Mechanisms.

OBJECTIVES: Older adults across the globe have been particularly affected by the novel coronavirus due to their increased susceptibility to the virus. With limited existing research, the aim of this study was to explore the psychological effects of COVID-19 public health measures on older adults in Uganda and their coping mechanisms. METHODS: Thirty semi-structured interviews were conducted with older Ugandans (aged 60+) in June 2020. Participants were asked about their experiences of public health measures, and their effects on the lives of older adults compared to pre-pandemic. RESULTS: Three themes were identified: Impact on emotional well-being; Implications on physical well-being; and Coping mechanisms. Older adults experienced both psychological and physical effects, including upset, fear, and frustration about restrictions and the virus, as well as early signs of increased frailty, thus causing concerns for the long-term emotional and physical health of older Ugandans. CONCLUSIONS: Public health measures need to be considerate of the potential long-term implications on the well-being of older adults in low-, middle-, and high-income countries, and ensure the possibility for continued physical exercise and social connection. This can be particularly challenging for people from more disadvantaged backgrounds who may not be able to afford a smartphone or laptop, with older adults further requiring support in using digital technologies. CLINICAL IMPLICATIONS: Older adults need to receive adequate psychological support to cope with the mental health impacts of the pandemic.