Effect of COVID-19 on Household Food Insecurity and Poverty: Evidence from Ghana

Can health financing programmes reduce food insecurity in a developing country?

Despite the devastating effects of out-of-pocket healthcare expenditures on households' financial outlays, which potentially stifle household resources needed for food consumption, the health financing program-food insecurity nexus is yet to receive much needed attention in the literature. This study makes a significant contribution by investigating the effect of health financing program, conceptualised as membership of a National Health Insurance Scheme, on household food insecurity using the food insecurity experience scale (FIES) and several quasi-experimental methods. Using data from the seventh round of the Ghana Living Standards Survey, our endogeneity-corrected results indicate that membership of a health financing program can contribute to reduction in household food insecurity. The results are robust to alternative conceptualisations of food insecurity and different quasi-experimental methods. The effect of health financing programme membership on food insecurity is more pronounced among urban and female-headed households. Our findings further point to household savings as an important channel through which membership of health financing program reduces food insecurity.

Household food insecurity, low maternal social support and maternal common mental disorders in East Mamprusi Municipality, Ghana

INTRODUCTION

Both household food insecurity and maternal common mental disorders are public health concerns in Ghana but studies on them, and their interrelatedness are scarce. Social support is an independent determinant of mental health but can also moderate the link between risk factors and mental illness. Identifying the risk factors of mental illness may provide opportunities for intervention and help reduce disease burden and impact. This study examined the association between household food insecurity or low maternal social support and maternal common mental disorders in East Mamprusi Municipality, Ghana.

METHODS

This was a community-based, cross-sectional study involving 400 mothers with children 6-23 months selected using multi-stage sampling. Summary scores for household food insecurity, maternal social support, and maternal common mental disorders were measured using Food Insecurity Experience Scale (FIES), Medical Outcome Study Social Support Scale (SSS), and WHO Self-Reporting Questionnaire 20 items (SRQ-20) respectively in personal interviews. Poisson regression models were fitted to determine the association of household food insecurity or low maternal social support with maternal common mental disorders, controlling for selected socio-demographic variables.

RESULTS

The mean age of the participants was 26.7 (± 6.68) years, and the mean FIES, SSS, and SRQ-20 scores were 5.62 [95% Confidence Interval (CI): 5.29-5.96] out of 8, 43.12 (95% CI: 41.34-44.90) out of 100, and 7.91 (95% CI: 7.38-8.45) out of 19 respectively. About two-thirds of the households (71.9%), and 72.7% and 49.5% of the women had food insecurity, low social support and probable common mental disorder respectively. In the adjusted analyses, a unit increase in FIES score was associated to a 4% increment in the predicted SRQ-20 score [Incident Risk Ratio (IRR) 1.04; 95% Confidence Interval (CI): 1.02, 1.06; p = 0.001], and the predicted SRQ-20 score of the women belonging to low social support category was 38% higher compared to that of women of high social support category (IRR 1.38; 95% CI: 1.14, 1.66; p = 0.001).

CONCLUSION

The prevalence of household food insecurity and common mental disorders among mothers are high, and both household food insecurity and low social support are significantly related to common mental disorders in women. Interventions to reduce both household food insecurity, and common mental disorders in women are warranted, and should include social support for women.

Perceptions about COVID-19 preventive measures among Ghanaian women

Though the advent of COVID-19 vaccines has significantly reduced severe morbidity and mortality, infection rates continue to rise. Therefore, adhering to COVID-19 preventive measures remains essential in the fight against the pandemic, particularly in Africa, where vaccination rates remain low. However, the perceived risk associated with COVID-19 and public education and awareness campaigns has waned over time. COVID-19 vaccine hesitancy is consistently high among women globally. This study, therefore, assessed the facilitators, and barriers to adherence to COVID-19 preventive measures. A qualitative descriptive study was conducted among Ghanaian women. Twenty-seven in-depth interviews were conducted with women in the Greater Accra and Ashanti regions. All interviews were audio-recorded and transcribed verbatim into English. The data were analysed using NVivo 10 software. While some participants found the use of face masks as the easiest, others found it as the most difficult. In addition, institutional and policy decisions such as access to water and the use of public transport impacted individual level adherence to preventive measures. In conclusion, the fight against COVID-19 is not over; hence public education and the provision of facilities that would enhance compliance with preventive measures should continue to be prioritised.

Household living conditions and food insecurity in Nigeria: a longitudinal study during COVID-19 pandemic

OBJECTIVE

This study set out to investigate the risk of household food insecurity in Nigeria during the novel COVID-19 pandemic using a harmonised dataset of Nigeria's prepandemic face-to-face survey and two waves of the COVID-19 National Longitudinal Phone Survey (NLPS).

SETTING

Nigeria.

PARTICIPANTS

A representative sample of 1674 households is used in the analysis.

DESIGN

A longitudinal study.

RESULTS

Our longitudinal study reveals a significant increase in the prevalence of food insecurity in Nigeria during the COVID-19 crisis. For a sample of 1674 households used in the analysis, nearly 32% were moderately food insecure in the baseline survey (ie, the prepandemic period), compared with 74% and 72% that faced the same degree of food insecurity in the two waves of the COVID-19 phone survey. In like manner, not up to 4% of the households faced severe food insecurity in the prepandemic period, compared with 43% and 22% that experienced the same level of food insecurity during the period of the pandemic. Based on the available information in the dataset, we construct a composite non-monetary measure (or index) of household well-being and employ the binary logistic model to investigate the objects under study. The empirical results show that the well-being index has a strong negative association with household food insecurity. Further investigation reveals that the risk of being food insecure increases for households in relatively poor living conditions compared with those in the middle category and conversely declines for households in much better living conditions.

CONCLUSION

This study informs an understanding of the prevalence and risk of household food insecurity in Nigeria during the novel COVID-19 pandemic and provides insights that can guide policy actions in responding to the current wave of food crises in Nigeria.

'We were not allowed to gather even for Christmas.' Impact of COVID-19 on South African young people: Exploring messaging and support

COVID-19 prevention measures including lockdowns, school closures, and restricted movement disrupted young people's lives. This longitudinal qualitative study conducted in Soweto, South Africa aimed to explore young people's knowledge and perceptions of COVID-19, vaccination, and the impact of infections. A convenience sample of 30 young black people (n = 15 men; n = 15 women, aged 16-21 years) from Soweto participated in 24 focus group discussions (FGDs), conducted in six phases - each phase had four FGDs stratified by gender and age. Young people's understanding of COVID-19 deepened throughout the study, however, did not always translate into adherence (following the government's COVID-19 prevention measures). Although deemed inadequate, TV and radio were preferred over internet COVID-19 information. Parents, teachers, and schools were trusted sources of information. Vaccines and limited access to information attributed to low-risk perception, while new COVID-19 variants attributed to high-risk perception. A low-risk perception and conspiracy theories contributed to non-adherence (disregarding COVID-19 preventative measures provided by the government), particularly among young men. Accessing reliable information that considers young people's lives and their living context is important. Communities, scientists, and policymakers must learn from the COVID-19 experience and implement localised preventive strategies for education, awareness, and economic support in future emergencies.

Effects of the COVID-19 Pandemic on Health Behaviors of Higher Education Students in Ghana: A Cross-Sectional Study

Stressful events can significantly impact health behaviors of tertiary students in various ways. Many studies reported adverse alterations in health behaviors during the COVID-19 pandemic. However, there is limited knowledge about students from sub-Saharan African countries. Therefore, this study aimed to assess effects of the COVID-19 pandemic on the health behaviors of Ghanaian tertiary students, with an emphasis on the association between sleep and other health behaviors. A cross-sectional study with eligible tertiary students from the Kwame Nkrumah University of Science and Technology in Ghana (n = 129) was conducted. An online survey assessed quality and duration of sleep, financial stress, dietary risk, alcohol misuse, and physical exercise using validated tools. Health behaviors did not differ by gender. The COVID-19 pandemic negatively affected health behaviors for many students including dietary intake (20.2%), sleep quality (20.2%) and duration (81.4%), alcohol consumption (3.1%), exercise frequency (4.1%), and exercise intensity (38%). Shorter sleep duration was linked with greater alcohol misuse scores (p < 0.05). A majority of the students (56%) had increased financial stress during the pandemic. This study contributes important insights into the effects that stressful events such as a pandemic have on the health of higher education students in sub-Saharan Africa.

Epidemiology of suicidal behaviors among junior and senior high school adolescents: Exploring the interactions between bullying victimization, substance use, and physical inactivity

Suicide is a pandemic among global youths and adolescents. Still, there is insufficient evidence to show whether the interactions between bullying victimization, physical inactivity, substance use, and mental health illness aggravate suicidal behaviors among high school students. Based on the Global School-Based Student Health Survey, we analyzed the individual and interaction impacts of bullying victimization, physical inactivity, substance use, and suicidal behaviors among 3,632 adolescents. The 12-month prevalence of suicidal thoughts and plans among senior high school students was over fifty percent. Junior high school students had higher rates of suicide attempts and bullying victimization than senior high school students. Multivariate results indicate that bullying victimization, substance use, and physical inactivity were significantly associated with suicidal thoughts, plans, and attempts among high school students. The interaction of physical inactivity and alcohol was significantly associated with suicidal thoughts in junior high school. In contrast, the interaction of bullying and alcohol was associated with suicidal plans among senior high school adolescents. We hope the findings from this study will generate interventions toward reducing the suicide epidemic in Ghana.

Surviving in Crisis Mode: The Effect of Material Hardship and Social Support on Emotional Wellbeing Among People in Poverty During COVID-19

The COVID-19 pandemic triggered a sudden economic crisis that led to increases in hardship and poverty. Motivated by the concern that people living in long-term poverty have few reserves to draw upon in times of crisis and may experience severe consequences, this study focuses on the association between material hardship and emotional wellbeing among people in poverty. The data were collected in two waves of telephone surveys during the pandemic (n = 88). Participants for the study were recruited through social service departments in six cities in Northern Israel. The findings show that COVID-19 increased material hardship, and that material hardship has detrimental effects on the four measures of emotional wellbeing selected (stress, anxiety, depression, and physical symptoms). Informal social support has positive effects on emotional wellbeing but it does not counter the negative effects of material hardship. Policy implications are discussed.

Does poverty increase COVID-19 in Africa? A cross-country analysis

BACKGROUND

Most economies in African countries are informal. As such, households in these countries tend to face higher levels of informality coupled with a lack of social protection, and have no replacement income or savings in the event of unexpected external shocks, such as COVID-19. Thus, the COVID-19 shock and its negative economic effects triggered a cascade of income losses and bankruptcies that pushed a significant share of households in African countries into poverty. This research analyzes the effect of poverty on the spread of COVID-19 using a sample of 52 African countries.

METHODS

To achieve the objective of this research, this paper uses a multiple linear regression model and a sample of 52 African countries observed in 2020 to conduct a cross-country analysis. More importantly, two COVID-19 indicators (total number of officially reported cases and disease severity) and six poverty indicators (average poverty, poverty incidence, poverty depth, poverty severity, multidimensional poverty index, and extreme poverty) were used in this research.

RESULTS

The results show a positive and significant relationship between poverty and the spread of COVID-19.

CONCLUSIONS

These results suggest that more attention needs to be paid to poor populations in African countries during the pandemic. These populations are generally vulnerable, and there is a need for support programs targeting them to be put in place quickly. These programs may include food aid, distribution of supplies, health care support, fee waivers, and interest deferrals. In addition, sensitization of these disadvantaged groups on vaccination against COVID-19 to achieve herd immunity is strongly encouraged.

Understanding the Food Insecurity and Coping Strategies of Indigenous Households during COVID-19 Crisis in Chittagong Hill Tracts, Bangladesh: A Qualitative Study

This study examined the food insecurity and coping mechanisms among the indigenous Bangladeshi population of the Chittagong Hill Tracts (CHT) region to extract empirical evidence on the ongoing discussion on the COVID-19 pandemic-exacerbated food-insecurity situation. The study adopted a qualitative approach by interviewing 60 indigenous households. Data were collected in two phases between 15 June 2020, and 30 July 2021 in Bangladesh's Chittagong Hill Tracts (CHT) region. Thematic data analyses were performed using the Granheim approach and NVivo-12 software. The authors used Huston's social-ecological theory to explain the indigenous coping mechanisms. The research evidence revealed that most households experienced challenges over daily foods, manifesting in the decreasing consumption of them, the increased price of food items, a food crisis due to an income shock, malnutrition, the shifting to unhealthy food consumption, starvation and hunger, and food insufficiency, thereby leading to mental stress. This study further revealed that the indigenous population took crucial coping strategies to survive the pandemic. In response to COVID-19, they took loans and borrowed foods, reduced expenses, changed their food habits, avoided nutritional foods, relied on vegetables, sold domestic animals and properties, collected forest and hill foods, and depended on governmental and societal relief. This study also provides the in-depth policy actions for the urgent intervention of government, stakeholders, policymakers, NGOs, and development practitioners to take necessary initiatives to enhance the quality of life of the people that were affected by the post-pandemic recovery period.

A Qualitative Study Exploring Management of Food Intake in the United Kingdom During the Coronavirus Pandemic

The coronavirus pandemic has impacted dietary quality through increased emotional eating and extended time spent at home, as well as instances of panic buying due to uncertainty over food availability. We recruited an opportunistic sample of 40 adults living in the United Kingdom (Female = 25; Mean age = 41.9 years) (SD = 14.4) without any prior history of eating disorders. Semi-structured interviews were conducted in June 2020 and focused on the impacts of the COVID-19 lockdown on eating habits and experiences of panic buying. The data were transcribed and organized using the softwares Otter and Quirkos, respectively. Reflexive thematic analysis identified positive and negative changes to eating habits. Overall, themes highlighted that effective organization was vital to manage food purchases and consumption due to a reduced shopping frequency. However, overconsumption frequently occurred due to boredom and ease of accessing energy dense foods, which had negative implications for weight and body image. After indulging, participants attempted to revert to prior eating habits and adhere to a nutritious diet. Many also expressed the importance of having enough food to feed families, which was often reported as a reason for buying extra supplies. Understanding the long-term impacts of changes to eating habits that account for the novel coronavirus context is required to preserve health and prevent unintended changes to weight.

Factors that most expose countries to COVID-19: a composite indicators-based approach

Studies carried out in different countries correlate social, economic, environmental, and health factors with the number of cases and deaths from COVID-19. However, such studies do not reveal which factors make one country more exposed to COVID-19 than other. Based on the composite indicators approach, this research identifies the factors that most impact the number of cases and deaths of COVID-19 worldwide and measures countries' exposure to COVID-19. Three composite indicators of exposure to COVID-19 were constructed through Principal Component Analysis, Simple Additive Weighting, and k-means clustering. The number of cases and deaths from COVID-19 is strongly correlated ( R  > 0.60) with composite indicator scores and moderately concordant ( K  > 0.4) with country clusters. Factors directly or indirectly associated with the age of the population are the ones that most expose countries to COVID-19. The population of countries most exposed to COVID-19 is 12 years older on average. The proportion of the elderly population in these countries is at least twice that of countries less exposed to COVID-19. Factors that can increase the population's life expectancy, such as Gross Domestic Product per capita and the Human Development Index, are four times and 1.3 times higher in more exposed countries to COVID-19. Providing better living conditions increases both the population's life expectancy and the country's exposure to COVID-19.