Skip to main content
Top
Published in: BMC Public Health 1/2022

Open Access 01-12-2022 | COVID-19 | Research

Unintended socio-economic and health consequences of COVID-19 among slum dwellers in Kampala, Uganda

Authors: Rebecca Nuwematsiko, Maxencia Nabiryo, John Bosco Bomboka, Sarah Nalinya, David Musoke, Daniel Okello, Rhoda K. Wanyenze

Published in: BMC Public Health | Issue 1/2022

Login to get access

Abstract

Background

To reduce the spread of COVID-19, several countries in Africa instituted countrywide lockdowns and other public health measures. Whereas lockdowns contributed to the control of the pandemic, there were concerns about the unintended consequences of these measures especially in the most vulnerable populations. We assessed unintended socio-economic and health consequences due to the COVID-19 pandemic and the mitigation measures among slum dwellers in Kampala to inform the on-going and future pandemic response strategies.

Methods

This was a mixed methods cross-sectional study conducted in Bwaise I and Bwaise III slums of Kawempe division, Kampala Uganda from October to December 2020. We used systematic sampling to randomly select 425 household heads for the face-to-face quantitative interviews. We also conducted six focus group discussions (FGDs) with slum dwellers and used photovoice among eight Community Health Workers (CHWs) to document unintended socio-economic and health consequences. Quantitative data were imported into STATA version 14.0 for analysis, while qualitative data were analysed thematically using NVivo version 12. Modified Poisson regression analysis was conducted to establish factors associated with impact on access to food.

Results

Most respondents reported limited access to food (71.1%; 302/425); disruption in education (77.1%; 270/350); drop in daily income and wages (86.1%; 329/382) and loss of employment (63.1; 125/198). Twenty five percent of the respondents (25.4%; 86/338) reported domestic violence as one of the challenges. Seven themes emerged from the qualitative findings on the impact of COVID-19 including: limited access to food; negative impact on children’s rights (child labour and teenage pregnancies) and education; poor housing and lack of accommodation; negative social behaviours; negative impact on family and child care; reduced income and employment; and negative impact on health and access to health care services.

Conclusion

The slum dwellers of Bwaise I and Bwaise III experienced several negative socio-economic and health consequences of COVID-19 and its prevention measures that severely affected their wellbeing. Children experienced severe consequences such as child labour and teenage pregnancies among the girls. Response activities should be contextualised to different settings and protocols to protect the vulnerable groups in the community such as children and women should be developed and mainstreamed in response activities.
Literature
1.
go back to reference WHO. WHO announces COVID-19 outbreak a pandemic 2020 [updated 2020-03-12]. WHO. WHO announces COVID-19 outbreak a pandemic 2020 [updated 2020-03-12].
4.
go back to reference WHO. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). Geneva: WHO; 2020. WHO. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). Geneva: WHO; 2020.
6.
7.
go back to reference Willan J, King AJ, Djebbari F, Turner GD, Royston DJ, Pavord S, et al. Assessing the impact of lockdown: fresh challenges for the Care of Haematology Patients in the COVID-19 pandemic. Br J Haematol. 2020;189:e224–7.PubMed Willan J, King AJ, Djebbari F, Turner GD, Royston DJ, Pavord S, et al. Assessing the impact of lockdown: fresh challenges for the Care of Haematology Patients in the COVID-19 pandemic. Br J Haematol. 2020;189:e224–7.PubMed
8.
go back to reference UNICEF. The socio-economic impact of COVID-19 in Uganda. Kampala: UNICEF; 2020. UNICEF. The socio-economic impact of COVID-19 in Uganda. Kampala: UNICEF; 2020.
10.
go back to reference Baral SD, Mishra S, Diouf D, Phanuphak N, Dowdy D. The public health response to COVID-19: balancing precaution and unintended consequences. Ann Epidemiol. 2020;46:12–3.PubMedPubMedCentralCrossRef Baral SD, Mishra S, Diouf D, Phanuphak N, Dowdy D. The public health response to COVID-19: balancing precaution and unintended consequences. Ann Epidemiol. 2020;46:12–3.PubMedPubMedCentralCrossRef
12.
go back to reference Oliver K, Lorenc T, Tinkler J, Bonell C. Understanding the unintended consequences of public health policies: the views of policymakers and evaluators. BMC Public Health. 2019;19(1):1–9.CrossRef Oliver K, Lorenc T, Tinkler J, Bonell C. Understanding the unintended consequences of public health policies: the views of policymakers and evaluators. BMC Public Health. 2019;19(1):1–9.CrossRef
13.
go back to reference Petross C, McMahon S, Lohmann J, Chase RP, Muula AS, De Allegri M. Intended and unintended effects: community perspectives on a performance-based financing programme in Malawi. BMJ Glob Health. 2020;5(4):e001894.PubMedPubMedCentralCrossRef Petross C, McMahon S, Lohmann J, Chase RP, Muula AS, De Allegri M. Intended and unintended effects: community perspectives on a performance-based financing programme in Malawi. BMJ Glob Health. 2020;5(4):e001894.PubMedPubMedCentralCrossRef
14.
go back to reference Bamweyana I, Okello DA, Ssengendo R, Mazimwe A, Ojirot P, Mubiru F, et al. Socio-economic vulnerability to COVID-19: the spatial case of greater Kampala metropolitan area (GKMA). J Geogr Inf Syst. 2020;12(04):302. Bamweyana I, Okello DA, Ssengendo R, Mazimwe A, Ojirot P, Mubiru F, et al. Socio-economic vulnerability to COVID-19: the spatial case of greater Kampala metropolitan area (GKMA). J Geogr Inf Syst. 2020;12(04):302.
15.
go back to reference Bukuluki P, Mwenyango H, Katongole SP, Sidhva D, Palattiyil G. The socio-economic and psychosocial impact of Covid-19 pandemic on urban refugees in Uganda. Soc Sci Human Open. 2020;2(1):100045. Bukuluki P, Mwenyango H, Katongole SP, Sidhva D, Palattiyil G. The socio-economic and psychosocial impact of Covid-19 pandemic on urban refugees in Uganda. Soc Sci Human Open. 2020;2(1):100045.
16.
go back to reference UN-HABITAT. Situation analysis of informal settlements in Kampala. Nairobi: United Nations Human Settlements Programme; 2007. UN-HABITAT. Situation analysis of informal settlements in Kampala. Nairobi: United Nations Human Settlements Programme; 2007.
17.
go back to reference Stewart-Wilson G, Sewankambo N, Muwanga N, Kasimbazi E, Musuya T, Droruga N, et al. Owning Our Urban Future: The Case of Kampala City: A Consensus Study Report of the Committee on Urbanization in Uganda. Uganda National Academy of Sciences Consensus Study Report. Kampala: Uganda National Academy of Sciences; 2017. Stewart-Wilson G, Sewankambo N, Muwanga N, Kasimbazi E, Musuya T, Droruga N, et al. Owning Our Urban Future: The Case of Kampala City: A Consensus Study Report of the Committee on Urbanization in Uganda. Uganda National Academy of Sciences Consensus Study Report. Kampala: Uganda National Academy of Sciences; 2017.
18.
19.
go back to reference Wang C, Burris MA. Photovoice: concept, methodology, and use for participatory needs assessment. Health Educ Behav. 1997;24(3):369–87.PubMedCrossRef Wang C, Burris MA. Photovoice: concept, methodology, and use for participatory needs assessment. Health Educ Behav. 1997;24(3):369–87.PubMedCrossRef
20.
go back to reference Sutton-Brown CA. Photovoice: A methodological guide. Photogr Cult. 2014;7(2):169–85.CrossRef Sutton-Brown CA. Photovoice: A methodological guide. Photogr Cult. 2014;7(2):169–85.CrossRef
21.
go back to reference Lavanya N, Malarvizhi T. Risk analysis and management: a vital key to effective project management. Australia: Project Management Institute; 2008. Lavanya N, Malarvizhi T. Risk analysis and management: a vital key to effective project management. Australia: Project Management Institute; 2008.
22.
go back to reference Musoke D, Ssemugabo C, Ndejjo R, Molyneux S, Ekirapa-Kiracho E. Ethical practice in my work: community health workers’ perspectives using photovoice in Wakiso district, Uganda. BMC Med Ethics. 2020;21(1):1–10.CrossRef Musoke D, Ssemugabo C, Ndejjo R, Molyneux S, Ekirapa-Kiracho E. Ethical practice in my work: community health workers’ perspectives using photovoice in Wakiso district, Uganda. BMC Med Ethics. 2020;21(1):1–10.CrossRef
23.
go back to reference Blair J, Conrad FG. Sample size for cognitive interview pretesting. Public Opin Q. 2011;75(4):636–58.CrossRef Blair J, Conrad FG. Sample size for cognitive interview pretesting. Public Opin Q. 2011;75(4):636–58.CrossRef
24.
go back to reference Perneger TV, Courvoisier DS, Hudelson PM, Gayet-Ageron A. Sample size for pre-tests of questionnaires. Qual Life Res. 2015;24(1):147–51.PubMedCrossRef Perneger TV, Courvoisier DS, Hudelson PM, Gayet-Ageron A. Sample size for pre-tests of questionnaires. Qual Life Res. 2015;24(1):147–51.PubMedCrossRef
25.
go back to reference Tamhane AR, Westfall AO, Burkholder GA, Cutter GR. Prevalence odds ratio versus prevalence ratio: choice comes with consequences. Stat Med. 2016;35(30):5730–5.PubMedPubMedCentralCrossRef Tamhane AR, Westfall AO, Burkholder GA, Cutter GR. Prevalence odds ratio versus prevalence ratio: choice comes with consequences. Stat Med. 2016;35(30):5730–5.PubMedPubMedCentralCrossRef
26.
go back to reference Corburn J, Vlahov D, Mberu B, Riley L, Caiaffa WT, Rashid SF, et al. Slum health: arresting COVID-19 and improving well-being in urban informal settlements. J Urban Health. 2020;97(3):348–57.PubMedPubMedCentralCrossRef Corburn J, Vlahov D, Mberu B, Riley L, Caiaffa WT, Rashid SF, et al. Slum health: arresting COVID-19 and improving well-being in urban informal settlements. J Urban Health. 2020;97(3):348–57.PubMedPubMedCentralCrossRef
27.
go back to reference Richmond A, Myers I, Namuli H. Urban informality and vulnerability: a case study in Kampala, Uganda. Urban Sci. 2018;2(1):22.CrossRef Richmond A, Myers I, Namuli H. Urban informality and vulnerability: a case study in Kampala, Uganda. Urban Sci. 2018;2(1):22.CrossRef
28.
go back to reference Kansiime MK, Tambo JA, Mugambi I, Bundi M, Kara A, Owuor C. COVID-19 implications on household income and food security in Kenya and Uganda: findings from a rapid assessment. World Dev. 2021;137:105199.PubMedCrossRef Kansiime MK, Tambo JA, Mugambi I, Bundi M, Kara A, Owuor C. COVID-19 implications on household income and food security in Kenya and Uganda: findings from a rapid assessment. World Dev. 2021;137:105199.PubMedCrossRef
29.
go back to reference Aday S, Aday MS. Impact of COVID-19 on the food supply chain. Food Qual Saf. 2020;4(4):167–80.CrossRef Aday S, Aday MS. Impact of COVID-19 on the food supply chain. Food Qual Saf. 2020;4(4):167–80.CrossRef
30.
go back to reference Gundersen C, Ziliak JP. Food insecurity and health outcomes. Health Aff. 2015;34(11):1830–9.CrossRef Gundersen C, Ziliak JP. Food insecurity and health outcomes. Health Aff. 2015;34(11):1830–9.CrossRef
32.
go back to reference Ruzibiza Y. ‘They are a shame to the community…‘stigma, school attendance, solitude and resilience among pregnant teenagers and teenage mothers in Mahama refugee camp, Rwanda. Global Public Health. 2021;16(5):763–74.PubMedCrossRef Ruzibiza Y. ‘They are a shame to the community…‘stigma, school attendance, solitude and resilience among pregnant teenagers and teenage mothers in Mahama refugee camp, Rwanda. Global Public Health. 2021;16(5):763–74.PubMedCrossRef
33.
go back to reference Gyan SE. Passing as “Normal”: adolescent girls’ strategies for escaping stigma of premarital sex and childbearing in Ghana. SAGE Open. 2018;8(3):2158244018801421.CrossRef Gyan SE. Passing as “Normal”: adolescent girls’ strategies for escaping stigma of premarital sex and childbearing in Ghana. SAGE Open. 2018;8(3):2158244018801421.CrossRef
35.
go back to reference Apondi R, Awor A, Nelson L, Cheptoris J, Ngabirano F, Egbulem CD, et al. Gender-based violence shadows COVID-19: increased sexual violence, HIV exposure and teen pregnancy among girls and women in Uganda [conference abstract]. J Int AIDS Soc. 2021;24(S4):53–5. Apondi R, Awor A, Nelson L, Cheptoris J, Ngabirano F, Egbulem CD, et al. Gender-based violence shadows COVID-19: increased sexual violence, HIV exposure and teen pregnancy among girls and women in Uganda [conference abstract]. J Int AIDS Soc. 2021;24(S4):53–5.
36.
go back to reference Denney L, Gordon R, Ibrahim A. Teenage pregnancy after Ebola in Sierra Leone. London: Overseas Development Institute; 2015. Denney L, Gordon R, Ibrahim A. Teenage pregnancy after Ebola in Sierra Leone. London: Overseas Development Institute; 2015.
37.
go back to reference Onyango MA, Resnick K, Davis A, Shah RR. Gender-based violence among adolescent girls and young women: a neglected consequence of the west African Ebola outbreak. Pregnant in the Time of Ebola. Switzerland: Springer; 2019. p. 121–32. Onyango MA, Resnick K, Davis A, Shah RR. Gender-based violence among adolescent girls and young women: a neglected consequence of the west African Ebola outbreak. Pregnant in the Time of Ebola. Switzerland: Springer; 2019. p. 121–32.
38.
go back to reference WHO. Coronavirus Disease (COVID-19) - events as they happen 2020 WHO. Coronavirus Disease (COVID-19) - events as they happen 2020
39.
go back to reference UNDP. Socio-economic impact of COVID-19 in Uganda: short-, medium-, and long-term impacts on poverty dynamics and SDGs using scenario anlaysis and system dynamics modeling: UNDP; 2020. UNDP. Socio-economic impact of COVID-19 in Uganda: short-, medium-, and long-term impacts on poverty dynamics and SDGs using scenario anlaysis and system dynamics modeling: UNDP; 2020.
40.
go back to reference UN. Everyone Included: Social Impact of COVID-19 | DISD 2020. UN. Everyone Included: Social Impact of COVID-19 | DISD 2020.
41.
go back to reference Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506.PubMedPubMedCentralCrossRef Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506.PubMedPubMedCentralCrossRef
42.
go back to reference Nicola M, Alsafi Z, Sohrabi C, Kerwan A, Al-Jabir A, Iosifidis C, et al. The socio-economic implications of the coronavirus pandemic (COVID-19): a review. Int J Surg. 2020;78:185.PubMedPubMedCentralCrossRef Nicola M, Alsafi Z, Sohrabi C, Kerwan A, Al-Jabir A, Iosifidis C, et al. The socio-economic implications of the coronavirus pandemic (COVID-19): a review. Int J Surg. 2020;78:185.PubMedPubMedCentralCrossRef
43.
go back to reference UNDP. Socio-economic impact of COVID-19 in Uganda. 2020. UNDP. Socio-economic impact of COVID-19 in Uganda. 2020.
44.
go back to reference Martin A, Markhvida M, Hallegatte S, Walsh B. Socio-economic impacts of COVID-19 on household consumption and poverty. Econ Disasters Clim Change. 2020;4:453–79. Martin A, Markhvida M, Hallegatte S, Walsh B. Socio-economic impacts of COVID-19 on household consumption and poverty. Econ Disasters Clim Change. 2020;4:453–79.
45.
go back to reference Peters DH, Garg A, Bloom G, Walker DG, Brieger WR, Hafizur RM. Poverty and access to health care in developing countries. Ann N Y Acad Sci. 2008;1136(1):161–71.PubMedCrossRef Peters DH, Garg A, Bloom G, Walker DG, Brieger WR, Hafizur RM. Poverty and access to health care in developing countries. Ann N Y Acad Sci. 2008;1136(1):161–71.PubMedCrossRef
46.
go back to reference Bengle R, Sinnett S, Johnson T, Johnson MA, Brown A, Lee JS. Food insecurity is associated with cost-related medication non-adherence in community-dwelling, low-income older adults in Georgia. J Nutr Elder. 2010;29(2):170–91.PubMedCrossRef Bengle R, Sinnett S, Johnson T, Johnson MA, Brown A, Lee JS. Food insecurity is associated with cost-related medication non-adherence in community-dwelling, low-income older adults in Georgia. J Nutr Elder. 2010;29(2):170–91.PubMedCrossRef
47.
go back to reference Taylor S. The psychology of pandemics: preparing for the next global outbreak of infectious disease. England: Cambridge Scholars Publishing; 2019. Taylor S. The psychology of pandemics: preparing for the next global outbreak of infectious disease. England: Cambridge Scholars Publishing; 2019.
48.
go back to reference Ravindran S, Shah M. Unintended consequences of lockdowns: Covid-19 and the shadow pandemic. Cambridge: National Bureau of Economic Research; 2020. p. 0898–2937. Ravindran S, Shah M. Unintended consequences of lockdowns: Covid-19 and the shadow pandemic. Cambridge: National Bureau of Economic Research; 2020. p. 0898–2937.
49.
go back to reference Agüero JM. Covid-19 and the rise of intimate partner violence; 2020. Agüero JM. Covid-19 and the rise of intimate partner violence; 2020.
50.
go back to reference AUC-WGDD UW, OHCHR and UNFPA. Gender-based violence in africa during the COVID-19 pandemic. 2020. AUC-WGDD UW, OHCHR and UNFPA. Gender-based violence in africa during the COVID-19 pandemic. 2020.
52.
go back to reference Pellegrini M, Ponzo V, Rosato R, Scumaci E, Goitre I, Benso A, et al. Changes in weight and nutritional habits in adults with obesity during the “lockdown” period caused by the COVID-19 virus emergency. Nutrients. 2020;12(7):2016.PubMedCentralCrossRef Pellegrini M, Ponzo V, Rosato R, Scumaci E, Goitre I, Benso A, et al. Changes in weight and nutritional habits in adults with obesity during the “lockdown” period caused by the COVID-19 virus emergency. Nutrients. 2020;12(7):2016.PubMedCentralCrossRef
53.
go back to reference Ghosal S, Sinha B, Majumder M, Misra A. Estimation of effects of nationwide lockdown for containing coronavirus infection on worsening of glycosylated haemoglobin and increase in diabetes-related complications: a simulation model using multivariate regression analysis. Diabetes Metab Syndr. 2020;14:319–23.PubMedPubMedCentralCrossRef Ghosal S, Sinha B, Majumder M, Misra A. Estimation of effects of nationwide lockdown for containing coronavirus infection on worsening of glycosylated haemoglobin and increase in diabetes-related complications: a simulation model using multivariate regression analysis. Diabetes Metab Syndr. 2020;14:319–23.PubMedPubMedCentralCrossRef
54.
go back to reference Bodrud-Doza M, Shammi M, Bahlman L, Islam ARMT, Rahman MM. Psychosocial and socio-economic crisis in Bangladesh due to COVID-19 pandemic: a perception-based assessment. Front Public Health. 2020;8:341.PubMedPubMedCentralCrossRef Bodrud-Doza M, Shammi M, Bahlman L, Islam ARMT, Rahman MM. Psychosocial and socio-economic crisis in Bangladesh due to COVID-19 pandemic: a perception-based assessment. Front Public Health. 2020;8:341.PubMedPubMedCentralCrossRef
55.
go back to reference WHO. COVID-19 significantly impacts health services for noncommunicable diseases 2020. WHO. COVID-19 significantly impacts health services for noncommunicable diseases 2020.
57.
58.
go back to reference Cellini N, Canale N, Mioni G, Costa S. Changes in sleep pattern, sense of time and digital media use during COVID-19 lockdown in Italy. J Sleep Res. 2020;29:e13074.PubMedCrossRef Cellini N, Canale N, Mioni G, Costa S. Changes in sleep pattern, sense of time and digital media use during COVID-19 lockdown in Italy. J Sleep Res. 2020;29:e13074.PubMedCrossRef
59.
go back to reference Javed B, Sarwer A, Soto EB, Mashwani ZU. The coronavirus (COVID-19) pandemic's impact on mental health. Int J Health Plann Manag. 2020;35(5):993–6.CrossRef Javed B, Sarwer A, Soto EB, Mashwani ZU. The coronavirus (COVID-19) pandemic's impact on mental health. Int J Health Plann Manag. 2020;35(5):993–6.CrossRef
60.
go back to reference Bauza V, Sclar GD, Bisoyi A, Majorin F, Ghugey A, Clasen T. Water, sanitation, and hygiene practices and challenges during the COVID-19 pandemic: a cross-sectional study in rural Odisha, India. Am J Trop Med Hyg. 2021;104(6):2264–74.PubMedCentralCrossRefPubMed Bauza V, Sclar GD, Bisoyi A, Majorin F, Ghugey A, Clasen T. Water, sanitation, and hygiene practices and challenges during the COVID-19 pandemic: a cross-sectional study in rural Odisha, India. Am J Trop Med Hyg. 2021;104(6):2264–74.PubMedCentralCrossRefPubMed
61.
go back to reference Vearey J, Luginaah I, Shilla DJ, Oni T. Urban health in Africa: a critical global public health priority. BMC Public Health. 2019;19(1):1–4.CrossRef Vearey J, Luginaah I, Shilla DJ, Oni T. Urban health in Africa: a critical global public health priority. BMC Public Health. 2019;19(1):1–4.CrossRef
63.
go back to reference Adams EA, Adams YJ, Koki C. Water, sanitation, and hygiene (WASH) insecurity will exacerbate the toll of COVID-19 on women and girls in low-income countries. Sustainability. 2021;17(1):86–90. Adams EA, Adams YJ, Koki C. Water, sanitation, and hygiene (WASH) insecurity will exacerbate the toll of COVID-19 on women and girls in low-income countries. Sustainability. 2021;17(1):86–90.
64.
go back to reference Anjum Z, Nagabhatla N. Women, WASH & COVID-19: The ‘burdens of’and ‘opportunities for’the vulnerable; 2020. Anjum Z, Nagabhatla N. Women, WASH & COVID-19: The ‘burdens of’and ‘opportunities for’the vulnerable; 2020.
65.
go back to reference Musoke D, Ekirapa-Kiracho E, Ndejjo R, George A. Using photovoice to examine community level barriers affecting maternal health in rural Wakiso district, Uganda. Reprod Health Matters. 2015;23(45):136–47.PubMedCrossRef Musoke D, Ekirapa-Kiracho E, Ndejjo R, George A. Using photovoice to examine community level barriers affecting maternal health in rural Wakiso district, Uganda. Reprod Health Matters. 2015;23(45):136–47.PubMedCrossRef
Metadata
Title
Unintended socio-economic and health consequences of COVID-19 among slum dwellers in Kampala, Uganda
Authors
Rebecca Nuwematsiko
Maxencia Nabiryo
John Bosco Bomboka
Sarah Nalinya
David Musoke
Daniel Okello
Rhoda K. Wanyenze
Publication date
01-12-2022
Publisher
BioMed Central
Keyword
COVID-19
Published in
BMC Public Health / Issue 1/2022
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-021-12453-6

Other articles of this Issue 1/2022

BMC Public Health 1/2022 Go to the issue