Harling, G;
Gómez-Olivé, FX;
Tlouyamma, J;
Mutevedzi, T;
Kabudula, CW;
Mahlako, R;
Singh, U;
... Herbst, K; + view all
(2021)
Protective behaviours and secondary harms from non-pharmaceutical interventions during the COVID-19 epidemic in South Africa: a multisite prospective longitudinal study.
JMIR Public Health and Surveillance
, 7
(5)
, Article e26073. 10.2196/26073.
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Abstract
BACKGROUND: In March 2020 South Africa implemented strict non-pharmaceutical interventions (NPIs) to contain Covid-19. Over the subsequent five months NPIs were eased in stages according to national strategy. Covid-19 spread throughout the country heterogeneously, reaching rural areas by July and peaking in July-August; a second wave began late in 2020. Data on the impact of NPI policies on social and economic wellbeing and access to healthcare is limited. OBJECTIVE: To determine how rural residents of three South African provinces changed their behaviour during the first Covid-19 epidemic wave. METHODS: The South African Population Research Infrastructure Network (SAPRIN) nodes in Mpumalanga (Agincourt), KwaZulu-Natal (AHRI) and Limpopo (DIMAMO) provinces conducted up to 14 rounds of longitudinal telephone surveys among randomly sampled households from rural and peri-urban surveillance populations every 2-3 weeks. Interviews included questions on: Covid-19 knowledge and behaviours; health and economic impact of NPIs; and mental health. We analysed how responses varied by NPI stringency and household socio-demographics. RESULTS: 5573 households completed 23,158 interviews between April and December 2020. Self-reported satisfaction with Covid-19 knowledge and facemask use rose rapidly to 85% and 95% respectively by August. As selected NPIs were eased mobility increased, and economic losses and anxiety and depression symptoms fell. When Covid-19 cases spiked at one node in July, movement dropped rapidly, and missed daily medication rates doubled. Economic and medication access concerns were lower in households where more adults received government-funded old-age pensions. CONCLUSIONS: South Africans complied with stringent Covid-19 NPIs despite the threat of substantial social, economic and health repercussions. Government-supported social welfare programmes appeared to buffer interruptions in income and healthcare access during local outbreaks. Epidemic control policies must be balanced against broader wellbeing in resource-limited settings and designed with parallel support systems where they threaten income and basic service access. CLINICALTRIAL:
| Type: | Article |
|---|---|
| Title: | Protective behaviours and secondary harms from non-pharmaceutical interventions during the COVID-19 epidemic in South Africa: a multisite prospective longitudinal study |
| Location: | Canada |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.2196/26073 |
| Publisher version: | https://doi.org/10.2196/26073 |
| Language: | English |
| Additional information: | ©Guy Harling, Francesc Xavier Gómez-Olivé, Joseph Tlouyamma, Tinofa Mutevedzi, Chodziwadziwa Whiteson Kabudula, Ruth Mahlako, Urisha Singh, Daniel Ohene-Kwofie, Rose Buckland, Pedzisai Ndagurwa, Dickman Gareta, Resign Gunda, Thobeka Mngomezulu, Siyabonga Nxumalo, Emily B Wong, Kathleen Kahn, Mark J Siedner, Eric Maimela, Stephen Tollman, Mark Collinson, Kobus Herbst. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 13.05.2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on https://publichealth.jmir.org, as well as this copyright and license information must be included. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10125905 |
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