Abstract
Background: This study explored how low-income women already distressed by reproductive challenges were affected during the initial lockdown conditions of the COVID-19 pandemic in Mumbai, India. Methods: Women with reproductive challenges and living in established slums participated in a longitudinal mixed-methods study comparing their mental health over time, at pre-COVID-19 and at one and four-months into India’s COVID-19 lockdown. Results: Participants (n = 98) who presented with elevated mental health symptoms at baseline had significantly reduced symptoms during the initial lockdown. Improvements were associated with income, socioeconomic status, perceived stress, social support, coping strategies, and life satisfaction. Life satisfaction explained 37% of the variance in mental health change, which was qualitatively linked with greater family time (social support) and less worry about necessities, which were subsidized by the government. Conclusions: As the pandemic continues and government support wanes, original mental health issues are likely to resurface and possibly worsen, if unaddressed. Our research points to the health benefits experienced by the poor in India when basic needs are at least partially met with government assistance. Moreover, our findings point to the critical role of social support for women suffering reproductive challenges, who often grieve alone. Future interventions to serve these women should take this into account.
Highlights
The global COVID-19 pandemic has wreaked havoc on human health, which continues to unfold as the subsequent lockdowns instituted have disrupted day-to-day life, and employment and economic status, with additional devastating consequences to physical and mental health—to which, India is no exception [1]
The COVID-19 pandemic delayed the intervention, in the current sub-study we recruited 98 women from the original group of women with reproductive challenges, who agreed to participate in phone follow-up interviews that focused on life during COVID-19
In combination with initial governmental measures of support during the lockdown, this support is associated with an improvement in the mental health distress they experience due to reproductive challenges
Summary
The global COVID-19 pandemic has wreaked havoc on human health, which continues to unfold as the subsequent lockdowns instituted have disrupted day-to-day life, and employment and economic status, with additional devastating consequences to physical and mental health—to which, India is no exception [1]. In India, the state of Maharashtra has experienced among the highest numbers of COVID-19 cases, with 6.61 million cases reported as of October 2021 The state reported 133,000 COVID-related deaths [3] despite strict lockdown measures instituted in mid-March, 2020 [4]. These lockdown measures continued [5] for months with constant uncertainty pertaining to severity and duration [6]. A government-approved study comparing COVID-19 infection rates in slums and non-slum communities in Mumbai found markedly higher rates in the slums
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