Mental health and wellbeing implications of the COVID-19 quarantine for disabled and disadvantaged children and young people: evidence from a cross-cultural study in Zambia and Sierra Leone

Darren Sharpe,Mohsen Rajabi,Sitali Mayamba Joseph,Ibrahim Sesay,Siraj Sait,James Williams,Clement Chileshe

doi:10.1186/s40359-021-00583-w

Abstract

BackgroundThe mental health impact of the COVID-19 pandemic and quarantining on children and young people (CYP) living in low- and middle-income countries (LMICs) has yet to be fully comprehended. CYP in LMICs are at utmost risk, given the COVID-19-related restrictions and social distancing measures, resulting in reduced access to school-based services for nutritional and mental health needs. This study examined mental health of CYP during the first COVID-19 lockdown in Zambia and Sierra Leone.MethodA total of 468 disabled and disadvantaged CYP aged 12 to 25 completed a planning tool that comprised the short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS), as well as open-ended questions covering social connectedness, physical distancing and educational challenges during the lockdown. The community coaches screened individuals and families who could be eligible to receive emergency aid, and based on a convenience sample following distribution of aid, recipients were invited to complete the planning tool.ResultsThe data showed that participants in the global south have increasing anxieties and fears centred on accessing offline educational resources and income loss in the family effecting food security and their ability to return to education. Mean (SD) SWEMWBS scores for all participants in Zambia and Sierra Leone, were 19.61 (3.45) and 21.65 (2.84), respectively. Mental well-being scores were lower in females, children aged 12–14 and participants with two or more disabilities. Factors significantly associated with poor mental wellbeing in the sample were: type of disability, nationality, peer relationships, connection to others during the pandemic, knowledge about COVID-19, worry about the long-term impact of COVID-19, and the types of self-isolating.ConclusionThe study shows that participants who self-reported low levels of COVID-19 health literacy also scored low on the mental wellbeing self-assessment. Yet, despite undoubted limited resources, these CYP are doing well in identifying their needs and maintaining hope in the face of the problems associated with COVID-19 in countries where stigma persists around mental ill-health.

Highlights

In late December 2019, a novel coronavirus (Coronavirus disease, COVID-19) originating from Wuhan, the capital of Hubei Province in China, started to spread over many countries, and aroused global concerns [1]
The study shows that participants who self-reported low levels of COVID-19 health literacy scored low on the mental wellbeing self-assessment
Despite undoubted limited resources, these children and young people (CYP) are doing well in identifying their needs and maintaining hope in the face of the problems associated with COVID-19 in countries where stigma persists around mental ill-health

Summary

Introduction

In late December 2019, a novel coronavirus (Coronavirus disease, COVID-19) originating from Wuhan, the capital of Hubei Province in China, started to spread over many countries, and aroused global concerns [1]. It is widely believed that there is substantial under-reporting in many African countries with less-developed healthcare systems [5] Against this background, this paper focuses on the mental health and wellbeing of children and young people (CYP) during the COVID-19 lockdown in Zambia and Sierra Leone. On 24 March, President Julius Maada Bio announced a year-long ‘state of emergency’ in order to cope with a potential global pandemic He confirmed the country’s first case of coronavirus on 31 March, contracted by a traveller from France on 16 March 2020 who had been in isolation. CYP of African heritage are often denied a human face for their plight, and are instead characterised as being somehow genetically predisposed to emotionally cope with the intersecting trauma of civil unrest, disease and poverty They need their voices heard, understanding and the right timely support. The project distributed over 17,000 items of COVID-19 personal protective equipment (PPE) in Zambia and Sierra Leone, directly supported over 5,000 vulnerable and disadvantaged children, young people and families, and co-produced and disseminated public health messages on social media that have reached over 428,000 citizens in the global south, increasing their COVID-19 health literacy

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