Navigating crisis: Household recomposition and welfare patterns during COVID-19 in South Africa

Globally, the adoption of COVID-19 containment measures, such as lockdowns, have been used to curb the rapid spread of the pandemic. However, these action regulations have caused substantial challenges to livelihoods. We explored the perceptions and experiences of COVID-19 implications for urban informal food traders in South Africa during the initial lockdown period that lasted five weeks. A rapid qualitative study was conducted during October–November 2020. Twelve key informants (seven men and five women) categorized into informal traders and food system expert groups were interviewed. Data were analyzed thematically using MAXQDA software. Participants perceived informal trading as a main source of livelihood for many individuals. Negative lockdown impacts described included forced business closure, increased food costs and reduced demand. The consensus among participants was that the government’s lack of formal recognition for informal food traders pre-COVID-19 contributed to challenges they faced during the pandemic, as evidenced by their exclusion as “essential service providers’’ at the start of lockdown. Policies that fail to recognize and consider informal food traders during ‘normal’ times lead to widened social inequality gaps among already vulnerable groups during natural disasters and disease outbreaks. In the case of COVID-19 in South Africa, this caused severe hunger, food insecurity and income loss.

BackgroundPerpetual food insecurity has long-term health and development effects on populations. The global pandemic created sub-populations that were newly food insecure, but there exists sub-populations were food insecure, and COVID-19 held that situation. This study seeks to identify the demographic and socioeconomic characteristics of the perpetually food insecure in South Africa in order to obtain specific evidence of populations to be prioritised in the post-pandemic era.MethodsSecondary data from the South African National Income Dynamics CRAM Survey for rounds (Waves) 1 and 5 are analysed. The study population are those respondents who reported a household member not having enough food to eat in the early stages of the pandemic (1st round) and remained without sufficient food a year later (5th round). The study controls for the demographic and socioeconomic characteristics of the population but also changes to employment status, social grant access and willingness to be vaccinated. Descriptive and analytical statistical tests are used.ResultsA total of 26.15% of respondents were food insecure at the start of the pandemic. Of these, 41.09% remained food insecure a year later. The drivers of perpetual food insecurity during the pandemic include unemployment (OR = 2.09; CI 1.335293–3.265678), still being unemployed (OR = 1.86; CI 1.308032–2.636252), seven or more (≥ 7) household members (OR = 1.24; CI 1.1611329–1.610126), those with only a primary education (OR = 1.11; CI 1.5051066–2.434695), participants between the ages of 45 and 64 years old (ORs = 1.03 and 1.20; CIs 1.0171956–1.0171956 and 1.1733304–2.144875, respectively) and women (OR = 1.09; CI 1.0745444–1.406035).ConclusionsSouth Africa needs to address socioeconomic challenges and inequalities to assist the perpetually food insecure and to ensure that, should there be a pandemic resurgence, or a new pandemic, individuals and households in the country are in a better financial situation and appropriately supported to avoid food insecurity at all costs.

Background The incidence and prevalence of COVID-19 continues to escalate globally, with the consequence to quality of life, the economies of nations and various sectors of society. While there is substantial research on the impact and experiences of the COVID-19 pandemic, little remains known about the perceptions and lived experiences of families living with people diagnosed with COVID-19, particularly within the South African context. Purpose To explore the perceptions and lived experiences of family members living with people diagnosed with COVID-19 in South Africa. Methods A descriptive phenomenological design was used. Data were collected from 15 participants who were family members of people diagnosed with COVID-19 in South Africa. Purposive snowball sampling was used to identify and recruit participants, and data were collected at community level in KwaZulu-Natal, Western Cape and Gauteng, South Africa. Individual in-depth interviews were used to collect the data, and an audio tape was used to record all interviews. Data were transcribed verbatim and analysed using a phenomenological data analysis processes. Ethical approval to conduct the study was obtained from the University of KwaZulu-Natal Research Ethics Committee—reference number: BREC00003228/2021. Results Four super-ordinate themes emerged in relation to the perceptions and lived experiences of family members living with people diagnosed with COVID-19 in South Africa. The superordinate themes were: (1) sources of information about COVID-19, (2) pandemic perceptions and experiences, (3) impact of diagnosis and related burden and (4) aftermath of living with a family member diagnosed with COVID-19. Discussion and conclusion Family members’ perceptions and lived experiences of COVID-19 are largely influenced by media, moreover, the impact of diagnosis has consequences for the physical, mental and emotional well-being of family members. Diagnosis disrupts family dynamics by depleting financial resources due to the caregiver burden experienced. The findings thus imply that provision of psychosocial support is imperative for families living with persons diagnosed with COVID-19.

We discuss the plight of urban poor African immigrants from the perspective of the right to food (food availability, accessibility and adequacy) for everyone during the COVID-19 in South Africa. Despite their disrupted sources of livelihood, the majority of the African immigrants are without a social welfare safety net and have little hope of benefiting from the Government relief packages. Consequently, it seems that the increase in the triple burden of food insecurity, poverty and malnutrition compounded with social injustice and income inequality is inevitable for the urban poor African immigrants in South Africa. Even though the Government may not have the capacity to address food insecurity by itself, the Government should endeavour to make the limited resources to access food equally available to all with no social injustice. By working hand in hand with foreign national associations, township councillors and other stakeholders, such as the food banks and faith-based organisations, that have stepped forward to try and bridge the widening incapacity of the Government to feed the food insecure, the nexus of food insecurity and social injustice of African immigrants will be alleviated.

In the wake of the unprecedented health crisis triggered by the global COVID-19 pandemic, countries are still grappling with the pandemic’s immediate health and socioeconomic consequences. This paper presents an extended SEIRD model with vaccination to study the evolution of COVID-19 in South Africa and Tunisia since the commencement of the vaccination campaign in each country, respectively. Epidemiologists often quantify a risk reduction following the implementation of non-pharmaceutical containment measures and vaccines when attempting to stem the spread of pandemics. However, an important question they often ask is the effectiveness of the non-pharmaceutical containment measures (social distancing and lockdowns) and the efficacy of such measures, including vaccines. Africa’s COVID-19 vaccine roll-out stands at 16% as of April 2022; however, the continent lags behind many developing countries even though it harbours about 16% of the world population. While proliferating literature quantifies the efficacy and effectiveness of COVID-19 vaccines, very little has been done using the SEIRDV model in African countries. This study compares the model-predicted results with the available data to estimate the dynamics of the infected population, using data from 20-03-2021 to 30-12-2021. A simulation of the SEIRDV model is performed and fitted to the data. Simulating the model involves solving a system of Ordinary Differential Equations numerically by taking the initial values for the key model parameters as inputs. After simulating the SEIRDV model, the model parameters are compared with real-world COVID-19 and vaccination data in order to estimate the values of the different parameters that best fit the observed data. The results of the study showed an inverted U-shaped trend for the infection rate after vaccination, indicating that increasing the vaccination rates reduces the transmission rates. Therefore African countries must continue to scale up the vaccination campaigns, and the world needs to endeavour to ensure an equitable vaccination roll-out to developing countries.

COVID-19 is a novel severe acute respiratory syndrome coronavirus 2 (SAR–CoV-2) spread from person to person through infected air droplets of saliva and discharged from sneezes and coughs. This study seeks to contribute to knowledge and understanding of how coronavirus outbreaks could be addressed by examining communication and media strategies used by governments and public health institutions in South Africa and Ghana during the coronavirus pandemic. The study systematically analysed published data on COVID-19 in South Africa and Ghana from 2019 to 2020 to identify recurring themes to discuss issues regarding communication strategies in response to the outbreak. This study found various inadequacies and challenges to communication and media strategies to address the spread of COVID-19. The governments and public health institutions in South Africa and Ghana used multiple mass media channels to communicate different messages and create awareness about COVID-19. This article recommends the improvement of communication and media engagements between governments and health stakeholders in South Africa and Ghana to increase public awareness of the risks, threats and outcomes of COVID-19. The media in South Africa and Ghana must conduct fact finding of information about coronavirus from official sources in government and health institutions before dissemination to the public to minimise fake news, misinformation and disinformation. The governments and health institutions must not rely solely on traditional mass media strategies but also integrate indigenous communication strategies for engagements to address the challenges of mass media to increase public awareness about COVID-19 in South Africa and Ghana.

Lack of proper messaging at an outbreak of a novel disease causes panic with more serious damaging impacts on livelihoods, social-fabric of communities, economic landscapes, and political stability. There have been notable high levels of panic in South Africa and the globe with regard to the outbreak of COVID-19. The current lack of knowledge and poor communication has been attributed as a precursor to the skyrocketing global panic (Freimuth, Linnan, Potter, 2000). Fuelling this panic is the rate at which the incidence of new infections is increasing in countries outside of China, with Italy and Iran leading on a number of new infections and death cases. A Content Analysis method was used to analyze articles, media clips and social network reactions to the outbreak of COVID-19 in South Africa on the 6th of March 2020. The key to the investigation was to understand how authorities are communicating with the public on matters of national concern – regarding how they are prepared to deal and handle the outbreak. This study further compares the South African response to China at the outbreak of SARS in 2003. Codes to analyze texts extracted from targeted media and scientific sources and themes were generated and presented. Findings indicate that the general public does not have faith in government authorities, due to a lack of communication. It is perceived that lack of communication is indicative of a lack of preparedness. Contrary to evident panic in South Africa, scientific data indicates that there is no need to panic as a result of the outbreak of COVID-19. Further, a study from the French Institute for Health and Medical Research in 2020 on the prepardness of African countries to handle COVID-19 indicates that South Africa is one of the better-equipped countries in Africa to detect and handle any incidence of COVID-19. This study further recommends that authorities and policy-makers use communications to educate the public far earlier at the onset of epidemic outbreaks, regardless of where it happens as the air-traffic connects global countries, resulting in the potential for disease importation.

To assess the prevalence of food insecurity and the independent association between depression and food insecurity among youth living in two urban settings in South Africa. Baseline cross-sectional survey data was analysed from a prospective cohort study conducted between 2014 and 2016 among youth (aged 16-24years) in Soweto and Durban. Interviewer-administered questionnaires collecting socio-demographic, sexual and reproductive health and mental health data were conducted. Household food insecurity was measured using the 3-item Household Hunger Scale, with food insecure participants defined as having 'moderate' or 'severe hunger' compared to 'no hunger'. Depression was assessed using the 10-item Center for Epidemiological Studies Depression (CES-D 10) Scale (range 0-30, probable depression≥10). Multivariable logistic regression models were used to estimate the association between depression and food insecurity. There were 422 participants. Median age was 19years (interquartile range [IQR] 18-21) and 60% were women. Overall, 18% were food insecure and 42% had probable depression. After adjustment for socio-demographic variables (age, gender, female-headed household, household size and school enrolment), participants with probable depression had higher odds of being food insecure than non-depressed participants (2.79, 95%CI 1.57-4.94). Nearly one-fifth of youth in this study were food insecure. Those with probable depression had increased odds of food insecurity. Interventions are needed to address food insecurity among urban youth in South Africa, combining nutritional support and better access to quality food with mental health support.

The South African government instituted a countermeasure against COVID-19 in March 2020, which had a significant impact on many individuals, particularly the youth. However, there is a limited understanding of how household characteristics influenced adolescents’ behavioral changes and their adoption of preventive measures during the pandemic. This study aimed to explore the relationship between the role of household characteristics and adolescents’ behavioral responses to COVID-19 in South Africa. Using the latest data from the South African National Income Dynamics-Coronavirus Rapid Mobile Survey (Wave 5), which includes responses from 5581 (99.9%) youths aged 15 – 24, we analyzed changes in their behaviors and the preventive measures they adopted. The study controlled for various household, demographic, and socioeconomic characteristics of the respondents. We utilized cross-tabulations and an ordinal logistics regression model to determine the relationship between the covariates and the outcome of behavioral changes and preventive measures adopted. Our findings revealed that none of the respondents adopted all recommended precautionary measures for COVID-19, while 55.7% exhibited low behavioral changes, and only 2.7% exhibited higher behavioral changes throughout the pandemic. The results indicate that, at both the individual and household levels, factors such as gender, educational attainment, source of household income, and access to electricity increase the odds of behavioral changes against COVID-19 in South Africa. In addition, among household-level factors, adolescents without access to water were more likely to adopt one to three preventive measures compared to those with access to water (52.2% vs. 47.9%, p < 0.001). Therefore, to effectively prevent the spread of infection in South Africa, it is pertinent to address these household characteristics and encourage preventive measures tailored to these factors.

Background Coronavirus disease (COVID-19) continues to ravage both the health and economy of South Africa. This study estimated the total present value of human life (TPVHL) losses associated with COVID-19 in South Africa. Methods The human capital approach (HCA) was used to value the 101,146 human life losses associated with COVID-19 in South Africa as of 30 May 2022 – assuming South Africa’s average life expectancy of 64.88 years and a 3% discount rate. The TPVHL was the sum of discounted values of human life (VHL) across the 17 age groups. The PVHL for each age group is the product of the sum of discounted years of life lost per person, gross domestic product per capita net of current health expenditure per person, and the number of COVID-19 deaths borne by a specific age group. During sensitivity analysis, the HCA model was reanalysed four times alternately, assuming a 5% discount rate, 10% discount rate, Africa’s highest average life expectancy of 78.76 years (Algeria females), and the world’s highest life expectancy of 88.17 years (Hong Kong females). Results The 101,146 human lives lost had a TPVHL of Int$7,566,656,063, and an average of Int$74,809 per human life lost to COVID-19. Subsequent re-calculation of the model with a 5% and 10% discount rates diminished the TPVHL by Int$1,177,446,403 (15.6%) and Int$2,997,459,371 (39.6%), respectively. Further, a reanalysis of the model with Africa’s highest average life expectancy and the world’s highest life expectancy triggered growth in the TPVHL of Int$8,846,142,813 (116.9%) and Int$15,363,165,669 (203.04%), respectively. Conclusions The average discounted value per human life lost to COVID-19 of Int$74,809 is five-fold the GDP per capita for South Africa in 2022, setting the country back a few years in terms of socio-economic development. Thus, COVID-19 continues to have a significant negative impact on the life and livelihoods of South Africans. The economic evidence complements the human rights case for increased domestic investment into health-related systems to bridge the gaps in coverage of health development-related services.

Cheryl Cohen—promoting evidence-based health policy

Covid 19 in South Africa created opportunity for criminals to enrich themselves at the expense of the poor. Public and private sector officials benefited due to irregular tenders and overpricing of personal protective equipments in South Africa as reported on media platforms. This article explores opportunistic crimes associated with Covid 19 and their impact on the fight against the pandemic. This qualitative article adopted a non-empirical research design: Systematic review, indirect observation schedules to identify and describe available research literature ‘using systematic and explicit accountable methods and pre-specified formalised tools for searching and integrating literature.
 The data was collected from January-July 2021. The collected data was analysed through inductive textual content analysis. Findings revealed that public officials benefited from irregular PPE tenders as well as friends and families of politicians. The findings further indicate that billions of Rands were looted from funds which were meant to fight Covid 19 in South Africa. Lastly the findings show that law enforcement agencies are not effective in dealing with cases of Covid 19 crimes. Based on the findings, the following recommendations were developed: Law enforcement agencies should be equipped with resources to deal with Covid 19 crimes and ensure successful prosecution of those crimes, Competition Commission should investigate the companies which benefited from irregular tenders and overpricing of PPE’s so that they could be held accountable. Public participation should be strengthened to combat crime.

Hunger, with its adverse consequences for children, continues to be an important national problem. Previous studies that document the deleterious effects of hunger among children cannot distinguish child from family hunger and do not take into account some critical environmental, maternal, and child variables that may influence child outcomes. This study examines the independent contribution of child hunger on children's physical and mental health and academic functioning, when controlling for a range of environmental, maternal, and child factors that have also been associated with poor outcomes among children. With the use of standardized tools, comprehensive demographic, psychosocial, and health data were collected in Worcester, Massachusetts, from homeless and low-income housed mothers and their children (180 preschool-aged children and 228 school-aged children). Mothers and children were part of a larger unmatched case-control study of homelessness among female-headed households. Hunger was measured by a set of 7 dichotomous items, each asking the mother whether she has or her children have experienced a particular aspect of hunger during the past year--1 concerns food insecurity for the entire family, 2 concern adult hunger, and 4 involve child hunger. The items, taken from the Childhood Hunger Identification Project measure, are summed to classify the family and divided into 3 categories: no hunger, adult or moderate child hunger, or severe child hunger (indicating multiple signs of child hunger). Outcome measures included children's chronic health condition count using questions adapted from the National Health Interview Survey, Child Health Supplement, and internalizing behavior problems and anxiety/depression, measured by the Child Behavior Checklist. Additional covariates included demographic variables (ie, age, gender, ethnicity, housing status, number of moves, family size, income), low birth weight, child life events (ie, care and protection order, out of home placement, abuse, severe life events count), developmental problems (ie, developmental delay, learning disability, emotional problems), and mother's distress and psychiatric illness. Multivariate regression analyses examined the effect of child hunger on physical and mental health outcomes. The average family size for both preschoolers and school-aged children was 3; about one third of both groups were white and 40% Puerto Rican. The average income of families was approximately $11 000. Among the school-aged children, on average 10 years old, 50% experienced moderate child hunger and 16% severe child hunger. Compared with those with no hunger, school-aged children with severe hunger were more likely to be homeless (56% vs 29%), have low birth weights (23% vs 6%), and have more stressful life events (9 vs 6) when compared with those with no hunger. School-aged children with severe hunger scores had parent-reported anxiety scores that were more than double the scores for children with no hunger and significantly higher chronic illness counts (3.4 vs 1.8) and internalizing behavior problems when compared with children with no hunger. There was no relationship between hunger and academic achievement. Among preschool-aged children, who averaged 4 years of age, 51% experienced moderate child hunger and 8% severe child hunger. For preschoolers, compared with children with no hunger, severe hunger was associated with homelessness (75% vs 48%), more traumatic life events (8.5 vs 6), low birth weight (23% vs 6%), and higher levels of chronic illness and internalizing behavior problems. Mothers of both preschoolers and school-aged children who reported severe hunger were more likely to have a lifetime diagnosis of posttraumatic stress disorder. For school-aged children, severe hunger was a significant predictor of chronic illness after controlling for housing status, mother's distress, low birth weight, and child live events. For preschoolers, moderate hunger was a significant predictor of health conditions while controlling for potenns while controlling for potential explanatory factors. For both preschoolers and school-aged children, severe child hunger was associated with higher levels of internalizing behavior problems. After controlling for housing status, mother's distress, and stressful life events, severe child hunger was also associated with higher reported anxiety/depression among school-aged children. This study goes beyond previous research and highlights the independent relationship between severe child hunger and adverse physical health and mental health outcomes among low-income children. Study findings underscore the importance of clinical recognition of child hunger and its outcomes, allowing for preventive interventions and efforts to increase access to food-related resources for families.

Background. Behavior change has been a critical factor in slowing the spread of COVID-19. In South Africa where infection rates are high, research is needed on the protective behaviors adopted by youth who have low infection rates but are carriers of the virus. Aims. The purpose of this study is to (1) identify the protective behaviors young people adopted during the pandemic and (2) to estimate the probability of positive behavior change by demographic and socioeconomic characteristics. Methods. The study uses data from the South African National Income Dynamics-Coronavirus Rapid Mobile Survey 2020. The sample includes 985 (n) youth aged 15-24 years. The outcome of interest is behavior change due to the Coronavirus. Cross-tabulations and an adjusted binary logistic regression model showing odds ratios, are fit to the data. Results. Not all youth adopted protective behaviors. The most prevalent behaviors adopted include washing hands (67.75%) and staying at home (54.02%). Youth in households with six or more members are more likely to change their behaviors (ORs = 1.67 and 1.64, both p-values < .05). However, youth who do not have access to water to wash hands (OR = 0.71), reside in households with food insecurity (OR = 0.94), and those living in nonformal housing (OR = 0.69) are less likely to adopt behavior change. Conclusion. Due to the socioeconomic inequalities associated with behavior change, there is need for more tailored approaches to address youth living in impoverished households in the country.

BackgroundThroughout the COVID-19 pandemic, concerns were raised about unintended effects of measures taken to prevent its spread, on sexual and gender-based violence (SGBV). The United Nations called for understanding how...