Four billion people worldwide have experienced COVID-19 confinement. Such unprecedented extent of mobility restriction to curb the COVID-19 pandemic may have profound impacts on how individuals live, travel, and retain well-being. This systematic review aims to identify: 1) the social consequences of mass quarantine—community-wide movement restrictions—during previous and current infectious disease outbreaks, and 2) recommended strategies to mitigate the negative social implications of COVID-19 lockdowns. Considering social determinants of health, we conducted a systematic review by searching five databases (Ovid-MEDLINE, EMBASE, PsycINFO, CNKI, and the WHO COVID-19 database) for publications from inception to 9 April 2020. No limitation was set on language, location, or study type. Studies that 1) contained peer-reviewed original empirical evidence and 2) focussed on non-epidemiological implications of mass quarantine were included. We thematically synthesised and reported data due to heterogeneous disease and country context. Of 3067 publications found, 15 original peer-reviewed articles were selected for full-text extraction. Psychological distress, heightened communication inequalities, food insecurity, economic challenges, diminished health care access, alternative delivery of education, and gender-based violence were identified as negative social consequences of community-based quarantine in six infectious disease epidemics, including the current COVID-19 pandemic. In contrast, altruistic attitudes were identified as a positive consequence during previous quarantines. Diverse psychological and social consequences of mass quarantine in previous and current epidemics were evident, but individual country policies had been highly varied in how well they addressed the needs of affected individuals, especially those who are socially marginalised. Policymakers should balance the pros and cons of movement restrictions, facilitate multi-sectoral action to tackle social inequalities, provide clear and coherent guidance to the public, and undertake time-bound policy evaluations to mitigate the negative impact of COVID-19 lockdowns and to establish preparedness strategies for future epidemics.

ObjectiveTo identify how 10 low- and middle-income countries achieved accelerated progress, ahead of comparable countries, towards meeting millennium development goals 4 and 5A to reduce child and maternal mortality.MethodsWe synthesized findings from multistakeholder dialogues and country policy reports conducted previously for the Success Factors studies in 10 countries: Bangladesh, Cambodia, China, Egypt, Ethiopia, the Lao People's Democratic Republic, Nepal, Peru, Rwanda and Viet Nam. A framework approach was used to analyse and synthesize the data from the country reports, resulting in descriptive or explanatory conclusions by theme.FindingsSuccessful policy and programme approaches were categorized in four strategic areas: leadership and multistakeholder partnerships; health sector; sectors outside health; and accountability for resources and results. Consistent and coordinated inputs across sectors, based on high-impact interventions, were assessed. Within the health sector, key policy and programme strategies included defining standards, collecting and using data, improving financial protection, and improving the availability and quality of services. Outside the health sector, strategies included investing in girls’ education, water, sanitation and hygiene, poverty reduction, nutrition and food security, and infrastructure development. Countries improved accountability by strengthening and using data systems for planning and evaluating progress.ConclusionReducing maternal and child mortality in the 10 fast-track countries can be linked to consistent and coordinated policy and programme inputs across health and other sectors. The approaches used by successful countries have relevance to other countries looking to scale-up or accelerate progress towards the sustainable development goals.

Background Despite global data around increased health risks among sexual and gender diverse populations, lived experiences of young lesbian, gay, bisexual, transgender, queer or questioning, and others (LGBTQ+) people are often ignored in mainstream health research. This is particularly evident in countries such as Bangladesh where the rights of sexual minorities are not recognised. This article looks at queer lived experiences of sexuality and sexual health within such a context. We use the phenomenological framework of heteronormative ‘straightening devices’ – mechanisms working to direct people towards heterosexuality, gender conformity, and procreative marriage – to identify ‘invisible’ structures upholding normative sexual behaviours and see how young people in Bangladesh navigate these in their everyday lives. Methods This article is based on qualitative data collected in Dhaka, Bangladesh over nine months in 2019 as part of the first author’s doctoral research. Using thematic analysis, we draw on experiences of normative sexual expectations from biographical in-depth interviews with 14 purposively sampled LGBTQ + individuals aged 18 to 24. Results Respondents identified heteronormative expectations around gender norms of traditional behaviour and presentation for men and women as well as parental expectations of compulsory heterosexuality through marriage. These straightening devices existed at multiple levels, including individual, interpersonal, community, and societal. The four main themes around straightening devices include marriage norms for women; harassment of feminine-presenting bodies in public spaces; heteronormative healthcare; and consequences of not embodying heteronormativity. Conclusion Our study highlighted young people’s everyday experiences of having to ‘bend’ to – and against – heteronormative straightening devices at home, in public spaces, and within institutions such as healthcare in Bangladesh. The exploration of queer experiences provides new insights into context-specific ways in which sexual and gender diverse people understand themselves. Further research using the framework of straightening devices can help public health professionals to identify more ‘barriers’ confronted by sexual and gender diverse young people.