Impact of Coronavirus Disease (COVID-19) Crisis on Migrants on the Move in Southern Africa: Implications for Policy and Practice

Mushomi, John; Palattiyil, George; Bukuluki, Paul; Sidhva, Dina; Myburgh, Nellie; Nair, Harish; Mulekya-Bwambale, Francis; Tamuzi, Jacques L.; Nyasulu, Peter

doi:10.1080/23288604.2021.2019571

Cited by 10 publications

(13 citation statements)

References 16 publications

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“…In this respect qualitative results show that people tended to prioritize survival and meeting basic needs especially food and shelter over seeking SRHR services. This is similar to findings of other studies conducted in low-income settings [8,13,31,35].…”

Section: Discussionsupporting

confidence: 91%

“…It reaffirms findings from related studies showing that COVID-19 disrupted access to sexual and reproductive health services for mobile populations including those at border points or areas [9,[31][32][33][34]. This implies that guaranteeing the SRHR of populations living in fragile settings including cross border settings like Mutukula and Busia amidst border closures and other movement restrictions similar to those experienced during lockdowns is essential and constitutes a basic human right [9,31,35].…”

Section: Discussionsupporting

confidence: 81%

“…In addition, some inherently high-risk women were unable to deliver in centres with more skilled and specialized care. Our study also demonstrates disruptions in access to antenatal and postnatal care for expectant mothers due to COVID-19 and its control measures [8,35] including lockdowns, border closures limiting crossing the border to seek services from the nearest hospitals across the border, skyrocketing of transport costs due to banning of public transport and difficulties in accessing movement or travel permits during lockdowns [8,13,31,33]. Our results are similar to those of Church et al [8] who observed that restrictions in movement coupled with reduction or suspension of mobile outreach programmes offering SRHR services heavily restricted women and girls from accessing essential SRHR services.…”

Section: Discussionmentioning

confidence: 58%

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Disruption in accessing sexual and reproductive health services among border populations during COVID-19 lockdown in Uganda

et al. 2022

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BackgroundThe spread of COVID-19 exposed the inadequacies inherent in the health care systems of many countries. COVID-19 and the attendant demands for emergency treatment and management put a significant strain on countries' health care systems, including hitherto strong health systems. In Uganda, as the government strived to contain COVID-19, other essential health care services were either disrupted or completely crowded out. Balancing the provision of COVID-19 treatment and management services and at the same time offering sexual and reproductive health and rights services (SRHR) proved to be a considerable challenge in these circumstances. COVID-19 prevention-related travel restrictions and border closures had far-reaching negative consequences on the mobility of individuals to access essential health services in Uganda. The situation may have been worse for cross-border communities that sometimes access services across the borders.Methods Using quantitative data from 1521 respondents and qualitative data (20 key informant interviews and 12 focus group discussions), we investigate the disruption in accessing SRHR services for border communities in Uganda during COVID-19. ResultsResults indicate that females (adjusted odds ratio (aOR) = 1.3; 95% confidence interval CI = 1.08-1.79), those with primary education (aOR = 1.47; 95% CI = 1.61-2.57), currently employed (aOR = 2.03; 95% CI = 1.61-2.57) and those with the intention to leave current residence (aOR = 2.09; 95% CI = 1.23-3.55) were more likely to have experienced a disruption in accessing SRHR services. However, respondents aged 35 years, or more were less likely to have experienced a disruption compared to their younger counterparts.Conclusions Results shed light on the disruption of access toSRHR services during pandemics such as COVID-19 among a highly mobile population. There is a need to invest in building strong and resilient health care systems that can guarantee continuous access to essential health services including SRHR provisions among mobile populations during pandemics.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 58%

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Disruption in accessing sexual and reproductive health services among border populations during COVID-19 lockdown in Uganda

et al. 2022

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“…Lack of access to healthcare during the journey may decrease detection and worsen TB outcomes. Note that lack of healthcare access has likely worsened for migrants during the recent COVID-19 pandemic [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Drivers determining tuberculosis disease screening yield in four European screening programmes: a comparative analysis

et al. 2023

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IntroductionThe WHO End-TB Strategy emphasises screening for early diagnosis of tuberculosis (TB) in high-risk groups, including migrants. We analysed key drivers of TB yield differences in four large migrant TB screening programmes to inform TB control planning and feasibility of a European approach.MethodsWe pooled individual TB screening episode data from Italy, the Netherlands, Sweden, and the UK and analysed predictors and interactions for TB case yield using multivariable logistic regression models.ResultsBetween 2005–2018 in 2,302,260 screening episodes among 2,107,016 migrants to four countries; the programmes identified 1,658 TB cases (yield 72.0 per 100,000; 95% confidence interval, CI68.6–75.6). In logistic regression analysis, we found associations between TB screening yield and age (>55 years odds ratio, OR2.91, CI2.24–3.78), being an asylum seeker (OR3.19, CI1.03–9.83) or on a settlement visa (OR1.78, CI1.57–2.01), close TB contact (OR12.25, 11.73–12.79), and higher TB incidence in the country of origin (CoO). We demonstrated interactions between migrant typology and age, as well as CoO. For asylum seekers, the elevated TB risk remained similar above CoO incidence thresholds of 100 per 100,000.ConclusionsKey determinants of TB yield included close contact, increasing age, incidence in CoO and specific migrant groups including asylum seekers and refugees. For most migrants such as UK students and workers, TB yield significantly increased with levels of incidence in CoO. The high, CoO-independent TB risk in asylum seekers above a 100 per 100,000 threshold could reflect higher transmission and reactivation risk of migration routes; with implications for selecting populations for TB screening.

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“…South Africa’s response to COVID-19 reflected this history, with initial reticence to include asylum seekers, refugees and foreign migrants in policies and mechanisms to deal with the pandemic [ 140 , 144 , 145 ], followed by confusion over the actual policy [ 146 ] and evidence of xenophobia and discrimination, including gender-based, in treatment [ 146 , 147 ]. By September 2021, South Africa had administered more than 16 million doses of COVID-19 vaccines to its citizens.…”

Section: Covid-19 Vaccination and Undocumented Migrants: Some Country...mentioning

confidence: 99%

The Challenge of Reaching Undocumented Migrants with COVID-19 Vaccination

Matlin

Smith²,

Merone

et al. 2022

IJERPH

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Access to vaccination against a health threat such as that presented by the COVID-19 pandemic is an imperative driven, in principle, by at least three compelling factors: (1) the right to health of all people, irrespective of their status; (2) humanitarian need of undocumented migrants, as well as of others including documented migrants, refugees and displaced people who are sometimes vulnerable and living in precarious situations; and (3) the need to ensure heath security globally and nationally, which in the case of a global pandemic requires operating on the basis that, for vaccination strategies to succeed in fighting a pandemic, the highest possible levels of vaccine uptake are required. Yet some population segments have had limited access to mainstream health systems, both prior to as well as during the COVID-19 pandemic. People with irregular resident status are among those who face extremely high barriers in accessing both preventative and curative health care. This is due to a range of factors that drive exclusion, both on the supply side (e.g., systemic and practical restrictions in service delivery) and the demand side (e.g., in uptake, including due to fears that personal data would be transmitted to immigration authorities). Moreover, undocumented people have often been at increased risk of infection due to their role as “essential workers”, including those experiencing higher exposure to the SARS-CoV-2 virus due to frontline occupations while lacking protective equipment. Often, they have also been largely left out of social protection measures granted by governments to their populations during successive lockdowns. This article reviews the factors that serve as supply-side and demand-side barriers to vaccination for undocumented migrants and considers what steps need to be taken to ensure that inclusive approaches operate in practice.

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Impact of Coronavirus Disease (COVID-19) Crisis on Migrants on the Move in Southern Africa: Implications for Policy and Practice

Cited by 10 publications

References 16 publications

Disruption in accessing sexual and reproductive health services among border populations during COVID-19 lockdown in Uganda

Disruption in accessing sexual and reproductive health services among border populations during COVID-19 lockdown in Uganda

Drivers determining tuberculosis disease screening yield in four European screening programmes: a comparative analysis

The Challenge of Reaching Undocumented Migrants with COVID-19 Vaccination

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