Mental Health during COVID-19 Pandemic among Caregivers of Young Children in Kenya’s Urban Informal Settlements. A Cross-Sectional Telephone Survey

Abstract

The emergence of COVID-19 has profoundly affected mental health, especially among highly vulnerable populations. This study describes mental health issues among caregivers of young children and pregnant women in three urban informal settlements in Kenya during the first pandemic year, and factors associated with poor mental health. A cross-sectional telephone survey was administered to 845 participants. Survey instruments included the Patient Health Questionnaire-9, General Anxiety Disorder-7 scale, COVID-19 Anxiety Scale, and questions on the perceived COVID-19 effects on caregiver wellbeing and livelihood. Data were analyzed using descriptive statistics, and univariate and multivariate analysis. Caregivers perceived COVID-19 as a threatening condition (94.54%), affecting employment and income activities (>80%). Caregivers experienced discrimination (15.27%) and violence (12.6%) during the pandemic. Levels of depression (34%), general anxiety (20%), and COVID-19 related anxiety (14%) were highly prevalent. There were significant associations between mental health outcomes and economic and socio-demographic factors, violence and discrimination experiences, residency, and perceptions of COVID-19 as a threatening condition. Caregivers high burden of mental health problems highlights the urgent need to provide accessible mental health support. Innovative and multi-sectoral approaches will be required to maximize reach to underserved communities in informal settlements and tackle the root causes of mental health problems in this population.

Association between recent COVID-19 diagnosis on depression and anxiety symptoms among slum residents in Kampala, Uganda

“…Our findings support new evidence from other LMICs on the state of mental health during the pandemic. For instance, a recent study conducted in a socially and economically comparable setting in Kenya, reported elevated rates of depression (34.1%) and GAD (14.0%) [2] while in Bangladesh, the estimated prevalence of depression was 33.0% [25]. A further study from the United Kingdom [26] has compared pre-and post-COVID-19 rates of psychological distress and has shown that deterioration of mental health did not recover after COVID-19 restrictions were eased.…”

“…The uncertainties and unpredictable nature of the pandemic resulted in individuals experiencing various forms of mental health problems such as depression, anxiety, psychosocial dysfunction, dissociation disorders, substance abuse, and insomnia. It was projected that these effects would be most severe in lowresourced settings due to constraints related to weak health systems with limited access to mental health services [2]. Low-resourced settings such as slum residences comprise of informal dwelling units which are poorly constructed, crowded with poor sanitary conditions and environmental pollution [3,4].…”

“…Slum dwellers usually have poor physical and economic access to health care including mental health care [5]. Most informal settlements comprise an assortment of individuals (e.g., low-income earners, asylum seekers, refugees), who are at high risk of mental health problems due to multiple stressors and this may be further aggravated by the COVID-19 pandemic [2]. Due to unfavourable conditions of unstable income sources, high dependence on daily casual jobs, and threatened livelihoods and food security [6,7], slum dwellers may be at elevated risk of experiencing mental health challenges.…”

Combining International Survey Datasets to Identify Indicators of Stress during the COVID-19 Pandemic: A Machine Learning Approach to Improve Generalization

“…In China [18], reported that women endorsed higher levels of hyperarousal, difficulty sleeping, and negative reactions or moods, symptoms commonly associated with posttraumatic stress disorder. Several studies proposed that the disproportionate number of women experiencing "high stress" is potentially attributable to women being more likely to work in high-risk environments, such as clinics, or as a function of their status as primary caregivers to children, significant others, or parental figures [19][20][21][22][23].…”

Mental Health in the Time of COVID-19 Pandemic: A Worldwide Perspective

“…In this Special Issue, entitled “Mental health in the time of COVID-19”, several studies, carried out in different parts of the world, such as China [ 66 ], Canada [ 67 ], the UK [ 68 ], Greece [ 69 ], Poland [ 70 ], Norway [ 71 ], India [ 72 ], Mexico [ 73 ], Malaysia [ 74 ], Kenya [ 75 ], Saudi Arabia [ 76 ], and Switzerland [ 77 ], describe the impact of the pandemic on different dimensions of people’s mental health.…”