The impact of COVID-19 on a cohort of origin residents and internal migrants from South Africa's rural northeast

Ginsburg, Carren; Collinson, Mark; Gómez‐Olivé, Francesc Xavier; Harawa, Sadson; Pheiffer, Chantel F.; White, Michael J.

doi:10.1016/j.ssmph.2022.101049

Cited by 10 publications

(17 citation statements)

References 13 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recent evidence from the Agincourt study area showed that migrants compared to non-migrants, and men compared to women, each had ∼70% lower odds of health service use in the last 12-months among individuals living with a chronic condition ( 15 ). However to interpret of our finding, there are two scenarios to consider; that educational and health selectivity upon migration ( 39 , 40 ) or observed health and wellbeing benefits occurring post-migration ( 41 ) is mediated through improved socio-economic status ( 42 , 43 ), which cannot be demonstrated using a cross-sectional design. Taking previous data into consideration, we posit that while migrants are at risk of gaps in healthcare engagement continuity, being more educated (i.e., higher socio-economic status and health literacy) helps overcoming barriers to accessing healthcare (i.e., both when at destination and origin) confers the preventive benefit to multimorbidity.…”

Section: Discussionmentioning

confidence: 88%

Epidemiology of chronic multimorbidity and temporary migration in a rural South African community in health transition: A cross-sectional population-based analysis

et al. 2023

Self Cite

View full text Add to dashboard Cite

IntroductionIn sub-Saharan African settings, the increasing non-communicable disease mortality is linked to migration, which disproportionately exposes sub-populations to risk factors for co-occurring HIV and NCDs.MethodsWe examined the prevalence, patterns, and factors associated with two or more concurrent diagnoses of chronic diseases (i.e., multimorbidity) among temporary within-country migrants. Employing a cross-sectional design, our study sample comprised 2144 residents and non-residents 18–40 years interviewed and with measured biomarkers in 2018 in Wave 1 of the Migrant Health Follow-up Study (MHFUS), drawn from the Agincourt Health and Demographic Surveillance System (AHDSS) in rural north-eastern South Africa. We used modified Poisson regression models to estimate the association between migration status and prevalent chronic multimorbidity conditional on age, sex, education, and healthcare utilisation.ResultsOverall, 301 participants (14%; 95% CI 12.6–15.6), median age 31 years had chronic multimorbidity. Multimorbidity was more prevalent among non-migrants (14.6%; 95% CI 12.8–16.4) compared to migrants (12.8%; 95% CI 10.3–15.7). Non-migrants also had the greatest burden of dual-overlapping chronic morbidities, such as HIV-obesity 5.7%. Multimorbidity was 2.6 times as prevalent (PR 2.65. 95% CI 2.07–3.39) among women compared to men. Among migrants, men, and individuals with secondary or tertiary education manifested lower prevalence of two or more conditions.DiscussionIn a rural community with colliding epidemics, we found low but significant multimorbidity driven by a trio of conditions: HIV, hypertension, and obesity. Understanding the multimorbidity burden associated with early adulthood exposures, including potential protective factors (i.e., migration coupled with education), is a critical first step towards improving secondary and tertiary prevention for chronic disease among highly mobile marginalised sub-populations.

show abstract

Section: Discussionmentioning

confidence: 88%

Epidemiology of chronic multimorbidity and temporary migration in a rural South African community in health transition: A cross-sectional population-based analysis

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…International migrants may face additional hurdles due to new South African laws restricting employment of foreign workers [ 61 ]. In addition, Covid-related restrictions during the time of this study further tightened job opportunities and exacerbated vulnerabilities for those working in South Africa’s informal labor sector [ 62 , 63 ].…”

Section: Discussionmentioning

confidence: 99%

“…Approximately a third of participants had not tested for HIV in the past year, despite the fact that testing at least annually has been shown to reduce the burden of undiagnosed HIV [ 13 ], and testing remains an important entry point for engagement in HIV care [ 74 – 76 ]. However, it may be difficult to interpret these data in the setting of Covid-related restrictions, which likely had an impact on HIV testing and other healthcare engagement for all participants during the year preceding this study [ 62 ].…”

Section: Discussionmentioning

confidence: 99%

Migrant men and HIV care engagement in Johannesburg, South Africa

Nardell,

Govathson,

Mngadi-Ncube

et al. 2024

BMC Public Health

View full text Add to dashboard Cite

Background South Africa (SA) has one of the highest rates of migration on the continent, largely comprised of men seeking labor opportunities in urban centers. Migrant men are at risk for challenges engaging in HIV care. However, rates of HIV and patterns of healthcare engagement among migrant men in urban Johannesburg are poorly understood. Methods We analyzed data from 150 adult men (≥ 18 years) recruited in 10/2020–11/2020 at one of five sites in Johannesburg, Gauteng Province, SA where migrants typically gather for work, shelter, transit, or leisure: a factory, building materials store, homeless shelter, taxi rank, and public park. Participants were surveyed to assess migration factors (e.g., birth location, residency status), self-reported HIV status, and use and knowledge of HIV and general health services. Proportions were calculated with descriptive statistics. Associations between migration factors and health outcomes were examined with Fisher exact tests and logistic regression models. Internal migrants, who travel within the country, were defined as South African men born outside Gauteng Province. International migrants were defined as men born outside SA. Results Two fifths (60/150, 40%) of participants were internal migrants and one fifth (33/150, 22%) were international migrants. More internal migrants reported living with HIV than non-migrants (20% vs 6%, p = 0.042), though in a multi-variate analysis controlling for age, being an internal migrant was not a significant predictor of self-reported HIV positive status. Over 90% all participants had undergone an HIV test in their lifetime. Less than 20% of all participants had heard of pre-exposure prophylaxis (PrEP), with only 12% international migrants having familiarity with PrEP. Over twice as many individuals without permanent residency or citizenship reported “never visiting a health facility,” as compared to citizens/permanent residents (28.6% vs. 10.6%, p = 0.073). Conclusions Our study revealed a high proportion of migrants within our community-based sample of men and demonstrated a need for HIV and other healthcare services that effectively reach migrants in Johannesburg. Future research is warranted to further disaggregate this heterogenous population by different dimensions of mobility and to understand how to design HIV programs in ways that will address migrants’ challenges.

show abstract

“…It is not possible to determine the reasons for the attrition of the 11 sample members who could not be tracked, and therefore whether this attrition is differential and might affect our analysis. For instance, it is possible that attrition rates are higher among those who migrated between 2017 and 2020, including migration as a response to the pandemic shock (Ginsburg et al, 2022 ; Posel & Casale, 2021 ). At the same time, in a context in which cell phone theft and loss are high and in which cell phones are often shared, it was to be expected that a considerable proportion of respondents would not be reached on the numbers that they provided three years prior.…”

Section: Methodsmentioning

confidence: 99%

“…It should be noted that the results reported in Table 1 do not account for potential migratory responses to the pandemic shock. Ginsburg et al, ( 2022 ) and Posel & Casale ( 2021 ) demonstrate that in the South African context of spatially ‘stretched’ households and circular migration between rural (labour sending) and urban (labour receiving) areas, the pandemic shock led to substantial urban-to-rural migration. Posel & Casale ( 2021 ), using NIDS-CRAM data, estimate that 16 per cent of adults in South Africa moved households during the early months of the pandemic.…”

Section: The Economic Impact Of the Pandemic: A Quantitative Snapshotmentioning

confidence: 99%

The livelihood impacts of COVID-19 in urban South Africa: a view from below

Schotte

Zizzamia

2022

Soc Indic Res

View full text Add to dashboard Cite

This paper investigates the impact of the COVID-19 pandemic and related policy measures on livelihoods in urban South Africa. Using qualitative research methods, we analyse two rounds of semi-structured phone interviews, conducted between June and September 2020 in the township of Khayelitsha, Cape Town. We contextualise these by presenting a snapshot of the nationwide dynamics using quantitative panel data. Our findings describe how the shock of the COVID-19 pandemic has deepened the economic vulnerability which preceded the crisis. Survivalist livelihood strategies were undermined by the economic disruption to the informal sector, while the co-variate nature of the shock rendered social networks and informal insurance mechanisms ineffective, causing households to liquidate savings, default on insurance payments, and deepen their reliance on government grants. In addition, the impact of the pandemic on schooling may deepen existing inequalities and constrain future upward mobility.

show abstract

The impact of COVID-19 on a cohort of origin residents and internal migrants from South Africa's rural northeast

Cited by 10 publications

References 13 publications

Epidemiology of chronic multimorbidity and temporary migration in a rural South African community in health transition: A cross-sectional population-based analysis

Epidemiology of chronic multimorbidity and temporary migration in a rural South African community in health transition: A cross-sectional population-based analysis

Migrant men and HIV care engagement in Johannesburg, South Africa

The livelihood impacts of COVID-19 in urban South Africa: a view from below

Contact Info

Product

Resources

About