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BHESP (Bar Hostess Empowerment and Support Programme) peer educators prepare food packages for distribution to members.
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The COVID-19 pandemic, and its attendant responses, has led to massive health, social, and economic challenges on a global scale. While, so far, having a relatively low burden of COVID-19 infection, it is the response in lower- and middle- income countries that has had particularly dire consequences for impoverished populations such as sex workers,...
Context in source publication
Context 1
... greatest source of distress that counsellors, peer educators and other frontline health workers are hearing from sex workers relates to food insecurity. After receiving funding from UHAI-EASHRI, 2 sex work leaders organised the purchase and distribution of food vouchers valued at 1,500 Ksh ($14 US) per member for the purchase groceries (see Figures 3 and 4). Another strategy adopted by the peer leaders is taking part in the distribution and selling of personal protective equipment (PPE). ...
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Citations
... In Kenya, the dusk-to-dawn curfew meant that places that offered sexual and reproductive health services (SRH) had fewer operating hours, a situation predicted in a United Nations Population Fund Technical Note on the possible effects of the pandemic on women (UNFPA, 2020). The physical distancing measures reduced the number of patients that health centres could care for at one time, and closure of entertainment facilities such as bars, and physical distancing directives instituted by the Ministry of Health to curb the spread of COVID-19 led to FSWs losing their livelihood (Gichuna et al., 2020;Kimani et al., 2020;Mantell et al., 2021). ...
... Reflections from the Ebola and Severe Acute Respiratory Syndrome (SARS) pandemics show that vulnerable populations, especially women and children, are disproportionately affected due to the underpinning sociocultural contexts (Saalim et al., 2021). This has also been the case during the COVID-19 pandemic (Hassan et al., 2021;Kimani et al., 2020), with evidence from Kenya suggesting that the COVID-19 containment measures may have increased physical, sexual, verbal, and economic violence against FSWs (Mantell et al., 2021). Reports from West Africa suggest that vulnerable people may also have suffered increased inaccessibility of healthcare, exacerbated sexual and domestic violence, economic disruptions, and arbitrary police arrests (Saalim et al., 2021). ...
At the beginning of the COVID-19 pandemic, the Kenya Ministry of Health instituted movement cessation measures and limits on face-to-face meetings. We explore the ways in which female sex workers (FSWs) in Nairobi were affected by the COVID-19 control measures and the ways they coped with the hardships. Forty-seven women were randomly sampled from the Maisha Fiti study, a longitudinal study of 1003 FSWs accessing sexual reproductive health services in Nairobi for an in-depth qualitative interview 4–5 months into the pandemic. We sought to understand the effects of COVID-19 on their lives. Data were transcribed, translated, and coded inductively. The COVID-19 measures disenfranchised FSWs reducing access to healthcare, decreasing income and increasing sexual, physical, and financial abuse by clients and law enforcement. Due to the customer-facing nature of their work, sex workers were hit hard by the COVID-19 restrictions. FSWs experienced poor mental health and strained interpersonal relationships. To cope they skipped meals, reduced alcohol use and smoking, started small businesses to supplement sex work or relocated to their rural homes. Interventions that ensure continuity of access to health services, prevent exploitation, and ensure the social and economic protection of FSWs during times of economic strain are required.
... According to the World Bank's most current poverty and shared prosperity report, the pandemic pushed 100 million people into severe poverty in 2020 alone, raising global poverty to its highest level since 1998 (World Bank 2020a). The impact of Covid-19 is visible in lower-and middle-income countries, which were already in recession by late 2019 (UNCTAD 2020) and this has had particularly dire consequences for impoverished groups, such as sex workers, many of whom rely on regular income from the informal economic sector to survive (Kimani et al. 2020). The Covid-19 pandemic was predicted to impact on Africa's economy substantially. ...
Contents Editorial Badar Alam Iqbal.........................................................................................v *** Can Africa Run? Industrialisation and Development in Africa Fiona Tregenna .................................................................................................. 1 [Revised Text of the Second Thandika Mkandawire Annual Memorial Lecture ] *** Selected Papers on Covid-19 Pandemic and African Economies Governance Issues and the Covid-19 Pandemic in West Africa: Are There Any Linkages? Félix Fofana N'Zue and Adjoua Math Komenan...................................................33 From Epidemic to Pandemic: Covid-19, Insecurity and Development in the Sahel Tope Shola Akinyetun ..............................................................................................61 Covid-19 Lockdown and the ‘Work-From-Home’ Approach: Effect on Nigerian Academics Tolulope Osinubi, Cleopatra Ibukun and Titus Ojeyinka..............................................87 Impact of Covid-19 Pandemic on the Financial Performance of SMEs in Nigeria: A Study of the South East Geopolitical Zone Stella Ngozi Okoroafor.............................................................................107 Digital Learning Response in the Midst of the Covid-19 Pandemic: The Case of Mauritius Verena Tandrayen-Ragoobur, Boopen Seetanah, Sheereen Fauzel and Viraiyan Teeroovengadum...................................129 Covid-19 Social Relief Programmes and Distribution Mechanisms in East Africa: Lessons Learned Ivan Kagimu...............................................................................159 Are the Covid-19 Pandemic and Public Procurement ‘Strange Bedfellows’? An African Perspective Ismail Abdi Changalima..............................................................175 Effets de la Covid-19 sur les entreprises du secteur informel agricole au Sénégal Sidia Diaouma Badiane, Amadou Tandjigora, Thierno Bachir Sy, Yessoufou et Mamoudou Dème ...................197
... According to the World Bank's most current poverty and shared prosperity report, the pandemic pushed 100 million people into severe poverty in 2020 alone, raising global poverty to its highest level since 1998 (World Bank 2020a). The impact of Covid-19 is visible in lower-and middle-income countries, which were already in recession by late 2019 (UNCTAD 2020) and this has had particularly dire consequences for impoverished groups, such as sex workers, many of whom rely on regular income from the informal economic sector to survive (Kimani et al. 2020). The Covid-19 pandemic was predicted to impact on Africa's economy substantially. ...
Covid-19 had social, physical and economic impacts that prompted governments to develop strategies to help their citizens cope with the mandatory lockdowns and curfews. East African countries faced several uncertainties and challenges in assisting their citizens, including a lack of funds to implement large-scale relief programmes, effective identification of eligible beneficiaries and viable distribution channels. Some African countries launched cash transfer and social assistance programmes. However, the size, efficiency and proportion of the population covered varied, leading to increased fraud, corruption and embezzlement. Patronage, political exploitation and partisanship were also prevalent. This article aims to assess the success of the East African Covid-19 cash and social assistance programmes and the mechanisms used and to draw lessons by comparing them with effective programmes outside Africa, in order to better inform the efficient design of future similar programmes. Using a data triangulation research methodology, the article finds that the Covid-19 relief programmes in many East African countries failed due to a lack of up-to-date multidimensional data on people's living standards, income and poverty levels. If East African countries are to implement effective social assistance programmes, they need to develop comprehensive and multi-faceted (resident) data collection systems to guide such programmes.
... The findings of (inter)national studies suggest that the coronavirus pandemic and associated restrictions had a farreaching impact on the situation of people engaged in prostitution (including Azam et al. 2021;Boyer 2020;Brüesch et al. 2021;Burgos and Del Pino 2021;Kimani et al. 2020;Macharia et al. 2021;Molnar and Ros 2022;Pereira 2021;Singer et al. 2020;Tan et al. 2021). For example, Azam et al. (2021), who studied the impact of the coronavirus pandemic in the Netherlands and Belgium, found that both the supply of and demand for sexual services declined and that prostitution, if still practiced, increasingly took place in comparatively less visible settings (such as private apartments instead of prostitution establishments). ...
During the coronavirus pandemic, prostitution was subject to considerable restrictions. The practice of prostitution, being inherently associated with physical closeness, was at times completely forbidden and at other times only permitted with considerable restrictions; prostitution establishments were sometimes not allowed to open at all, and sometimes only under strict criteria. This contributed to the fact that discussion about the situation of people involved in prostitution became increasingly the focus of medial and political debates. Pertinent articles repeatedly reported on the increasingly precarious position of prostitutes. However, a systematic scientific appraisal of the situation of prostitutes during the coronavirus pandemic has been lacking until now. The Criminological Research Institute of Lower Saxony (KFN) addressed this topic in an explorative study carried out in 2021. It examined how the coronavirus pandemic and, in particular, the restrictions in the prostitution industry associated with it, had affected the life situations of people working in the industry. A written survey was conducted among a total of 63 specialist counselling centres for prostitution workers as well as a total of four expert interviews with employees of these centres. This revealed, first and foremost, that despite coronavirus-related bans in Germany, prostitution continued, albeit at a reduced level. The reasons given were mostly financial plight as well as a lack of alternatives on the part of prostitution workers. Ultimately, it has emerged that people working in prostitution increasingly reported violent incidents and increased dependency during the pandemic.
... The supply of other healthcare resources likely declined due to the high priority placed on COVID-19 resources. This led to fewer healthcare services for non-COVID-19related issues (38,39). In some cases, this has decreased the quality of care for those seeking treatment for other medical issues (13,39). ...
... This led to fewer healthcare services for non-COVID-19related issues (38,39). In some cases, this has decreased the quality of care for those seeking treatment for other medical issues (13,39). Furthermore, appointment wait times may have increased, causing further delays in treatment. ...
Background
Young people are increasingly seeking employment in the informal sector due to increasing global unemployment. However, the precarious nature of work in the informal sectors, coupled with the high risk of occupational hazards, calls for a greater need for effective healthcare for informal sector workers, particularly young people. In addressing the health vulnerabilities of informal workers, systematic data on the determinants of health is a persistent challenge. Therefore, the objective of this systematic review was to identify and summarise the existing factors that affect access to healthcare among young people from the informal sector.
Methods
We searched six data databases (PubMed, Web of Science, Scopus, ProQuest, Crossref, and Google Scholar), which was followed by hand searching. Then we screened the identified literature using review-specific inclusion/exclusion criteria, extracted data from the included studies and assessed study quality. Then we presented the results in narrative form, though meta-analysis was not possible due to heterogeneity in the study design.
Results
After the screening, we retrieved 14 studies. The majority were cross-sectional surveys and were conducted in Asia (n = 9); four were conducted in Africa, and one in South America. Samples ranged in size from 120 to 2,726. The synthesised results demonstrate that problems of affordability, availability, accessibility, and acceptability of healthcare were barriers to young informal workers seeking healthcare. We found social networks and health insurance as facilitators of access for this group of people.
Conclusion
To date, this is the most comprehensive review of the evidence on access to healthcare for young people in the informal sector. Our study finding highlights the key gaps in knowledge where future research could further illuminate the mechanisms through which social networks and the determinants of access to healthcare could influence the health and well-being of young people and thus inform policy development.
... The non-pharmaceutical interventions initiated by the government to prevent the spread of the infection included cessation of all movement by road, rail, or air in and out of the Nairobi metropolitan area, Kilifi, Kwale, and Mombasa counties; a nationwide curfew from 7:00 p.m. to 5:00 a.m.; closure of all bars, hotels, and places of worship; wearing masks while in public areas; frequent hand washing and sanitising; and keeping a physical distance of 1.5 m from other people. For female sex workers (FSWs) working in Nairobi county, these restrictions presented challenges that disrupted their lives and livelihoods [2,3]. Night curfews led to reduced working hours, closure of venues where they met clients, and fewer clients wanting to buy sex. ...
... Night curfews led to reduced working hours, closure of venues where they met clients, and fewer clients wanting to buy sex. The Ministry of Health (MoH) recommendation of physical distancing and putting on face masks complicated sex work, which involves close contact with clients during negotiations and sexual intercourse [2,4]. The cessation of movement to and from Nairobi County meant FSWs could no longer move around to solicit clients elsewhere in the country, reducing clients and income potential. ...
... Sex workers also suffered isolation from their peers and other contacts, forcing some to adopt alternative ways to find clients. These changes included a shift to online platforms for those with smartphones, while others solicited clients during the day, before curfew, which negatively affected their volume of clients [2]. The Kenyan Government provided no financial support or other social protection measures to help alleviate the loss of income for FSWs, which resulted in economic hardship. ...
Conducting violence and mental health research during the COVID-19 pandemic with vulnerable groups such as female sex workers (FSWs) required care to ensure that participants and the research team were not harmed. Potential risks and harm avoidance needed to be considered as well as ensuring data reliability. In March 2020, COVID-19 restrictions were imposed in Kenya during follow-up data collection for the Maisha Fiti study (n = 1003); hence data collection was paused. In June 2020, the study clinic was re-opened after consultations with violence and mental health experts and the FSW community. Between June 2020 and January 2021, data were collected in person and remotely following ethical procedures. A total of 885/1003 (88.2%) FSWs participated in the follow-up behavioural–biological survey and 47/47 (100%) participated in the qualitative in-depth interviews. A total of 26/885 (2.9%) quantitative surveys and 3/47 (6.4%) qualitative interviews were conducted remotely. Researching sensitive topics like sex work, violence, and mental health must guarantee study participants’ safety and privacy. Collecting data at the height of COVID-19 was crucial in understanding the relationships between the COVID-19 pandemic, violence against women, and mental health. Relationships established with study participants during the baseline survey—before the pandemic—enabled us to complete data collection. In this paper, we discuss key issues involved in undertaking violence and mental health research with a vulnerable population such as FSWs during a pandemic. Lessons learned could be useful to others researching sensitive topics such as violence and mental health with vulnerable populations.
... Thus, the contributors confronted numerous obstacles when carrying out research and producing papers amidst a worldwide health crisis, which was characterized by economic depression, lockdown of workplaces and communities, sickness, premature mortality, and moral fear. This uncharacteristic global situation not only affected the subject of empirical inquiries about structural interventions that might improve the circumstances of people engaged in sex work (Döring and Walter 2020; Jozaghi and Bird 2020; Kimani et al. 2020;Lam 2020;Platt et al. 2020;Singer et al. 2020), but also the work of the authors themselves, especially those marginalized by their gender, race, or geographic location who have been contending with major challenges in conducting research during these unusual times (Benoit et al. 2022;King and Frederickson 2021;Döring and Walter 2020). ...
Researchers have argued that the current punitive approaches to regulating sex work expose underlying structures that seek to preserve a social order embedded with stigmas related to the race, gender, sexuality, class, and migration status of sex sellers (Benoit et al [...]
... The pandemic has posed challenges to health systems and emergency response systems worldwide in managing the disease's morbidity and mortality [1]. In Africa, COVID-19-related restrictions on mobility have adversely affected the health and access to healthcare, especially for vulnerable populations [2,3]. The Covid-19 restrictions have significantly impacted maternal and newborn healthcare delivery with subsequent effects on newborn care postdelivery [4]. ...
Objective
African newborns undergo numerous traditional and religious practices ranging from fontanelle fomentation to total head shaving, scalp molding, skin scarification and ano-genital irrigation which can negatively impact the health of neonates. Hot fomentation of fontanelles has been a predominant indigenous home-based postnatal practice in Ghana and among Africans in the diaspora. Mobility restrictions during the Covid-19 pandemic has impacted direct access to facility-based care as well as home care. The flourishing of newborn traditional practices among African populations during this Covid-19 pandemic offers opportunities to rethink the provision of family healthcare support for newborns during the ongoing pandemic and beyond. Hence, the aim of this critical review was to examine and describe a common indigenous practice—hot fontanelle fomentation to inform home birth support, discharge planning, and the delivery of optimal home-based care support.
Study design
This study is a review of literature on hot fomentation of newborn fontanelles.
Methods
Literature search in CINAHL, PubMed, African Index Medicus and Scopus, was conducted and evidence synthesised from articles ranging from 1983–2022. Sixty articles were reviewed; however, 10 manuscripts were excluded prior to screening. The other 19 were exempted because they were either below 1983 or were not the best fit for the study purpose. In all, 31 studies were included in the study. The study was guided by Madeleine Leininger’s Culture Care Diversity and Universality care theory.
Results
The current study identifies hot fomentation of newborn fontanelles practices in Ghana, the description of hot fomentation practices and the dangers associated with it. The findings and suggested ways to help overcome this challenge.
Conclusion
There are several neonatal indigenous practices including fontanelle fomentation which pose threat to the health of the neonate as discussed in this study. Future research needs to investigate innovative ways of fontanelle fomentation where necessary instead of the use of hot water by mothers, especially in this Covid-19 pandemic where health and mobility restrictions impact physical access to timely health care. This research will help educate mothers about the dangers of fontanel fomentation and reduce the practice, especially in rural areas of developing countries. This could help reduce neonatal mortality and unnecessary healthcare costs.
... Open access from Thailand, 4 Hong Kong, 5 Poland, 6 Kenya, 7 Nigeria, Uganda and Botswana, 8 the USA 9 and Canada 10 shows that sex workers were largely excluded from or unable to access government supports extended to other workers. Facing existing criminalisation which was intensified by the pandemic crisis, sex workers' labour became even more precarious. ...
... In Kenya, venue closures resulted in sex workers working in clients' homes, where they had less control over the work environment, less support from other sex workers and third parties (ie, managers, venue owners), and heightened vulnerability to violence and theft. 7 Dawn-to-dusk curfews in many countries also exposed sex workers to client and police harassment at night. 7 8 33 In Canada, sex workers reported heightened police presence under the guise of public safety, suggesting that pandemic-related public health enforcement promoted hyper-surveillance of marginalised sex workers. ...
Objectives
Globally, criminalisation has shaped sex workers’ structural exclusion from occupational protections, and this exclusion has been exacerbated during the COVID-19 pandemic. While community organisations aim to bridge this gap through providing health and safety resources for sex workers, many were forced to scale back services when Canadian provinces declared a state of emergency at the pandemic onset. As little empirical research has examined the impacts of sex work community services interruptions amid COVID-19, our objectives were to (1) examine the correlates of interrupted access to community services and (2) model the independent association between interrupted access to community services and changes in working conditions (ie, self-reported increases in workplace violence or fear of violence), among sex workers during the COVID-19 pandemic.
Design, setting and participants
As part of an ongoing community-based cohort of sex workers in Vancouver, Canada (An Evaluation of Sex Workers Health Access, 2010–present), 183 participants completed COVID-19 questionnaires between April 2020 and April 2021.
Analysis
Cross-sectional analysis used bivariate and multivariable logistic regression with explanatory and confounder modelling approaches.
Results
18.6% of participants (n=34) reported interrupted access to community services (closure/reduction in drop-in hours, reduced access to spaces offering sex worker supports and/or reduced access/contact with outreach services). In multivariable analysis, sex workers who had difficulty maintaining social supports during COVID-19 (adjusted OR, AOR 2.29, 95% CI 0.95 to 5.56) and who experienced recent non-fatal overdose (AOR 2.71, 95% CI 0.82 to 8.98) faced marginally increased odds of service interruptions. In multivariable confounder analysis, interrupted access to community services during COVID-19 was independently associated with changes in working conditions (ie, self-reported increases in workplace violence or fear of violence; AOR 4.00, 95% CI 1.01 to 15.90).
Conclusions
Findings highlight concerning implications of community service interruptions for sex workers’ labour conditions. Sustainable funding to community organisations is urgently needed to uphold sex workers’ occupational safety amid COVID-19 and beyond.
... Some recent studies on vulnerable populations such as sex workers in low-and middleincome countries have reported on this population's access to health care during COVID-19 [21][22][23][24]. Globally, vulnerable populations are often marginalized, economically disempowered, experience poor social conditions (violence, poor housing, food insecurity, etc.), lack access to health care, education, social services and may practice sex work to survive even though the profession is illegal in many countries. ...
In 2020–2021 the COVID-19 pandemic led to multiple and diverse global public health response strategies globally and in Uganda to slow the spread of the virus by promoting wearing face coverings in public, frequent hand washing, physical distancing, restricting travel, and imposing home lockdowns. We conducted 146 interviews over four rounds of phone-follow up calls over 15 months with 125 young female sex workers coinciding in time with four different government-imposed lockdown periods in Kampala, Uganda, to assess the impact of these measures on young sex workers, their families and their communities as well as to gauge their resilience. Our findings revealed how COVID-19 fears and public health restrictions over time pushed an already marginalized population to the brink and how that pressure drove some participants into a new way of life.
