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How Has the COVID-19 Response Impacted People Living in Slum Neighborhoods?

Lockdowns implemented for pandemic control have broad health, social, and economic consequences. This is especially true for people who live and work in slum communities around the world.

As seen in a new study published in BMJ Global Health, direct stakeholder perspectives can shine a light on the matter. Investigators compared survey data from across 7 slums in Kenya, Nigeria, Bangladesh, and Pakistan gathered between March 2018 and May 2020.

The 860 survey respondents were community leaders, slum residents, health care workers, and local health authorities.

Normal health burdens across all sites included respiratory, gastric, waterborne and mosquitoborne illnesses and hypertension.

“Before the coronavirus pandemic, stakeholders identified preventive, diagnostic and treatment services, including well-used antenatal and immunization programs and screening for hypertension, tuberculosis, HIV and vector-borne disease,” according to study authors.

Afterward, that limited support evaporated.

With the advent of COVID-19 associated restrictions, a reduction in access to healthcare services was reported in all sites, including preventive services.

Cost of healthcare increased as household income was reduced. Residents also reported difficulty reaching health care facilities due to border controls and other restrictions.

Fear of being diagnosed with COVID-19 also discouraged healthcare seeking, according to respondents.

While telehealth and philanthropic support assisted, these were inconsistent and inadequate. There was no serious long-term support structure put in place for the world’s slums as health care systems and governments evacuated limited existing services.

The authors conclude that slum residents’ ability to seek health care for non-COVID-19 conditions has been dramatically reduced during lockdowns. Clear communication about risk, infection control services, and the import of other health burdens is necessary as fear of COVID-19 continues to drive treatment seeking behavior downwards.
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