International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh.
Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia; Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia.
Lancet Glob Health. 2020 Nov;8(11):e1380-e1389. doi: 10.1016/S2214-109X(20)30366-1. Epub 2020 Aug 25.
Stay-at-home orders (lockdowns) have been deployed globally to control COVID-19 transmission, and might impair economic conditions and mental health, and exacerbate risk of food insecurity and intimate partner violence. The effect of lockdowns in low-income and middle-income countries must be understood to ensure safe deployment of these interventions in less affluent settings. We aimed to determine the immediate impact of COVID-19 lockdown orders on women and their families in rural Bangladesh.
An interrupted time series was used to compare data collected from families in Rupganj upazila, rural Bangladesh (randomly selected from participants in a randomised controlled trial), on income, food security, and mental health a median of 1 year and 2 years before the COVID-19 pandemic to data collected during the lockdown. We also assessed women's experiences of intimate partner violence during the pandemic.
Between May 19 and June 18, 2020, we randomly selected and invited the mothers of 3016 children to participate in the study, 2424 of whom provided consent. 2414 (99·9%, 95% CI 99·6-99·9) of 2417 mothers were aware of, and adhering to, the stay-at-home advice. 2321 (96·0%, 95·2-96·7) of 2417 mothers reported a reduction in paid work for the family. Median monthly family income fell from US$212 at baseline to $59 during lockdown, and the proportion of families earning less than $1·90 per day rose from five (0·2%, 0·0-0·5) of 2422 to 992 (47·3%, 45·2-49·5) of 2096 (p<0·0001 comparing baseline with lockdown period). Before the pandemic, 136 (5·6%, 4·7-6·6) of 2420 and 65 (2·7%, 2·1-3·4) of 2420 families experienced moderate and severe food insecurity, respectively. This increased to 881 (36·5%, 34·5-38·4) of 2417 and 371 (15·3%, 13·9-16·8) of 2417 during the lockdown; the number of families experiencing any level of food insecurity increased by 51·7% (48·1-55·4; p<0·0001). Mothers' depression and anxiety symptoms increased during the lockdown. Among women experiencing emotional or moderate physical violence, over half reported it had increased since the lockdown.
COVID-19 lockdowns present significant economic, psychosocial, and physical risks to the wellbeing of women and their families across economic strata in rural Bangladesh. Beyond supporting only the most socioeconomically deprived, support is needed for all affected families.
National Health and Medical Research Council, Australia.
为控制 2019 冠状病毒病（COVID-19）的传播，全球各地实施了居家令（封锁），这可能会影响经济状况和心理健康，加剧粮食不安全和亲密伴侣暴力的风险。为确保在不太富裕的环境中安全实施这些干预措施，必须了解低收入和中等收入国家的封锁情况。我们旨在确定 COVID-19 封锁令对孟加拉国农村地区妇女及其家庭的直接影响。
采用中断时间序列的方法，对孟加拉国农村如普里甘杰县（从参加一项随机对照试验的参与者中随机选择）的家庭进行收入、粮食安全和心理健康方面的数据进行比较，这些数据在 COVID-19 大流行前中位数为 1 年和 2 年，在封锁期间进行收集。我们还评估了女性在大流行期间遭受亲密伴侣暴力的情况。
2020 年 5 月 19 日至 6 月 18 日，我们随机选择并邀请了 3016 名儿童的母亲参加研究，其中 2424 名母亲同意参加。2417 名母亲中有 2414 名（99.9%，95%CI 99.6-99.9）知晓并遵守居家建议。2417 名母亲中有 2321 名（96.0%，95.2-96.7）报告家庭减少了有薪工作。家庭月收入中位数从基线时的 212 美元降至封锁期间的 59 美元，每天收入不足 1.90 美元的家庭比例从基线时的 5 户（0.2%，0.0-0.5）增至 2096 户中的 992 户（47.3%，45.2-49.5）（与封锁期相比，p<0.0001）。在大流行之前，2420 名家庭中有 136 名（5.6%，4.7-6.6）和 2420 名家庭中有 65 名（2.7%，2.1-3.4）经历了中度和重度粮食不安全，分别。这一数字在封锁期间分别增加到 2417 名中的 881 名（36.5%，34.5-38.4）和 371 名（15.3%，13.9-16.8）（p<0.0001）；经历任何程度粮食不安全的家庭数量增加了 51.7%（48.1-55.4；p<0.0001）。母亲的抑郁和焦虑症状在封锁期间增加。在经历情绪或中度身体暴力的妇女中，超过一半的人报告自封锁以来暴力有所增加。
COVID-19 封锁对孟加拉国农村地区不同经济阶层妇女及其家庭的福祉造成了重大的经济、心理社会和身体风险。除了只支持最贫困的家庭外，还需要为所有受影响的家庭提供支持。
澳大利亚国家卫生和医学研究委员会。
