Africa Health Research Institute, KwaZulu-Natal, Durban & Mtubatuba, South Africa.
Institute for Global Health, University College London, London, United Kingdom.
Afr J AIDS Res. 2022 Jul;21(2):162-170. doi: 10.2989/16085906.2022.2095921.
: The impact of school closures due to COVID-19 raised widespread concerns about children's health and well-being. We examine the impact on the sexual health needs of learners in the context of COVID-19 related lockdowns in rural KwaZulu-Natal, South Africa.: In july-November 2020 and August-November 2021 we conducted 24 in-depth interviews and 8 group discussions with teachers and learners from 4 schools, community members and key education stakeholders. All interviews were conducted by telephone. We used a thematic analysis approach and Nvivo 12 software to manage the data.: Four main themes related to the COVID-19 pandemic emerged from the data: the sexual and reproductive health (SRH) of learners in the lead-up to the pandemic; the impact of COVID-19 on learners' SRH and wellbeing; the opportunities schools provided to support sexual well-being of learners during the pandemic; and the role of schools in supporting SRH for learners during the pandemic. Learners and stakeholders reported that the SRH of young people was affected by alcohol misuse, poor SRH knowledge and few pathways to link learners with services. Stakeholders working with schools reported that a lack of access to biomedical interventions (e.g., contraception) increased learner pregnancies. Gender-based violence in learners' households was reported to have increased during the COVID-19 pandemic related to loss of income. School closures disrupted the provision of a safe space to provide SRH and HIV-education through Life Orientation lessons and school nurse talks. This loss of a safe space also left learners vulnerable to sexual and physical violence. However, once schools re-opened, daily COVID-19 screening in schools provided the opportunity to identify and support vulnerable children who had other social needs (food and uniforms).Conclusion: The COVID-19 pandemic may have increased SRH needs and vulnerability of school-going children in a high HIV-burden rural setting. School shutdowns reduced the opportunity for schools to provide a vital safe space and information to enhance SRH for adolescents. Schools play a vital health promotion and social protection role.
由于 COVID-19 而关闭学校引起了人们对儿童健康和福祉的广泛关注。我们研究了 COVID-19 相关封锁对南非夸祖鲁-纳塔尔省农村地区学习者性健康需求的影响。在 2020 年 7 月至 11 月和 2021 年 8 月至 11 月期间，我们对来自 4 所学校的教师和学生、社区成员和主要教育利益相关者进行了 24 次深入访谈和 8 次小组讨论。所有访谈均通过电话进行。我们使用主题分析方法和 Nvivo 12 软件来管理数据。从数据中出现了四个与 COVID-19 大流行相关的主要主题：大流行前学习者的性和生殖健康（SRH）；COVID-19 对学习者的 SRH 和幸福感的影响；学校在大流行期间为支持学习者的性健康提供的机会；以及学校在大流行期间支持学习者 SRH 的作用。学习者和利益攸关方报告说，年轻人的 SRH 受到酒精滥用、SRH 知识匮乏和与服务联系的途径有限的影响。与学校合作的利益攸关方报告说，由于收入减少，无法获得生物医学干预措施（例如，避孕）增加了学生怀孕的人数。据报道，COVID-19 大流行期间，由于收入减少，学习者家庭中的性别暴力有所增加。学校关闭中断了通过生活指导课和学校护士谈话提供 SRH 和艾滋病毒教育的安全空间的提供。这种安全空间的丧失也使学习者容易受到性暴力和身体暴力的侵害。然而，一旦学校重新开放，学校每天进行的 COVID-19 筛查就为识别和支持有其他社会需求（食物和制服）的弱势儿童提供了机会。结论：COVID-19 大流行可能增加了高艾滋病毒负担的农村地区在校儿童的 SRH 需求和脆弱性。学校关闭减少了学校为增强青少年 SRH 提供重要安全空间和信息的机会。学校在促进健康和提供社会保护方面发挥着重要作用。
