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非药物干预措施在非洲应对 COVID-19 中的意外后果:来自刚果民主共和国、尼日利亚、塞内加尔和乌干达的经验。

Unintended consequences of implementing non-pharmaceutical interventions for the COVID-19 response in Africa: experiences from DRC, Nigeria, Senegal, and Uganda.

机构信息

Public Health Department, Faculty of Health Sciences, University Amadou Hampaté Ba, Dakar, Senegal.

Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.

出版信息

Global Health. 2023 Jun 6;19(1):36. doi: 10.1186/s12992-023-00937-6.

Abstract

INTRODUCTION

The coronavirus (COVID 19) pandemic is one of the most terrifying disasters of the twenty-first century. The non-pharmaceutical interventions (NPIs) implemented to control the spread of the disease had numerous positive consequences. However, there were also unintended consequences-positively or negatively related to the nature of the interventions, the target, the level and duration of implementation. This article describes the unintended economic, Psychosocial and environmental consequences of NPIs in four African countries.

METHODS

We conducted a mixed-methods study in the Democratic Republic of Congo (DRC), Nigeria, Senegal and Uganda. A comprehensive conceptual framework, supported by a clear theory of change was adopted to encompass both systemic and non-systemic interventions. The data collection approaches included: (i) review of literature; (ii) analysis of secondary data for selected indicators; and (ii) key informant interviews with policy makers, civil society, local leaders, and law enforcement staff. The results were synthesized around thematic areas.

RESULTS

Over the first six to nine months of the pandemic, NPIs especially lockdowns, travel restrictions, curfews, school closures, and prohibition of mass gathering resulted into both positive and negative unintended consequences cutting across economic, psychological, and environmental platforms. DRC, Nigeria, and Uganda observed reduced crime rates and road traffic accidents, while Uganda also reported reduced air pollution. In addition, hygiene practices have improved through health promotion measures that have been promoted for the response to the pandemic. All countries experienced economic slowdown, job losses heavily impacting women and poor households, increased sexual and gender-based violence, teenage pregnancies, and early marriages, increased poor mental health conditions, increased waste generation with poor disposal, among others.

CONCLUSION

Despite achieving pandemic control, the stringent NPIs had several negative and few positive unintended consequences. Governments need to balance the negative and positive consequences of NPIs by anticipating and instituting measures that will support and protect vulnerable groups especially the poor, the elderly, women, and children. Noticeable efforts, including measures to avoid forced into marriage, increasing inequities, economic support to urban poor; those living with disabilities, migrant workers, and refugees, had been conducted to mitigate the negative effects of the NIPs.

摘要

简介

冠状病毒(COVID-19)大流行是 21 世纪最可怕的灾难之一。为控制疾病传播而实施的非药物干预措施(NPIs)带来了许多积极的结果。然而,也有一些意想不到的后果——无论是与干预措施的性质、目标、实施的水平和持续时间有关的积极后果还是消极后果。本文描述了在四个非洲国家实施非药物干预措施的意外经济、心理社会和环境后果。

方法

我们在刚果民主共和国(DRC)、尼日利亚、塞内加尔和乌干达进行了一项混合方法研究。采用了一个全面的概念框架,并辅以明确的变革理论,以涵盖系统和非系统干预措施。数据收集方法包括:(i)文献综述;(ii)为选定指标分析二手数据;(iii)与政策制定者、民间社会、地方领导人和执法人员进行关键意见访谈。结果围绕主题领域进行综合。

结果

在大流行的头六到九个月里,非药物干预措施,特别是封锁、旅行限制、宵禁、学校关闭和禁止群众集会,造成了跨越经济、心理和环境平台的积极和消极的意外后果。刚果民主共和国、尼日利亚和乌干达观察到犯罪率和交通事故减少,而乌干达也报告说空气污染减少。此外,通过促进卫生措施,改善了卫生习惯,这些措施是为应对大流行而推广的。所有国家都经历了经济放缓,失业严重影响了妇女和贫困家庭,性暴力和性别暴力增加,少女怀孕和早婚增加,心理健康状况恶化,垃圾产生增加,处理不善等。

结论

尽管实现了大流行控制,但严格的非药物干预措施带来了一些负面和少数积极的意外后果。各国政府需要通过预测和实施支持和保护弱势群体(特别是穷人、老年人、妇女和儿童)的措施,来平衡非药物干预措施的负面影响和积极影响。已经做出了明显的努力,包括避免被迫结婚、加剧不平等、为城市贫困人口、残疾人和难民提供经济支持,以减轻非药物干预措施的负面影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ebb/10243042/ecf36c3fb99d/12992_2023_937_Fig1_HTML.jpg

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