Hughes Robert C, Onyango Silas, Langat Nelson, Muendo Ruth, Juel Rachel, Kimani-Murage Elizabeth, Hill Zelee, Kirkwood Betty, Bhopal Sunil S, Kitsao-Wekulo Patricia
Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya.
PLOS Glob Public Health. 2025 May 28;5(5):e0003286. doi: 10.1371/journal.pgph.0003286. eCollection 2025.
The Covid-19 pandemic and mitigation measures had widespread societal impacts. Young children are particularly vulnerable yet the ways the pandemic affected children in informal settlements (slums) are not well described. This study aimed to investigate the impacts of the pandemic on early childhood in three Nairobi informal settlements. Five rounds of cross-sectional computer assisted telephone surveys (with 578-774 respondents in each) in three settlements (Kibera; Mukuru-Viwandani; Kawangware) over 13 months, correlating with different phases Covid-19 restrictions. Impact was assessed through comparing changes in summary statistics on responses to survey questions on each domain of Nurturing Care over time. Survey results found significant disruptions in healthcare services, particularly in early rounds with missed vaccinations (reported by 1 in 5 parents of infants) and therapeutic healthcare seeking (missed by up to 21% of families). Persistent food and nutrition insecurity, with a large majority of families struggling to feed their children (72% in Round 1) due to financial constraints. Economic shocks were near-universal; 99.7% of respondents reporting earning less since the start of the pandemic. Use of paid childcare initially plummeted but showed a resurgence over time (up to 21% by Round 5) as pandemic control measures evolved. Young children were commonly left alone in all rounds, but especially earlier ones; underscoring the enduring challenges in providing nurturing care in these settings. Very few (<2%) of study participants reported direct experience of illness from Covid-19 in their family in any round. In conclusion, despite adaptations over time and the decrease in reported disruptions, prolonged economic shock was associated with multiple adverse effects on Nurturing Care. The study's longitudinal scope provides insights into the dynamic nature of ensuring young children in slums thrive during crises, highlighting the need for interventions and policies that address the compounded vulnerabilities of young children in these communities.
新冠疫情及缓解措施产生了广泛的社会影响。幼儿尤其脆弱，但疫情对非正式定居点（贫民窟）儿童的影响方式却鲜有描述。本研究旨在调查疫情对内罗毕三个非正式定居点幼儿期的影响。在13个月内，对三个定居点（基贝拉、穆库鲁 - 维万达尼、卡万加雷）进行了五轮横断面计算机辅助电话调查（每轮有578 - 774名受访者），与新冠疫情不同阶段的限制措施相关联。通过比较不同时间对养育照护各领域调查问题的回答的汇总统计数据的变化来评估影响。调查结果发现医疗服务受到严重干扰，尤其是在早期阶段，疫苗接种错过（五分之一的婴儿家长报告）以及寻求治疗性医疗服务（高达21%的家庭错过）。持续存在粮食和营养不安全问题，绝大多数家庭因经济拮据难以养活孩子（第一轮为72%）。经济冲击几乎普遍存在；99.7%的受访者报告自疫情开始以来收入减少。随着疫情防控措施的演变，付费托儿服务的使用最初大幅下降，但后来有所回升（到第五轮时达到21%）。在所有轮次中，幼儿通常都无人照看，尤其是在早期阶段；这凸显了在这些环境中提供养育照护面临的持久挑战。在任何一轮调查中，很少有（<2%）研究参与者报告其家庭中有新冠直接感染病例。总之，尽管随着时间推移情况有所改善，报告的干扰也有所减少，但长期的经济冲击与对养育照护的多种不利影响相关。该研究的纵向范围为了解在危机期间确保贫民窟幼儿茁壮成长的动态性质提供了见解，强调了需要采取干预措施和政策来应对这些社区幼儿的多重脆弱性。
