The corona measures of 2020-2022 were detrimental to the health of children in a rich country like the Netherlands, as argued by educationalist Hans Koppies last year. But what is the situation for children in low- and middle-income countries? To answer this question, scientists from Utrecht and Amsterdam investigated the effect of corona measures in a number of countries in East Africa (1), namely Ethiopia, Kenya, Madagascar, Malawi, Mozambique, Rwanda, Somalia, South Sudan, Tanzania, Uganda , Zambia and Zimbabwe. They did this by combining data from 70 different studies related to the measures to contain the spread of Covid-19 and focused specifically on the effects in children.
Eight containment measures impacting children’s health and healthcare were identified: lockdowns, school closures, physical distancing, travel restrictions, business closures, stay-at-home, curfews, and quarantine measures with contact tracing.
The researchers conclude that while these containment measures could limit the spread of Covid-19, they had adverse indirect effects on children in East Africa. These indirect effects were:
- economic damage;
- limited access to education;
- food insecurity;
- child abuse;
- limited access to healthcare;
- disrupted health programs;
- mental health problems.
Increase in child abuse, child labor and child marriage
For example, lockdowns and curfews have led to an increase in neglect, sexual abuse and violence against children in Ethiopia, Kenya, Rwanda, Uganda and Zimbabwe.
Business and school closures disrupted daily routines, forcing people to spend long periods together in cramped living spaces. Children with disabilities, in particular, were victims of neglect and abuse.
The disruption of daily routine also harmed children because schools are often hotlines of child abuse. Closing schools leads to developmental delays and diseases later in life.
Due to financial tightness and food insecurity, children more often ended up on the street and ended up in child labour.
Child marriages also increased due to financial constraints and food insecurity. In regions of East Africa, the increase in child marriages due to the Covid-19 pandemic could continue until 2035. Vulnerable children and girls were most at risk of child abuse.
Therefore, based on this research, it is recommended that government leaders and policymakers take better account of the adverse indirect effects of Covid-19 measures on children, especially in regions with limited resources such as East Africa. A concrete option for this is to base measures on realistic estimates of the impact of an infectious disease, and not on the basis of a worst-case scenario.
The Doctors Collective advocates well-thought-out pandemic preparedness, in which the interests of children should come first, not only in the Netherlands but also, and especially, in low- and middle-income countries.
Reference
- El Salih I, Njuguna FM, Widjajanto PH, Kaspers G, Bailey A, Mostert S. Impact of COVID-19 measures on the health and healthcare of children in East-Africa: Scoping review. Int J Health Plann Manage. 2023 Jan 23. doi: 10.1002/hpm.3612. Epub ahead of print. PMID: 36691260.
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