Immediate impact of stay-at-home orders to control COVID-19 transmission on socioeconomic conditions, food insecurity, mental health, and intimate partner violence in Bangladeshi women and their families: an interrupted time series

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 unders...

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Published in:	The Lancet global health Vol. 8; no. 11; pp. e1380 - e1389
Main Authors:	Hamadani, Jena Derakhshani, Hasan, Mohammed Imrul, Baldi, Andrew J, Hossain, Sheikh Jamal, Shiraji, Shamima, Bhuiyan, Mohammad Saiful Alam, Mehrin, Syeda Fardina, Fisher, Jane, Tofail, Fahmida, Tipu, S M Mulk Uddin, Grantham-McGregor, Sally, Biggs, Beverley-Ann, Braat, Sabine, Pasricha, Sant-Rayn
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01.11.2020 The Author(s). Published by Elsevier Ltd
Subjects:	Adult Bangladesh - epidemiology Child, Preschool Coronavirus Infections - epidemiology Coronavirus Infections - prevention & control COVID-19 Family Female Food Supply - statistics & numerical data Humans Income - statistics & numerical data Infant Interrupted Time Series Analysis Intimate Partner Violence - statistics & numerical data Male Mental Disorders - epidemiology Mothers - psychology Mothers - statistics & numerical data Pandemics - prevention & control Pneumonia, Viral - epidemiology Pneumonia, Viral - prevention & control Quarantine - legislation & jurisprudence Randomized Controlled Trials as Topic Rural Population - statistics & numerical data Young Adult Bangladesh
ISSN:	2214-109X, 2214-109X
Online Access:	Get full text
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Abstract	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.
AbstractList	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. 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.BACKGROUNDStay-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.METHODSAn 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.RESULTSBetween 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.INTERPRETATIONCOVID-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.FUNDINGNational Health and Medical Research Council, Australia.
Author	Tipu, S M Mulk Uddin Hossain, Sheikh Jamal Mehrin, Syeda Fardina Hasan, Mohammed Imrul Fisher, Jane Bhuiyan, Mohammad Saiful Alam Braat, Sabine Baldi, Andrew J Shiraji, Shamima Hamadani, Jena Derakhshani Grantham-McGregor, Sally Biggs, Beverley-Ann Pasricha, Sant-Rayn Tofail, Fahmida
Author_xml	– sequence: 1 givenname: Jena Derakhshani surname: Hamadani fullname: Hamadani, Jena Derakhshani organization: International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh – sequence: 2 givenname: Mohammed Imrul surname: Hasan fullname: Hasan, Mohammed Imrul organization: International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh – sequence: 3 givenname: Andrew J surname: Baldi fullname: Baldi, Andrew J organization: Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia – sequence: 4 givenname: Sheikh Jamal surname: Hossain fullname: Hossain, Sheikh Jamal organization: International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh – sequence: 5 givenname: Shamima surname: Shiraji fullname: Shiraji, Shamima organization: International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh – sequence: 6 givenname: Mohammad Saiful Alam surname: Bhuiyan fullname: Bhuiyan, Mohammad Saiful Alam organization: International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh – sequence: 7 givenname: Syeda Fardina surname: Mehrin fullname: Mehrin, Syeda Fardina organization: International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh – sequence: 8 givenname: Jane surname: Fisher fullname: Fisher, Jane organization: Department of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia – sequence: 9 givenname: Fahmida surname: Tofail fullname: Tofail, Fahmida organization: International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh – sequence: 10 givenname: S M Mulk Uddin surname: Tipu fullname: Tipu, S M Mulk Uddin organization: International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh – sequence: 11 givenname: Sally surname: Grantham-McGregor fullname: Grantham-McGregor, Sally organization: Institute of Child Health, University College London, London, UK – sequence: 12 givenname: Beverley-Ann surname: Biggs fullname: Biggs, Beverley-Ann organization: Department of Medicine, Peter Doherty Institute, The University of Melbourne, Parkville, VIC, Australia – sequence: 13 givenname: Sabine surname: Braat fullname: Braat, Sabine organization: Department of Medicine, Peter Doherty Institute, The University of Melbourne, Parkville, VIC, Australia – sequence: 14 givenname: Sant-Rayn surname: Pasricha fullname: Pasricha, Sant-Rayn email: pasricha.s@wehi.edu.au organization: Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/32857955$$D View this record in MEDLINE/PubMed
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Snippet	Stay-at-home orders (lockdowns) have been deployed globally to control COVID-19 transmission, and might impair economic conditions and mental health, and...
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SubjectTerms	Adult Bangladesh - epidemiology Child, Preschool Coronavirus Infections - epidemiology Coronavirus Infections - prevention & control COVID-19 Family Female Food Supply - statistics & numerical data Humans Income - statistics & numerical data Infant Interrupted Time Series Analysis Intimate Partner Violence - statistics & numerical data Male Mental Disorders - epidemiology Mothers - psychology Mothers - statistics & numerical data Pandemics - prevention & control Pneumonia, Viral - epidemiology Pneumonia, Viral - prevention & control Quarantine - legislation & jurisprudence Randomized Controlled Trials as Topic Rural Population - statistics & numerical data Young Adult
Title	Immediate impact of stay-at-home orders to control COVID-19 transmission on socioeconomic conditions, food insecurity, mental health, and intimate partner violence in Bangladeshi women and their families: an interrupted time series
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