Impact of COVID-19 pandemic on women’s rights and wellbeing:Analysis of the Ugandan response to the global virus

The COVID-19 pandemic caused dilemmas for the most vulnerable populations around the world. This article describes the gendered effects of the pandemic on Ugandan women’s rights and wellbeing and provides suggestions for local and international practice. Mandatory lockdowns and movement restrictions created negative implications for women’s attainment of economic, social, cultural, political and civil rights and intensified pre-existing gender inequalities between women and men. The findings of intensified gender inequities, gender-based violence, sexual abuse, scanty access to reproductive health services and social justice, and barriers to participation in education, employment and politics indicate that response measures were not aligned with the government’s legal and policy framework for addressing gender inequities. This research indicates that governments, civil society organisations and the international community must undertake proper gender analysis in designing response measures and guidelines not only for COVID-19 but also in other emergencies. All response measures during emergencies must be coordinated, monitored and evaluated to ensure efficient and effective protection of the vulnerable and conformity to human rights standards.</p

Health needs and services for refugee women and children in Uganda’s settlements: articulating a role for social work

Approximately 70.8 million individuals are displaced worldwide and of these 25.9 million are refugees (UNHCR, 2019). According to UNHCR (2018), 85% of the world’s refugees are hosted by low-income nations such as Uganda. Presently, the country faces Africa’s highest refugee crisis in years (ibid). The scale of the problem is growing rapidly, with refugee numbers increasing from half a million in 2016 to 1.36 million in 2019 making it the third-highest refugee-hosting country in the world (ibid). Most of the refugees in the country are women and children (IRC, 2014). While the country recently shot to prominence with regards to refugee settlement and management, it is confronted with the subsequent protection and assistance demands (Mwenyango and Palattiyil, 2019). Refugees have the right to the highest attainable standard of health. Health, however, is influenced by individual behaviour, social-cultural factors and other social determinants including the migration process and status (WHO, 2018). The conditions experienced before, during transit and in host destinations create and increase vulnerability for poor health outcomes (ibid). Women and children on the move are exceptionally vulnerable to inequities that operate through exploitation and abuse (Freedman, 2019; Alsaba and Kapilashrami, 2016; IOM, 2014; Papadopoulos; 2008; Berends, 2017). Social work is a distinct profession that alleviates suffering and deprivation of individuals and groups, due to its professional values of respect for human rights, social justice and care (IFSW, 2012). This study sought to examine the health needs and services for refugee women and children in the Nakivale refugee settlement (NRS) Uganda and enunciated the role of social work in responding to such needs. I specifically examined: (a) the public health needs, vulnerabilities and experiences of refugee women and children (b) accessible health services and (c) barriers to accessing and utilising health services for this group. All three were united by the overarching goal of interrogating social work’s role in health promotion. The study used mixed methods (quantitative and qualitative). I administered a survey of 377 refugee women and 69 in-depth interviews (refugee women and men and key informants). The findings indicate that the Government of Uganda and its partners in refugee work are trying to support refugees to overcome the devastating conditions. However, there are outstanding gaps/ barriers (individual, socio-cultural and structural) to access and utilisation of health services. Women and children continue to live in vulnerable conditions. The study reveals a necessity for social work in settlements and provides recommendations for improving health services. The need to improve refugees’ access to health care is urgent because it impacts their worth and dignity and is essential for the country’s development (UNDP, 2016)

HIV testing disruptions and service adaptations during the COVID-19 pandemic:A systematic literature review

Access to treatment and care in safe clinical settings improves people’s lives with HIV. The COVID-19 pandemic disrupted vital HIV programs and services, increasing the risk of adverse health outcomes for people with HIV and HIV transmission rates in the community. This systematic literature review provides a meta-analysis of HIV testing disruptions and a synthesis of HIV/AIDS services adapted during COVID-19. We searched scholarly databases from 01 January 2020 to 30 June 2022 using key terms on HIV testing rates and services during the COVID-19 pandemic. The process of how the included articles were identified, selected, appraised, and synthesised was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We included 17 articles that reported changes in HIV testing during the COVID-19 pandemic and 22 that reported adaptations in HIV/AIDS services. We found that HIV testing decreased by 37% during the search period because of the COVID-19 pandemic. Service providers adopted novel strategies to support remote service delivery by expanding community antiretroviral therapy dispensing, setting up primary care outreach points, and instituting multi-month dispensing services to sustain client care. Therefore, service providers and policymakers should explore alternative strategies to increase HIV testing rates impacted by COVID-19 and leverage funding to continue providing the identified adapted services.</p

Adolescent sexual behaviour in a refugee setting in Uganda

BackgroundChildren under 18 years old constituted more than half (52%) of the refugee population in 2017. Adolescent Sexual and reproductive health is an essential component of primary health care. Yet, not every refugee adolescent is able to access sexual and reproductive health services.MethodsUsing quantitative data from 356 refugee adolescents and qualitative data (17 in-depth interviews and nine key informant interviews), we examine refugee adolescent sexual behaviour in Bidibidi settlement—the largest refugee settlement in Uganda using a binary logistic regression model.ResultsThe results show that 25% of refugee adolescents in Bidibidi refugee settlement had ever had sex. After controlling for all factors, results show that refugee adolescents aged 16–18 years (OR  =  3.47; 95% CI  =  1.09–10.94), males (OR  =  17.59; 95% CI  =  4.48–69.07), not in school (OR  =  14.57; 95% CI  =  2.20–96.35) were more likely to engage in sexual behaviour than their counterparts. Refugee adolescents who do not agree that a girl cannot get pregnant if she has sex while standing up (knowledge about getting pregnant) were significantly less associated with sexual behaviour (OR  =  0.30; 95% CI  =  0.10–0.85).ConclusionsResults from this study show that keeping refugee adolescents in school and providing sexual and reproductive health information are likely to delay refugee adolescents’ engagement in sexual behaviour. Therefore, there is need to promote keeping refugee adolescents in school in order to improve sexual and reproductive health of adolescent refugees living in low-income countries such as Uganda

Climate change aggravating migration and health issues in the African context:The views and direct experiences of a community of interest in the field

Climate change is an increasingly important theme in Africa, where a large majority of its people depend on livestock and agricultural activities for livelihood. Concurrently, the topic of health of migrants and people on the move is rapidly raising both in the health debate and migration governance agenda in the Region. The link with climate change from the perspective of health and migration experts needs to be systematically addressed. Objectives: The article aims to contribute to the discourse on the interrelation of climate change, migration, and health by providing contributions of experts in the field of health and migration directly working with migrant and refugee communities in Africa. Methods: A webinar was conducted to collect and discuss first-hand experience with 25 participants from a postgraduate online course on health and migration funded by the Austrian Government and implemented in a co-operation of the Center for Health and Migration, Austria, with Makerere University, Uganda, the International Organization for Migration – UN Migration, and Lancet-Migration. As a result from the discussions, two cases from Sudan and Zimbabwe were selected to be further analysed with desk research to illustrate and underpin the points made. Results: All webinar participants reported to encounter climate change effects on health and migration in their professional practice. In their experience, climate change aggravates issues of health and migration by fueling forced migration and displacement, increasing health care needs, and deteriorating access to health care. Specific health challenges were identified for mental health problems caused by effects of climate change-induced migration, which remain widely undiagnosed and untreated, and the special affectedness of women and girls, with their mental, sexual and reproductive health severely deteriorated in insecure environments. The case studies from Sudan and Zimbabwe underline these observations. Conclusions: The interplay of effects of climate change, (internal) migration, and health is reported by a community of experts in the field of health and migration who are residing in Africa and working with migrant communities. Webinars prove to be an easy to implement tool to collect first hand evidence from practice experts, to foster exchange of experiences, and to get people engaged in further collaboration and discussion.</p

Climate change aggravating migration and health issues in the African context: The views and direct experiences of a community of interest in the field

Climate change is an increasingly important theme in Africa, where a large majority of its people depend on livestock and agricultural activities for livelihood. Concurrently, the topic of health of migrants and people on the move is rapidly raising both in the health debate and migration governance agenda in the Region. The link with climate change from the perspective of health and migration experts needs to be systematically addressed.Objectives The article aims to contribute to the discourse on the interrelation of climate change, migration, and health by providing contributions of experts in the field of health and migration directly working with migrant and refugee communities in Africa.Methods A webinar was conducted to collect and discuss first-hand experience with 25 participants from a postgraduate online course on health and migration funded by the Austrian Government and implemented in a co-operation of the Center for Health and Migration, Austria, with Makerere University, Uganda, the International Organization for Migration – UN Migration, and Lancet-Migration. As a result from the discussions, two cases from Sudan and Zimbabwe were selected to be further analysed with desk research to illustrate and underpin the points made.Results All webinar participants reported to encounter climate change effects on health and migration in their professional practice. In their experience, climate change aggravates issues of health and migration by fueling forced migration and displacement, increasing health care needs, and deteriorating access to health care. Specific health challenges were identified for mental health problems caused by effects of climate change-induced migration, which remain widely undiagnosed and untreated, and the special affectedness of women and girls, with their mental, sexual and reproductive health severely deteriorated in insecure environments. The case studies from Sudan and Zimbabwe underline these observations. Conclusions The interplay of effects of climate change, (internal) migration, and health is reported by a community of experts in the field of health and migration who are residing in Africa and working with migrant communities. Webinars prove to be an easy to implement tool to collect first hand evidence from practice experts, to foster exchange of experiences, and to get people engaged in further collaboration and discussion

GENDER, ETHNICITY, AND PLACE Contextualizing Gender and Social Background to the Private and Public livelihoods of African women in the Diaspora (Case study - Gothenburg, Sweden).

Human beings in all societies are attributed to a gender that supposedly has/has not certain properties and with high identity-forming significance for the individual. Critical debates show that the magnitude and effect of gender symbolic construction, articulation as well as its dissemination differs for different groups of women depending on society and history. It is not uncommon that conflicts among women of some social backgrounds point to the careful adherence to culturally defined norms as the best guarantee for women’s fulfillment rather than doing different. This study adopts a feminist social work perspective to explore and explain how the gender division of roles affect the status and position of a group of Sub Saharan African women (living in Gothenburg), both within their families as well as their general participation in the Swedish society. The study thus seeks to examine the gendered division of roles in African households with a particular focus on women’s roles; the factors that engender women’s roles; the impact of gender roles on the status and position of women within their families; as well as on women’s participation in the Swedish society. The findings derived from interviews (with African women and professional Social workers); critical reviews of literature; as well as expert observations; reveal evidence of doing gender among these African women. Women dominate in roles such as care, nurturance, monitoring households and, supporting their spouses. All such roles culminate from socialization, institutional factors, as well as contingent on the context. The impact of such gender roles on women’s status and positions varied depending on marital status and parental responsibility. Thus within families, women command significant autonomy and independence. Gender roles only had a limited effect to women’s participation in the Swedish society compared to contextual effects that is, the political was more significant than the personal. The study thus concludes that the women’s descriptions of their roles do not manifest pertinent progress towards gender equality and/or equity, but rather good gender relations; whereas their perceived autonomy and independence exhibit spousal autonomy under overarching male superiorities. General conclusions pertaining to women’s participation in the Swedish society drawn from the evidence of women’s reasonable educational attainments, yet without matching levels of career mobility - coupled with state measures developed and planned from a sorry based perspective, the study argues for the adoption of a development strategy that can enhance women’s position; or that can promote their ability to participate fully with men as agents of development and change

Impact of COVID-19 Pandemic on Women’s Rights and Wellbeing: Analysis of the Ugandan Response to the Global Virus

The COVID-19 pandemic caused dilemmas for the most vulnerable populations around the world. This article describes the gendered effects of the pandemic on Ugandan women’s rights and wellbeing and provides suggestions for local and international practice. Mandatory lockdowns and movement restrictions created negative implications for women’s attainment of economic, social, cultural, political and civil rights and intensified pre-existing gender inequalities between women and men. The findings of intensified gender inequities, gender-based violence, sexual abuse, scanty access to reproductive health services and social justice, and barriers to participation in education, employment and politics indicate that response measures were not aligned with the government’s legal and policy framework for addressing gender inequities. This research indicates that governments, civil society organisations and the international community must undertake proper gender analysis in designing response measures and guidelines not only for COVID-19 but also in other emergencies. All response measures during emergencies must be coordinated, monitored and evaluated to ensure efficient and effective protection of the vulnerable and conformity to human rights standards

The place of social work in improving access to health services among refugees: A case study of Nakivale settlement, Uganda

About 70.8 million individuals are displaced worldwide, and of these, 25.9 million are refugees. Accessibility to health care is a central aspect of the well-being of refugees. This article examines the communication, institutional and socio-cultural challenges to access and use of health services among refugee women and children and conceptualises the social work position in tackling such issues. The study used mixed quantitative and qualitative methods. The findings indicate complex experiences of refuge and ongoing gendered oppression and vulnerability. This research proposes a rights-based social work approach to addressing impediments at micro, meso and macro levels

Gendered dimensions of health in refugee situations: An examination of sexual and gender-based violence faced by refugee women in Nakivale refugee settlement, Uganda

This article analyses the interplay between women’s social identity, migration and manifestation of sexual and gender-based violence. The research used mixed quantitative and qualitative methods. The findings show experiences of domestic, sexual, community and survival violence. Their predicaments are exacerbated by socio-cultural and structural influences, and despite commitments for protecting refugees, more has to be done to meet the needs of victims. The article reveals the urgency for the adoption of gender-responsive and rights-based approaches in refugee interventions. The capacity of frontline workers must be enhanced to detect violence, appreciate the needs and rights of victims and provide appropriate support