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Child protection and resilience in the face of COVID-19 in South Africa: A rapid review of C-19 legislation.

ABSTRACT: BACKGROUND & PURPOSE:In response to the COVID-19 (C-19) pandemic, the South African government instituted strict lockdown and related legislation. Although this response was well intended, many believed it advanced children's vulnerability to abuse and neglect. This article interrogates these concerns. It investigates how C-19 legislation enabled, or constrained, South African children's protection from abuse and neglect and appraises the findings from a social-ecological resilience perspective with the aim of advancing child protection in times of emergency. METHOD:The authors conducted a rapid review of the legislation, directives and regulations pertaining to South Africa's strict lockdown (15 March to 31 May 2020). They searched two databases (SA Government platform and LexisNexus) and identified 140 documents for potential inclusion. Following full-text screening, 17 documents were reviewed. Document analysis was used to extract relevant themes. FINDINGS:The regulations and directives that informed South Africa's strict lockdown offered three protective pathways. They (i) limited C-19 contagion and championed physical health; (ii) ensured uninterrupted protection (legal and statutory) for children at risk of abuse; and (iii) advanced social protection measures available to disadvantaged households. CONCLUSION:C-19 legislation has potential to advance children's protection from abuse and neglect during emergency times. However, this potential will be curtailed if C-19 legislation is inadequately operationalised and/or prioritises physical health to the detriment of children's intellectual, emotional, social and security needs. To overcome such risks, social ecologies must work with legislators to co-design and co-operationalise C-19 legislation that will not only protect children, but advance their resilience.

SUBMITTER: Fouche A

PROVIDER: S-EPMC7473143 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Child protection and resilience in the face of COVID-19 in South Africa: A rapid review of C-19 legislation.

Fouché Ansie A Fouché Daniël F DF Theron Linda C LC

Child abuse & neglect 20200904 Pt 2

<h4>Background & purpose</h4>In response to the COVID-19 (C-19) pandemic, the South African government instituted strict lockdown and related legislation. Although this response was well intended, many believed it advanced children's vulnerability to abuse and neglect. This article interrogates these concerns. It investigates how C-19 legislation enabled, or constrained, South African children's protection from abuse and neglect and appraises the findings from a social-ecological resilience pers ...[more]

PMID: 32938531

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Project description:BackgroundRecent studies have confirmed that the COVID-19 lockdown has caused massive job losses. However, the impact of this loss on food security is not well-understood. Moreover, a paucity of evidence exists regarding social protection grants' countervailing effects against such shocks. This study examined the effects of job loss (labour income loss) on child and household hungers (our two measures food insecurity) during COVID-19 pandemic in South Africa. It also ascertained whether these effect were offset by alternative social grant programs to document the protective role of the latter.Data and methodsWe used South Africa's National Income Dynamics Study (NIDS) and the Coronavirus Rapid Mobile Survey (CRAM) data. These data cover a nationally representative sample of 7073 individuals. We employed a probit model to estimate the effect of job loss and receipts of various social grants on child and households' hungers. We also estimated the double-selection logit model to account for the model's uncertainty surrounding the variable selection and treatment-effects estimation using lasso (Telasso) for causal inference of our analysis.ResultsOur analyses showed that households exposed to a labour market shock during the pandemic experienced a significant increase in our measures of food insecurity (child and household hungers). Specifically, we found that compared with households containing employed respondents, households with respondents who lost their jobs due to COVID-19 lockdown were 5.4% more likely to report child hunger and 2.6% more likely to report household hunger in the past seven days A receipt of child support grant reduces the likelihood of reporting child hunger and household hunger by 21.7%and 16.9% respectively among these households. A receipt of old age pension grant reduces the likelihood of reporting household hunger by 24% with no significant effect on child hunger.ConclusionThe COVID-19 lockdown resulted in unprecedent job losses with significant implications for food insecurity. Job loss due to COVID-19 lockdown significantly increased food insecurity in South Africa. Receipts of social grants effectively offset this adverse effect. The protective effect of the social grant is heterogenous across its alternative programs (child support grant and old age pension grant) and food insecurity, suggesting the differences in the size of transfers and motivations for sending these transfers.

Project description:BackgroundHealth workers, in short supply in many low-and-middle-income countries, are at increased risk of SARS-CoV-2 infection. This study aimed to assess how South Africa, prepared to protect its health workers from SARS-CoV-2 infection.MethodsThis was a cross-sectional study design applying participatory action research in four provinces of South Africa. A semi-structured questionnaire and a qualitative observational HealthWISE walkthrough risk assessment was carried out to collect data on occupational safety and health (OSH) systems in 45 hospitals across four provinces to identify factors associated with health worker protection. Adapting the International Labour Organization (ILO) and World Health Organization (WHO) HealthWISE tool, we compiled compliance scores through walkthrough surveys. We used logistic regression to analyze the relationship between readiness indicators and the actual implementation of protective measures.ResultsWe found that health facilities in all four provinces had SARS-CoV-2 plans for the general population but no comprehensive OHS plan for health workers. Provincial Departments of Health (PDoH) varied in how they were organized to respond: Provinces A and D had an OSH SARS-CoV-2 provincial coordinating team and a dedicated budget for occupational health; Province A had an occupational health doctor and nurse; while Province B had an occupational health nurse; Province A and D PDoHs had functional OSH committees; and Province D had conducted some health risk assessments specific to SARS-CoV-2. However, none of the assessed health facilities had an acceptable HealthWISE compliance score (≥ 75%) due to poor ventilation and inadequate administrative control measures. While the supply of personal protective equipment was adequate, it was often not worn properly. Our study found that having an OSH SARS-CoV-2 policy was significantly associated with higher personal protective equipment and ventilation scores. In addition, our analysis showed that hospitals with higher compliance scores had significantly lower infection rates (IRR 0.98; 95% CI: 0.97, 0.98).ConclusionsDespite some initial preparedness, greater effort to protect health workers is still warranted. Low-and-middle-income countries may need to pay more attention to OSH systems and consider using tools, such as ILO/WHO HealthWISE tool, to protect health workers' health.

Project description:BackgroundGiven the economic and social divide that exists in South Africa, it is critical to manage the health response of its residents to the Covid-19 pandemic within the different socio-economic contexts that define the lived realities of individuals.ObjectiveThe objective of this study is to analyse the Covid-19 preventive behaviour and the socio-economic drivers behind the health-response behaviour.DataThe study employs data from waves 1 and 2 of South Africa's nationally representative National Income Dynamics Study (NIDS)-Coronavirus Rapid Mobile Survey (CRAM). The nationally representative panel data has a sample of 7073 individuals in Wave 1 and 5676 individuals in Wave 2.MethodsThe study uses bivariate statistics, concentration indices and multivariate estimation techniques, ranging from a probit, control-function approach, special-regressor method and seemingly unrelated regression to account for endogeneity while identifying the drivers of the response behaviour.FindingsThe findings indicate enhanced behavioural responsiveness to Covid-19. Preventive behaviour is evolving over time; the use of face mask has overtaken handwashing as the most utilised preventive measure. Other measures, like social distancing, avoiding close contact, avoiding big groups and staying at home, have declined between the two periods of the study. There is increased risk perception with significant concentration among the higher income groups, the educated and older respondents. Our findings validate the health-belief model, with perceived risk, self-efficacy, perceived awareness and barriers to preventive strategy adoption identified as significant drivers of health-response behaviour. Measures such as social distancing, avoiding close contact, and the use of sanitisers are practised more by the rich and educated, but not by the low-income respondents.ConclusionThe respondents from lower socio-economic backgrounds are associated with optimism bias and face barriers to the adoption of preventive strategies. This requires targeted policy attention in order to make response behaviour effective.

Project description:Medical staff caring for COVID-19 patients face mental stress, physical exhaustion, separation from families, stigma, and the pain of losing patients and colleagues. Many of them have acquired SARS-CoV-2 and some have died. In Africa, where the pandemic is escalating, there are major gaps in response capacity, especially in human resources and protective equipment. We examine these challenges and propose interventions to protect healthcare workers on the continent, drawing on articles identified on Medline (Pubmed) in a search on 24 March 2020. Global jostling means that supplies of personal protective equipment are limited in Africa. Even low-cost interventions such as facemasks for patients with a cough and water supplies for handwashing may be challenging, as is 'physical distancing' in overcrowded primary health care clinics. Without adequate protection, COVID-19 mortality may be high among healthcare workers and their family in Africa given limited critical care beds and difficulties in transporting ill healthcare workers from rural to urban care centres. Much can be done to protect healthcare workers, however. The continent has learnt invaluable lessons from Ebola and HIV control. HIV counselors and community healthcare workers are key resources, and could promote social distancing and related interventions, dispel myths, support healthcare workers, perform symptom screening and trace contacts. Staff motivation and retention may be enhanced through carefully managed risk 'allowances' or compensation. International support with personnel and protective equipment, especially from China, could turn the pandemic's trajectory in Africa around. Telemedicine holds promise as it rationalises human resources and reduces patient contact and thus infection risks. Importantly, healthcare workers, using their authoritative voice, can promote effective COVID-19 policies and prioritization of their safety. Prioritizing healthcare workers for SARS-CoV-2 testing, hospital beds and targeted research, as well as ensuring that public figures and the population acknowledge the commitment of healthcare workers may help to maintain morale. Clearly there are multiple ways that international support and national commitment could help safeguard healthcare workers in Africa, essential for limiting the pandemic's potentially devastating heath, socio-economic and security impacts on the continent.

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Child protection and resilience in the face of COVID-19 in South Africa: A rapid review of C-19 legislation.

Publications

Child protection and resilience in the face of COVID-19 in South Africa: A rapid review of C-19 legislation.

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