The paper draws on primary research into the conditions of domestic workers in Bangladesh and how they coped with the shocks and disruptions associated with COVID-19. We can see our research as a lens to view the lives and livelihoods of workers with no legal or social protection and with the tenuous relationship they have with their employers. The country’s trade unions bypassed these workers during this unprecedented crisis which they had to deal with almost entirely on their own. We carried out detailed qualitative interviews by telephone between January and February 2021 with 30 female domestic workers aged over 18 years. These were “untied” domestic workers who worked for more than one employer and lived in their own accommodation. We asked them to recall their lives and livelihoods before COVID-19 (Jan–Feb 2020), to discuss the period of strict lockdown (Mar–Apr 2020) and then the changes that may have occurred after April when the strict lockdown was lifted. Almost all domestic workers in our study had lost their jobs within a day after the lockdown was announced, pushing them into extreme uncertainty. Since domestic workers were the main breadwinners for most of the households in our sample, the loss of their jobs meant a total or substantial loss of income for at least two-thirds of our respondents. Some domestic workers received government relief, but lack of NID cards and contacts with influential community members made accessing it very difficult and impossible for some.
When the World Health Organization declared that COVID-19 was a pandemic, on March 11, 2020, it also encouraged world governments to take strong action to limit and stop the spread of the novel coronavirus. Alberta, along with other provinces, announced a public health emergency shortly thereafter. As a consequence of health measures that were brought into force at the time, nonessential businesses were shuttered, schools implemented emergency online remote teaching, child care centres and recreation facilities were closed, and public and private gatherings were limited. The impact of these measures on the service sector was especially severe and, because women tend to be disproportionately employed in service-related occupations, the burden fell disproportionately upon women.
In particular, the economic recession caused by the pandemic has led to the loss of jobs for many Albertans and Canadians, but women have been much slower to return to the labour market. The disproportionate impact on women, particularly those living at the intersections of gender, caused by the COVID-19 pandemic is coined the “She-cession” by economists such as Armine Yalnizyan.
Given the impact of COVID-19 on Canadian women generally, and on those in the kindergarten to Grade 12 education sector in particular, the Women in Leadership Committee of the Alberta Teachers’ Association turned its attention in September 2020 to documenting the experience of women teachers and school leaders during the pandemic period. Given that the teaching profession is primarily female, at 74 per cent of the Alberta teaching profession (Alberta Teachers’ Retirement Fund 2017), a systemic examination of the lived experience of Alberta teachers and school leaders who have caregiving responsibilities became a clear priority. Consequently, the Association embarked on a research project to explore the lived experiences of women teachers and school leaders. A qualitive methodology was adopted for this study, as it was hoped that the endeavour would provide rich description of the lives of women teachers and school leaders during COVID-19 so that meaningful supports might be identified.
This paper analyzes results from focus groups held with women physicians in British Columbia which explored questions around how gender norms and roles influenced their experiences during COVID-19.
Four virtual focus groups were organized between July and September 2020. Participants (n = 27) were voluntarily recruited. Data were analyzed using applied thematic analysis.
In addition to the COVID-19-related changes experienced across the profession, women physicians faced distinct challenges related to an increase in unpaid care responsibilities, and often felt excluded from, and occasionally dismissed by, leadership. Women leaders often felt their contributions were unrecognized and undervalued. Participants drew strength from other women leaders, peer networks, and professional support, but these strategies were limited by unpaid care and emotional labour demands, which were identified as increasing risk of burnout.
Even though women physicians hold a degree of relative privilege, unpaid care work and gender norms contribute to distinct secondary effects of COVID-19. Women physicians link these to pre-pandemic assumptions (within families and communities) that women would absorb care deficits at their own cost. Health system leadership continues to reflect a masculine normative experience wherein the personal and professional are separated, and which devalues the emotional labour often associated with feminine leadership. The strategies participants employed to address negative impacts, while demonstrating resourcefulness and peer support, reflect individualistic responses to social-structural challenges. There is a need for greater recognition of women’s contributions at home and work, increased representation in decision-making, and practical supports such as childcare and counselling.
Smith, J., Abouzaid, L., Masuhara, J. et al. “I may be essential but someone has to look after my kids”: women physicians and COVID-19. Can J Public Health (2021). https://doi.org/10.17269/s41997-021-00595-4
Objective A weak and politicised COVID-19 pandemic response in the United States (US) that failed to prioritise sexual and reproductive health and rights (SRHR) overlaid longstanding SRHR inequities. In this study we investigated how COVID-19 affected SRHR service provision in the US during the first 6 months of the pandemic.
Methods We used a multiphase, three-part, mixed method approach incorporating: (1) a comprehensive review of state-by-state emergency response policies that mapped state-level actions to protect or suspend SRHR services including abortion, (2) a survey of SRHR service providers (n=40) in a sample of 10 states that either protected or suspended services and (3) in-depth interviews (n=15) with SRHR service providers and advocacy organisations.
Results Twenty-one states designated some or all SRHR services as essential and therefore exempt from emergency restrictions. Protections, however, varied by state and were not always comprehensive. Fourteen states acted to suspend abortion. Five cross-cutting themes surrounding COVID-19’s impact on SRHR services emerged across the survey and interviews: reductions in SRHR service provision; shifts in service utilisation; infrastructural impacts; the critical role of state and local governments; and exacerbation of SRHR inequities for certain groups.
Conclusions This study demonstrates serious disruptions to the provision of SRHR care that exacerbated existing SRHR inequities. The presence or absence of policy protections for SRHR services had critical implications for providers and patients. Policymakers and service providers must prioritise and integrate SRHR into emergency preparedness planning and implementation, with earmarked funding and tailored service delivery for historically oppressed groups.
Maier M, Samari G, Ostrowski J, et al ‘Scrambling to figure out what to do’: a mixed method analysis of COVID-19’s impact on sexual and reproductive health and rights in the United States BMJ Sexual & Reproductive Health 2021;47:e16.
A Q&A with Dismas Damian
Globally, it is estimated that more than 220 million women in LMICs have an unmet need for family planning. Adolescents especially are some of the most at-risk groups for early pregnancy and parenthood. They face difficulties accessing contraception and safe abortion, as well as suffering from high rates of HIV and sexually transmitted infections. Various political, economic, and sociocultural factors contribute to poor information and access to services for this group. Among those are the attitudes of healthcare workers who often fail to provide young people with supportive, nonjudgmental, youth-appropriate services.
But access to reproductive health services, including contraception, can often literally be a matter of life and death for adolescents, who are much more at risk of maternal mortality than other age groups. Complications during pregnancy and childbirth are the leading cause of death for 15–19-year-old girls around the world. For example, a recent study on maternal mortality in Tanzania found that women aged 20 to 29 years were 43% less likely to die from pregnancy-related issues compared to those younger than 20 years. One of the Sustainable Development Goals is to reduce their maternal mortality ratio to less than 70 deaths per 100,000 live births by 2030. Because adolescents are a high risk group, improving access to family planning is a huge way this goal can be reached.
Dismas Damian is a medical doctor and consultant who is working to increase adolescence contraceptive access in Tanzania. Dismas started his professional journey working in pediatric HIV programs. He was curious not just about the medical condition, but also how social norms influenced how people perceived and dealt with the condition. He soon realized that social perceptions and values were a huge factor influencing disease outcomes, and beneficiaries of health care programs needed to be included in the design to improve health care access. He is currently working with Pathfinder in Tanzania to implement programs that provide sexual and reproductive health care to adolescents. Yarrow Global had a virtual chat to talk about the unique needs of adolescent sexual and reproductive health, how health providers can make or break the success of a program, and why including adolescents in the design of a program is essential to making it work.
The main purpose of this publication is to advocate for the need to understand the gendered nature of vulnerabilities to poor health. Gender equality in health is an integral dimension of sustainable development, and it is critical to apply a “gender lens” to all aspects of the health system, including financing mechanisms in health. The impact of health-related out-of-pocket expenditure (OPE) on household poverty has been a significant factor driving the move toward universal health coverage across much of Latin America and beyond. However, not only do health care users still face a broad range of health-related OPEs that can contribute to the impoverishment of households, but the gender dimensions of OPEs have received very little attention. Drawing primarily on data from Bolivia (Plurinational State of), Guatemala, Nicaragua, and Peru, this report offers an in-depth analysis of the gender dimensions of health-related OPEs in Latin America. It highlights the limitations of survey data in determining levels of household spending on health as well as the potential failure of indicators to capture the impacts of coping strategies that households adopt to pay for OPEs. This publication calls for the application of an intersectional analysis to ensure a more nuanced understanding of the ways in which other social identity markers, such as race and ethnicity, alongside gender shape the ability of individuals and households to respond to the different OPEs they may encounter. Until policymakers consider the issue through a gender lens, OPE will continue to limit the potential of universal health care coverage to effectively address health inequalities.
Out-of-Pocket Expenditure: The Need for a Gender Analysis. Washington, D.C.: Pan American Health Organization; 2021. License: CC BY-NC-SA 3.0 IGO.
As the world learns to live with COVID-19, to emerge from the current crisis, and to “build back better”, UN Women’s new “Feminist plan” provides a visionary but practical roadmap for putting gender equality, social justice, and sustainability at the centre of the recovery and transformation.
COVID-19 has revealed and worsened inequalities and is a reminder of just how unsustainable and fragile the world’s economies and democracies are. The crisis also provides a warning about what is rapidly coming down the track on climate change and environmental degradation. This has created both a need and an opening to rethink economic and social policies and re-evaluate what needs to be prioritized.
The “Feminist plan” maps the ambitious and transformative policies—on livelihoods, care, and the environment—that are needed to build a more equal and sustainable future. To get there, it calls for context-specific policy pathways, tailored political strategies, and financing. The plan identifies key levers that can create change and the actors at global, national, and local levels that need to take action to move towards this vision.
Drawing upon the empirical scholarship and research expertise of contributors from all settled continents and from diverse life settings and economies, Viral Loads illustrates how the COVID-19 pandemic, and responses to it, lay bare and load onto people’s lived realities in countries around the world.
A crosscutting theme pertains to how social unevenness and gross economic disparities are shaping global and local responses to the pandemic, and illustrate the effects of both the virus and efforts to contain it in ways that amplify these inequalities. At the same time, the contributions highlight the nature of contemporary social life, including virtual communication, the nature of communities, neoliberalism and contemporary political economies, and the shifting nature of nation states and the role of government. Over half of the world’s population has been affected by restrictions of movement, with physical distancing requirements and self-isolation recommendations impacting profoundly on everyday life but also on the economy, resulting also, in turn, with dramatic shifts in the economy and in mass unemployment.
By reflecting on how the pandemic has interrupted daily lives, state infrastructures and healthcare systems, the contributing authors in this volume mobilise anthropological theories and concepts to locate the pandemic in a highly connected and exceedingly unequal world. The book is ambitious in its scope – spanning the entire globe – and daring in its insistence that medical anthropology must be a part of the growing calls to build a new world.
The coronavirus disease 2019 (COVID-19) pandemic has affected children’s risk of violence in their homes, communities and online, and has compromised the ability of child protection systems to promptly detect and respond to cases of violence. However, the need to strengthen violence prevention and response services has received insufficient attention in national and global pandemic response and mitigation strategies. In this paper, we summarize the growing body of evidence on the links between the pandemic and violence against children. Drawing on the World Health Organization’s INSPIRE framework to end violence against children, we illustrate how the pandemic is affecting prevention and response efforts. For each of the seven INSPIRE strategies we identify how responses to the pandemic have changed children’s risk of violence. We offer ideas for how governments, policy-makers, and international and civil society organizations can address violence in the context of a protracted COVID-19 crisis. We conclude by highlighting how the current pandemic offers opportunities to improve existing child protection systems to address violence against children. We suggest enhanced multisectoral coordination across the health, education, law enforcement, housing, child and social protection sectors. Actions need to prioritize the primary prevention of violence and promote the central role of children and adolescents in decision-making and programme design processes. Finally, we stress the continued need for better data and evidence to inform violence prevention and response strategies that can be effective during and beyond the COVID-19 pandemic.
Throughout the coronavirus disease 2019 (COVID-19) pandemic, children have often been referred to as silent spreaders, low-risk or invisible carriers of the disease. These descriptions negate the well-documented adverse effects of the COVID-19 pandemic on child health and well-being, including the increased risk of experiencing violence. Violence against children includes physical, sexual and emotional abuse, neglect, bullying, assault, homicide and sexual exploitation. Caregivers, adults, peers, teachers, law enforcers or strangers can perpetrate violence against children in public, private and institutional spaces. Ongoing responses to the pandemic have included restrictions on people’s movements and the closure of schools, services and businesses. Increases in violence against children and women can be linked to the COVID-19 pandemic and the associated response measures which have limited people’s access to health services and exacerbated economic insecurity. The pandemic has exposed and entrenched pre-existing social inequities in the prevalence of violence against children, and has highlighted important shortcomings in global and national violence prevention and response efforts. Evidence from past epidemics also indicates an increased risk of violence against children, affirming the important role that child safeguarding should play during, and beyond, protracted crises. Although the pandemic has drawn global attention to violence against women and children, prevention and response efforts continue to be underfunded and have received insufficient attention in COVID-19 strategies developed by governments and global organizations.
Violence against children during the COVID-19 pandemic Amiya Bhatia, Camilla Fabbri, Ilan Cerna-Turoff, Ellen Turner, Michelle Lokot, Ajwang Warria, Sumnima Tuladhar, Clare Tanton, Louise Knight, Shelley Lees, Beniamino Cislaghi, Jaqueline Bhabha, Amber Peterman, Alessandra Guedes, Karen Devries, Bull World Health Organ. 2021 Oct 1; 99(10): 730–738. Published online 2021 Aug 13. doi: 10.2471/BLT.20.283051
COVID-19 has walloped the world’s women. As the virus spread, women—who are overrepresented in hard-hit industries like food service, hospitality, education and, crucially, health care—found themselves vulnerable, unemployed and without a social safety net, and often neglected by government crisis responses. Closures of businesses and schools, necessitated by social distancing, have pushed millions of women from the global workforce: Worldwide, women lost 64 million jobs—$800 billion in earnings—in 2020.
At the same time, women’s retreat to the home widened gendered inequities in household labor, as women shouldered ever-greater child care responsibilities and more domestic chores. More time at home also increased women’s exposure to domestic violence, and gendered violence in general spiked in every region of the world. They suffered more from food and housing insecurities, and perhaps not surprisingly, have reported worse mental health outcomes compared to men globally.
Nearly two years since the first cases of the virus, these gendered trends are still largely unaddressed. National GDPs, for example, will not bounce back without addressing the plunge in women’s employment. But stimulus plans from Australia to the United Kingdom have mainly focused on creating jobs in construction and technology, two male-dominated fields. Meanwhile, only 8 percent of economic recovery plans have addressed unpaid care work.
The problem is that women have generally been excluded from decision-making tables during the pandemic. Women heads of government—like New Zealand’s Jacinda Ardern and Finland’s Sanna Marin—have won well-deserved accolades for their ability to combine swift and decisive action with empathy and compassion, and for cultivating trust and resilience through clear, science-centered communication. But they were among only 11 women serving as the sole or top chief executive in 2020, and women currently comprise just 24 percent of the members of national coronavirus task forces. This is not enough to push along the needed transformation in how governments value women’s labor.