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Falling through the cracks: Increased vulnerability and limited social assistance for TB patients and their households during COVID-19 in Cape Town, South Africa

Amid the COVID-19 crisis, Tuberculosis (TB) patients in South Africa, as elsewhere, faced increased vulnerability due to the consequences of the COVID-19 response such as loss of income, challenges to access diagnostic testing, healthcare services and TB medication. To mitigate the socio-economic im...

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Autores principales: Vanleeuw, Lieve, Zembe-Mkabile, Wanga, Atkins, Salla
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021457/
https://www.ncbi.nlm.nih.gov/pubmed/36962428
http://dx.doi.org/10.1371/journal.pgph.0000708
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author Vanleeuw, Lieve
Zembe-Mkabile, Wanga
Atkins, Salla
author_facet Vanleeuw, Lieve
Zembe-Mkabile, Wanga
Atkins, Salla
author_sort Vanleeuw, Lieve
collection PubMed
description Amid the COVID-19 crisis, Tuberculosis (TB) patients in South Africa, as elsewhere, faced increased vulnerability due to the consequences of the COVID-19 response such as loss of income, challenges to access diagnostic testing, healthcare services and TB medication. To mitigate the socio-economic impact of the pandemic, especially among the most vulnerable, the South African government expanded social assistance programmes by creating the Social Relief of Distress grant (SRDG), the first grant for unemployed adults in South Africa. Our study investigated how TB patients experienced the COVID-19 pandemic and the ensuing socio-economic fallout, how this affected their health and that of their household, income and coping mechanisms, and access to social assistance. We interviewed 15 TB patients at a health facility in Cape Town and analysed data thematically. To situate our findings, we adapted the United Nations’ conceptual framework on determinants of vulnerability and resilience during or following a shock such as climate shocks or pandemics. We found increased vulnerability among TB patients due to a high exposure and sensitivity to the COVID-19 shock but diminished coping capacity. The loss of income in many households resulted not only in increased food insecurity but also a decreased ability to support others. For the most vulnerable, the loss of social support meant resorting to begging and going hungry, severely affecting their ability to continue treatment. In addition, most participants in the study and especially the most vulnerable, fell through the cracks of the most extensive social assistance programme in Africa as few participants were accessing the special COVID-19 SRDG. Targeted social protection for TB patients with a heightened vulnerability and low coping capacity is urgently needed. TB patients with a heightened vulnerability and low coping capacity should be prioritized for urgent assistance.
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spelling pubmed-100214572023-03-17 Falling through the cracks: Increased vulnerability and limited social assistance for TB patients and their households during COVID-19 in Cape Town, South Africa Vanleeuw, Lieve Zembe-Mkabile, Wanga Atkins, Salla PLOS Glob Public Health Research Article Amid the COVID-19 crisis, Tuberculosis (TB) patients in South Africa, as elsewhere, faced increased vulnerability due to the consequences of the COVID-19 response such as loss of income, challenges to access diagnostic testing, healthcare services and TB medication. To mitigate the socio-economic impact of the pandemic, especially among the most vulnerable, the South African government expanded social assistance programmes by creating the Social Relief of Distress grant (SRDG), the first grant for unemployed adults in South Africa. Our study investigated how TB patients experienced the COVID-19 pandemic and the ensuing socio-economic fallout, how this affected their health and that of their household, income and coping mechanisms, and access to social assistance. We interviewed 15 TB patients at a health facility in Cape Town and analysed data thematically. To situate our findings, we adapted the United Nations’ conceptual framework on determinants of vulnerability and resilience during or following a shock such as climate shocks or pandemics. We found increased vulnerability among TB patients due to a high exposure and sensitivity to the COVID-19 shock but diminished coping capacity. The loss of income in many households resulted not only in increased food insecurity but also a decreased ability to support others. For the most vulnerable, the loss of social support meant resorting to begging and going hungry, severely affecting their ability to continue treatment. In addition, most participants in the study and especially the most vulnerable, fell through the cracks of the most extensive social assistance programme in Africa as few participants were accessing the special COVID-19 SRDG. Targeted social protection for TB patients with a heightened vulnerability and low coping capacity is urgently needed. TB patients with a heightened vulnerability and low coping capacity should be prioritized for urgent assistance. Public Library of Science 2022-07-28 /pmc/articles/PMC10021457/ /pubmed/36962428 http://dx.doi.org/10.1371/journal.pgph.0000708 Text en © 2022 Vanleeuw et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Vanleeuw, Lieve
Zembe-Mkabile, Wanga
Atkins, Salla
Falling through the cracks: Increased vulnerability and limited social assistance for TB patients and their households during COVID-19 in Cape Town, South Africa
title Falling through the cracks: Increased vulnerability and limited social assistance for TB patients and their households during COVID-19 in Cape Town, South Africa
title_full Falling through the cracks: Increased vulnerability and limited social assistance for TB patients and their households during COVID-19 in Cape Town, South Africa
title_fullStr Falling through the cracks: Increased vulnerability and limited social assistance for TB patients and their households during COVID-19 in Cape Town, South Africa
title_full_unstemmed Falling through the cracks: Increased vulnerability and limited social assistance for TB patients and their households during COVID-19 in Cape Town, South Africa
title_short Falling through the cracks: Increased vulnerability and limited social assistance for TB patients and their households during COVID-19 in Cape Town, South Africa
title_sort falling through the cracks: increased vulnerability and limited social assistance for tb patients and their households during covid-19 in cape town, south africa
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021457/
https://www.ncbi.nlm.nih.gov/pubmed/36962428
http://dx.doi.org/10.1371/journal.pgph.0000708
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