UNDERSTANDING THE REALITY: THE PANDEMIC AND ITS EFFECTS
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The COVID-19 pandemic and resulting lockdowns had significant negative impacts on communities in South Asia served by Action Against Hunger according to two rapid assessment surveys. The surveys found that household incomes decreased drastically, food insecurity increased in many areas, and stress and anxiety levels remained high. Action Against Hunger used the survey results to refocus their work on continuing routine services while also providing COVID-19 relief in the hardest-hit areas where income loss was highest and access to health services was most reduced.
![HOUSEHOLD FOOD INSECURITY
RAS 1 (May '20) RAS 2 (Aug '20)
47 52
58
65
27
44
7
12
12
11
12
19
44 22
17
16
19
8
2
15 14
8
42
28
0%
20%
40%
60%
80%
100%
Dharni
(N = 59)
Palghar
(N = 60)
Dhar
(N = 59)
Baran
(N = 62)
Govandi
(N = 59)
Andheri
(N = 36)
Household Food Insecurity Prevalence (%)
(N = 335)
Secure (FI 1) Mildly Insecure (FI 2)
Moderately Insecure (FI 3) Severely Insecure (FI 4)
• In the initial phase of lockdown, more
than 50% of the households at most
locations experienced food insecurity
with more than 25% of the households
facing severe food insecurity.
• By Aug '20, food security improved to
some extent in Andheri, Baran, Dhar and
Palghar.
• However, during the same period, food
insecurity in Govandi worsened with 42%
households experiencing severe
insecurity.
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0%
20%
40%
60%
80%
100%
Dharni
(N = 26)
Palghar
(N = 64)
Dhar
(N = 47)
Baran
(N = 45)
Govandi
(N = 45)
Andheri
(N = 28)
Household Food Insecurity Prevalence (%)
(N = 255)
Secure (FI 1) Mildly Insecure (FI 2)
Moderately Insecure (FI 3) Severely Insecure (FI 4)
Household food insecurity calculated using the 'Household Food Insecurity Access Scale (HFIAS)
for Measurement of Food Access: Indicator Guide' by FHI 360/FANTA](https://image.slidesharecdn.com/2-211208120133/85/UNDERSTANDING-THE-REALITY-THE-PANDEMIC-AND-ITS-EFFECTS-8-320.jpg)
![STRESS AND ANXIETY
29
7
2 6 7 6
42
29
24 21
34
25
20
34 52 51
40
33
5
3
7 9 4
7
3
27
15 13 13
30
0%
20%
40%
60%
80%
100%
Baran
(N= 93)
Dhar
(N=89)
Palghar
(N=91)
Dharni
(N=90)
Andheri
(N=67)
Govandi
(N=89)
Frequency of feeling stress and Anxiety (%)
(N = 519)
Never Once a week 2-3 days a week 3-5 days a week Everyday
• The sudden lockdown had its implications
such as disruption in access to health and
nutrition services, movement restrictions,
and drastic loss of income.
• The fear of infection additionally weighed in
to all these aspects.
• A reflection of this can be seen in the
frequency of stress experienced by the
respondents on a weekly basis.
• At both timepoints, the frequency of feeling
stress and anxiety was more than 2-3 days a
week for a majority of the respondents.
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0%
20%
40%
60%
80%
100%
Baran
(N = 45)
Dhar
(N = 47)
Palghar
(N = 64)
Dharni
(N = 26)
Andheri
(N = 28)
Govandi
(N = 45)
Frequency of feeling stress and anxiety (%)
(N = 255)
Never Once a week 2-3 days a week 3-5 days a week Everyday
RAS 1 (May 20) RAS 2 (Aug 20)](https://image.slidesharecdn.com/2-211208120133/85/UNDERSTANDING-THE-REALITY-THE-PANDEMIC-AND-ITS-EFFECTS-9-320.jpg)
UNDERSTANDING THE REALITY: THE PANDEMIC AND ITS EFFECTS
- 1. DELIVERING FOR NUTRITION IN SOUTH ASIA Implementation Research in the Context of COVID-19 02/12/2021 Isha Rangnekar Officer – Nutrition and Research Action Against Hunger, India Dr. Pawankumar Patil1, Isha Rangnekar1, Gyanika Narayanaswamy, Nancy Gupta, Aakanksha Pandey1, Rashmi Panigrahi1, Snigdha Sahal1 1Action Against Hunger India UNDERSTANDING THE REALITY: THE PANDEMIC AND ITS EFFECTS
- 2. BACKGROUND • Action Against Hunger India works in 4 states towards the prevention, early detection, and treatment of malnutrition. • In the three states of Maharashtra, Madhya Pradesh, and Rajasthan, the primary beneficiaries include malnourished children, pregnant, and lactating women. • The outbreak of coronavirus disease (COVID 19), first reported in December 2019 has continued to be a global pandemic. • The three intervention states of Action Against Hunger India were among the top ten states in terms of number of COVID 19 cases being reported. • The imposed lockdown created multiple challenges in accessing the basic healthcare and nutrition services. • It also caused a sudden halt in Action Against Hunger India’s on-field activities. • The unprecedented situation made it imperative to assess the impact of the pandemic in the intervention areas to prioritize actions.
- 3. • To assess the impact of COVID-19 pandemic and the subsequent lockdown on access to health and nutrition services, food security and livelihood of the fragile communities served by Action Against Hunger, India. • To formulate data-driven strategies for prioritization and continuation of Action Against Hunger India's health and nutrition services for vulnerable communities. RATIONALE
- 4. RAJASTHAN • Rural tribal MADHYA PRADESH • Rural tribal MAHARASHTRA • Rural tribal – Dharni and Palghar • Urban slum – Mumbai (Andheri and Govandi) Dhar 📍 Baran📍 Dharni 📍 Palghar 📍 Mumbai 📍 Descriptive analysis and crosstabulation were conducted for quantitative data. Inductive analysis was done for qualitative data. METHOD Jan ‘20 Feb ‘20 Mar ‘20 Apr ‘20 May ‘20 Jun ‘20 Jul ‘20 Aug ‘20 Sep ‘20 COVID-19 outbreak in India Nationwide imposed lockdown RAS 1 (N = 257) RAS 2 (N = 616) Two mixed-methods, cross-sectional, rapid assessment surveys (RAS) with structured and semi-structured questionnaires • Pregnant women • Lactating mothers • Caregivers of SAM/MAM children DATA COLLECTION SURVEY DESIGN DATA ANALYSIS Malnutrition status of children Needs and support IYCF practices Food insecurity Access to health and nutrition services IPC measures and WASH practices Income loss Mental health DOMAINS OF ASSESSMENT
- 5. RESULTS
- 6. IMPACT OF LOCKDOWN ON MONTHLY HOUSEHOLD INCOME 51 57 63 3 56 67 76 7 4 17 11 16 19 62 24 60 19 68 26 48 20 7 4 9 38 18 36 6 32 33 5 100 26 96 16 0% 20% 40% 60% 80% 100% Before After Before After Before After Before After Before After Before After Baran Dhar Dharni Palghar Andheri Govandi Household income (%) (N=247) INR 0 INR 0-1000 INR 1001-5000 INR 5001 and above 4 6 7 13 8 19 8 6 3 7 2 28 20 40 1 1 1 4 51 63 41 59 50 52 63 49 4 27 2 37 49 26 50 28 48 6 18 4 94 52 97 51 0% 20% 40% 60% 80% 100% Before After Before After Before After Before After Before After Before After Baran Dhar Dharni Palghar Andheri Govandi Household income (%) (N=520) INR 0 INR 0-1000 INR 1001-5000 INR 5001 and above 23 38 48 26 52 69 0 20 40 60 80 Baran Dhar Palghar Dharni Andheri Govandi Average income loss (%) 0-25% (IR 1) 26-50% (IR 2) 51-75% (IR 3) 76-100% (IR 4) 67 57 66 94 79 91 0 20 40 60 80 100 Baran Dhar Palghar Dharni Andheri Govandi Average Income Loss (%) 0-25% (IR 1) 26-50% (IR 2) 51-75% (IR 3) 76-100% (IR 4) RAS 1 (May '20) RAS 2 (Aug '20) • After the COVID 19 lockdown, there was a drastic reduction in income for a majority of respondents across all locations. • Among the six surveyed locations, respondents from Dharni, Andheri and Govandi experienced the highest percentages of average income loss. • By Aug '20, there was a great reduction in the percentage of respondents with no monthly household income. • However, 48-96% of the respondents across all locations still had income less than Rs.5000/month.
- 7. SOURCES OF FINANCIAL SUSTAINABILITY DURING LOCKDOWN • With sudden loss of income, by May '20, utilization of savings became the most prominent form of financial sustainability for respondents from all locations. • By Aug '20, with ease of lockdown to some extent, financial sustainability from ongoing income started factoring in. • However, the dependence on loans also increased at most of the locations. 27 26 23 12 25 25 49 55 41 62 71 48 49 21 22 23 29 23 24 26 53 42 11 9 0 20 40 60 80 100 120 140 160 Baran (N=45) Dhar (N=47) Palghar (N=64) Dharni (N=26) Andheri (N=28) Govandi (N=44) Financial sources during lockdown (%) (N=254) Ongoing income from job/work Savings Loans Other 44 18 10 39 37 34 32 30 46 31 54 44 34 61 24 29 28 54 46 21 50 16 1 3 0 20 40 60 80 100 120 140 160 Baran (N=93) Dhar (N=87) Palghar (N=90) Dharni (N=90) Andheri (N=67) Govandi (N=89) Financial sources during lockdown (%) (N=516) Ongoing income from job/work Savings Loans Other RAS 1 (May ‘20) RAS 2 (Aug ‘20) ‘Other’ sources include Government cash vouchers, selling assets, PMGKY, MGNREGA
- 8. HOUSEHOLD FOOD INSECURITY RAS 1 (May '20) RAS 2 (Aug '20) 47 52 58 65 27 44 7 12 12 11 12 19 44 22 17 16 19 8 2 15 14 8 42 28 0% 20% 40% 60% 80% 100% Dharni (N = 59) Palghar (N = 60) Dhar (N = 59) Baran (N = 62) Govandi (N = 59) Andheri (N = 36) Household Food Insecurity Prevalence (%) (N = 335) Secure (FI 1) Mildly Insecure (FI 2) Moderately Insecure (FI 3) Severely Insecure (FI 4) • In the initial phase of lockdown, more than 50% of the households at most locations experienced food insecurity with more than 25% of the households facing severe food insecurity. • By Aug '20, food security improved to some extent in Andheri, Baran, Dhar and Palghar. • However, during the same period, food insecurity in Govandi worsened with 42% households experiencing severe insecurity. [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] 0% 20% 40% 60% 80% 100% Dharni (N = 26) Palghar (N = 64) Dhar (N = 47) Baran (N = 45) Govandi (N = 45) Andheri (N = 28) Household Food Insecurity Prevalence (%) (N = 255) Secure (FI 1) Mildly Insecure (FI 2) Moderately Insecure (FI 3) Severely Insecure (FI 4) Household food insecurity calculated using the 'Household Food Insecurity Access Scale (HFIAS) for Measurement of Food Access: Indicator Guide' by FHI 360/FANTA
- 9. STRESS AND ANXIETY 29 7 2 6 7 6 42 29 24 21 34 25 20 34 52 51 40 33 5 3 7 9 4 7 3 27 15 13 13 30 0% 20% 40% 60% 80% 100% Baran (N= 93) Dhar (N=89) Palghar (N=91) Dharni (N=90) Andheri (N=67) Govandi (N=89) Frequency of feeling stress and Anxiety (%) (N = 519) Never Once a week 2-3 days a week 3-5 days a week Everyday • The sudden lockdown had its implications such as disruption in access to health and nutrition services, movement restrictions, and drastic loss of income. • The fear of infection additionally weighed in to all these aspects. • A reflection of this can be seen in the frequency of stress experienced by the respondents on a weekly basis. • At both timepoints, the frequency of feeling stress and anxiety was more than 2-3 days a week for a majority of the respondents. [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE][CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE][CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE] [CELLRANGE][CELLRANGE] [CELLRANGE] [CELLRANGE] 0% 20% 40% 60% 80% 100% Baran (N = 45) Dhar (N = 47) Palghar (N = 64) Dharni (N = 26) Andheri (N = 28) Govandi (N = 45) Frequency of feeling stress and anxiety (%) (N = 255) Never Once a week 2-3 days a week 3-5 days a week Everyday RAS 1 (May 20) RAS 2 (Aug 20)
- 10. • Building on RAS learnings, Action Against Hunger India re-strategized their work to continue reaching out to beneficiaries and maintaining routine services along with providing COVID-19 related additional critical support. • Relief efforts were initiated and remained continued in targeted areas where there was high income loss, food insecurity, and drastic reduction in accessing health and nutrition services. • Such utilization focused rapid assessments can aid in identifying hotspots demanding immediate attention and developing rapid response to similar future crises and disasters. POLICY IMPLICATIONS
- 11. THANK YOU!