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Impact of COVID-19 on Young People _ Rapid Assessment in Three States%2C May 2020%2C Bihar%2C Rajasthan and Uttar pradesh Executive Summary %28English%29 |
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Impact of COVID-19
on young people:
Rapid assessment in three states, May 2020
(Bihar, Rajasthan and Uttar Pradesh)
Executive Summary
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Abbreviations
COVID-19
EE
FP
FLW
GOI
IFA
MoHFW
NGO
PFI
PSA
RH
SBCC
SC
ST
Coronavirus Disease
Entertainment Education
Family Planning
Front-line Workers
Government of India (GoI)
Iron and Folic Acid
Ministry of Health and Family Welfare
Non-government Organization
Population Foundation of India
Public Service Announcement
Reproductive Health
Social and Behavioural Change Communication
Scheduled Caste
Schedule Tribe
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Executive Summary
The COVID-19 pandemic has engulfed countries
across the world in a short span of time. For India,
it was and continues to be the biggest health and
humanitarian crisis since independence. The
Government of India declared COVID-19 as a
national disaster and, to contain the spread of the
disease, imposed a complete lockdown across the
country on March 25, 2020. This continues till date,
in myriad forms and with variations across states
and zones.
The pandemic and the prolonged lockdown have
adversely impacted a wide range of areas, including
health, economy, livelihood, social and professional
interactions. It led to loss of livelihoods for millions
of people, and an exodus of migrants from cities
back to their villages, with a devastating cost of
human lives and suffering.
Although the Ministry of Health and Family Welfare,
Government of India, included reproductive health
and family planning as essential health services in its
guidelines, the lockdown and the focus of the public
health machinery on containing the pandemic,
restricted women’s mobility and access to health
services.
Slowly but steadily, the adverse impact of COVID-19
on mental health are beginning to emerge globally.
There was a surge in gender-based, and intimate
partner violence across countries such as China,
UK, USA, and India, and a high prevalence of
psychological distress, anger, depression and post-
traumatic stress disorder.
The implications of interrupted reproductive
healthcare and on mental health have to be critically
explored among young people in India. Constituting
nearly one-fifth of the country’s population,
adolescents face educational uncertainties (with the
closure of schools and colleges, and a patchy access
to digital learning), restrictions on their mobility,
freedom and socialisation, an increase in domestic
chores and household conflict (disproportionately
borne by women), and anxieties around their
employment prospects, among others.
To understand how India’s young people are
coping with these challenges, in May 2020,
Population Foundation of India (PFI) conducted
a rapid assessment to understand the level of
knowledge and attitude of young population (15-
24 years) towards COVID-19, how it has impacted
their lives and mental health, and their needs and
priorities. The responses thus generated would be
analysed to advocate for measures that can best
address these needs, both during the COVID-19
outbreak and continuing after that.
Mindful of the limitations on inter-personal
interactions during the lockdown, a telephonic
survey was deemed to be the most appropriate
method of data collection. The survey questionnaire
was developed and digitised for use on Collect, a
mobile data collection platform. The survey was
conducted in the three states of Uttar Pradesh,
Rajasthan and Bihar, where PFI has state offices and
has ongoing initiatives with young people.
The selection of districts, blocks and respondents
in three states was purposive in nature, based on
presence of NGO partners and availability of contact
details of young people with them. The objective was
to ensure seeking varied perspectives and insights
from the respondents on research questions.
Key Findings
The rapid assessment revealed that young people
in India were well aware of COVID-19, its symptoms,
care, and safety measures, but they continue to
face certain challenges during the accompanying
lockdown, including in their access to reproductive
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Executive Summary
health and mental well-being. Key findings are
summarized below:
Awareness
z Respondents’ awareness on the symptoms of
COVID-19 was high; a majority were able to
identify at least two key symptoms, such as
cough, fever, breathing difficulties and body
ache. Respondents were also very well-informed
on the basic safety and prevention practices,
such as washing hands frequently, covering
faces, and practicing social distancing. An
overwhelming majority also reported following
these practices diligently. The lockdown, which
was in effect nationwide at the time of the study,
was being followed by most of them.
z Generally, males, those who were older, and
with higher levels of education were better
informed than females, younger cohort and
those with lower levels of education. The
awareness of symptoms was lower among
socially marginalised groups, like SCs and STs.
z The primary sources of information for young
people continue to be traditional media such
as TV and policy briefings, and face-to-face
interactions with FLWs. WhatsApp was another
common medium although other digital
technology-dependent portals such as Twitter,
Arogya Setu app, and Facebook were not
common sources of information.
z Schools were rarely listed as a source of
information, indicating the inability of
educational institutions to transcend the
boundaries of school premises and the
academic session to stay connected with
students. But here, states can learn from one
another to emulate best practices: in Rajasthan,
for example, one-fourth of the total respondents
listed schools as a reliable source of information
on COVID-19.
z A majority of the respondents also noted that
they would contact a doctor, self-isolate, and
facilitate contact tracing, if they or someone they
knew exhibited symptoms. A sizeable number
also said that they would contact a FLW or the
Pradhan to relay their symptoms and seek
advice on the way forward.
z The continued relevance of local on-ground
persons and institutions, like FLWs, as reliable
sources of information and as persons to
contact in case of suspected COVID-19 reiterate
the importance of these institutions in handling
a public health emergency. Going forward, it
is essential to empower, equip and strengthen
these as much as possible.
Challenges
z One of the primary challenges that young
people experienced with the nationwide
lockdown was the increase in their workload of
domestic chores. Expectedly, more females than
males reported an increase in their domestic
workload.
z Increase in domestic conflicts or fights at
home were only reported by one-fourth of the
participants. Many of those who did report an
increase in domestic fights were women.
z A small number of respondents reported about
economic anxieties during the lockdown, and
most of these were those who were already
employed, followed closely by those who were
unemployed and actively looking for a job.
z A little more than half the total respondents
reported watching more TV during the lockdown
while a little less than half reported an increase
in their social media use. However, many of
those who reported a decrease in their TV
watching or social media use were women.
z A small fraction of the total respondents
reported feeling depressed, frustrated and
irritable. Interestingly, there was a coincidence
whereby a greater number of those feeling
depressed or frustrated and irritable also
reported an uptick in their TV and social media
consumption during the lockdown. More
in-depth qualitative research is needed to
understand what this trend signifies.
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Impact of COVID-19 on young people: Rapid assessment in three states, May 2020
Access to Reproductive Healthcare
z Although nearly 3 out of 5 respondents reported
having had some contact with FLWs during
the lockdown, their access to reproductive
healthcare was interrupted during the lockdown.
z More than half the women reported an unmet
need for sanitary pads and only one-third of the
young people confirmed their receipt of IFAs
during the lockdown. A majority of young people
were also not aware that FLWs could provide
contraceptives during the lockdown
Mental Health Services
z More than half the young people confirmed
that they had access to information on mental
health, and nearly half among them said that
they had used some form of mental health
service or resource. In Uttar Pradesh, 89%
women reported having used some mental
health service during the lockdown.
z Nearly all of those who sought mental health
services found the assistance offered to be
either helpful or very helpful.
z Among the different resources that were used,
most common were face to face interaction with
healthcare providers, interactions with friends,
and TV. The high prevalence of informal channels
of information on healthcare, such as friends or
TV shows, is not ideal as the care provided is not
vetted for accuracy and those delivering it are not
trained to do so.
Needs and Priorities
Based on the rapid assessment findings, we have
identified the following core needs and priorities of
young people, during the pandemic and sustaining
them beyond.
z Access to Reproductive Health: As the
pandemic has shown, and our assessment
reiterated, access to reproductive healthcare
services suffered a blow during the COVID-19
outbreak. Young people reported unmet
needs for such services as the focus of India’s
public health system shifted to managing and
containing the pandemic.
z Mental Health Care: Young people have
expressed the need for mental health care
services, and those who have used these, have
found them to be positively influential. However,
for many young people, informal channels
for mental health–such as conversations with
friends–dominate the available resources.
These informal channels are not necessarily
verified and the information or mediation they
offer are not necessarily vetted or appropriate.
Hence, there is an urgent need to develop and
streamline formal channels of mental health
services that are trained, reliable and that are
easily accessible to young people.
z Double Care Burden on Women: A greater
proportion of female participants than male
participants reported an increase in their
domestic work as well as fights at home. This
is also mirrored in related figures, such as
more women reporting a decrease in their
TV consumption and social media usage
(presumably because of their increased workload,
which leaves less recreational time available), and
a large proportion of women in Uttar Pradesh
reported having sought and used some mental
health services during the pandemic. There is
an immediate need to address these through
social messaging on sharing domestic work
responsibilities and through easy availability of
mental healthcare services.
z Economic Anxieties among Men: Some men
reported being anxious about the economic
fallout of the pandemic; mostly, men who were
already employed showed concern, followed
by those who were unemployed but actively
seeking employment. The strengthening of
mental healthcare services in the wake of
COVID-19 must factor in economic anxiety and
be equipped to address it.
Recommendations
To address the aforementioned needs of young
people, the following strategies are suggested:
z Strengthen Information and its Dissemination
among Socially Marginalised Communities:
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Executive Summary
There is a need to strengthen the messaging of
core information that is disseminated for public
consumption during a public health emergency,
like the current pandemic. A concerted
effort needs to be made to ensure that this
information reaches socially marginalized
communities, like SCs and STs. Targeted PSAs
on TV, communication through WhatsApp, and
door-to-door visits by FLWs can achieve this.
z Train Frontline Workers: FLWs were critical in
multiple roles: as sources of information, to
access primary healthcare facilities, for reporting
suspected symptoms, and as sources for mental
health related information. As multifaceted
and on-the-ground personnel, FLWs represent
the foundation of India’s public health system.
Investing time and resources in strengthening,
training and empowering them will serve us well
both during the pandemic and going ahead.
z Prioritize Reproductive Health Services: As
the pandemic has shown, and our assessment
reiterated, access to reproductive health
services and family planning-related services,
suffered a blow during the COVID-19 outbreak.
Young people reported unmet needs for such
services as the focus of India’s public health
system shifted to managing and containing
the pandemic. There is therefore, a need
to advocate for a continued priority for
reproductive health. FLWs need to be equipped
with better resources to effectively and
continually deliver reproductive health services.
Furthermore, to ensure that reproductive
health services are not interrupted, there is
a need to continually reiterate at the level of
public discourse that reproductive health is a
fundamental and inalienable aspect of public
health, and that its quality delivery is not a
choice but a requirement, especially in times of
a public health emergency. Relevant civil society
organizations need to collaborate and work with
different levels of governance toward this end.
z Social and Behavioural Change
Communication for Equitable Gender Norms:
Our research highlighted that more women
than men experienced an increase in their
workload, reported domestic fights, and used
mental health care services. These are related
statistics that demonstrate the double burden
of care on women during any public health
emergency. Government agencies and civil
society organizations need to continue making
concerted efforts to address and challenge
social norms that traditionally put the burden
for caregiving on women, with mental health
consequences. Employing edutainment –
educational entertainment – for social and
behavioural change is a step in the right
direction, given the high prevalence of TV
viewership among both men and women.
z Mental Healthcare Services: The delivery of
mental healthcare services through formal
and trained channels needs to be expanded
in response to young people’s growing need
for and use of it. There is a need to identify
and include more resources that can serve
young people, such as self-help kits, WhatsApp
communities, phone helplines and by training
lay counsellors and educators. FLWs, who were
one of the most reliable and commonly sources
for addressing mental health concerns, can be
further trained to effectively address young
people’s mental health concerns. Various civil
society organizations are already working in this
sphere, and their collaboration with relevant
government agencies is highly recommended.
z Reimagine Educational Institutions: Schools
were not a widely used source for reliable
information, and nor were they critical to the
continued delivery of mental health care or
access to IFAs. There is a need to reimagine
educational institutions in a way that fosters
deeper connections and interactions with
students that are not limited to them being in
school or the school being in academic session.
One way forward is to explore WhatsApp groups
and communities. Training educators to deliver
mental healthcare can strengthen a closer
interaction between students and educational
institutions.
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B-28, Qutab Institutional Area, New Delhi – 110016
T: +91 11 43894 100
State Offices: Bihar | Rajasthan | Uttar Pradesh
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