Community-Level Experiences, Understandings, and Responses to COVID-19 in Low- and Middle-Income Countries: A Systematic Review of Qualitative and Ethnographic Studies
Abstract
:1. Introduction
2. Materials and Methods
Citation | Country | COVID-19 Focus | Target Pop. | Article Title and Key Outcomes | Approaches |
---|---|---|---|---|---|
Adom et al. [57] | Ghana | Stigma and mental distress | HCWs and patients | The psychological distress and mental health disorders from COVID-19 stigmatization in Ghana—Stigma and psychological distress among HCWs, patients, and others; psychosocial recommendations for policy change | Phenomenology |
Ali [58] | Pakistan | COVID-19 burials | Local community | Rituals of containment: many pandemics, body politics, and social dramas during COVID-19 in Pakistan—Ethnography of funeral rites in the context of COVID-19 government restrictions; changes in burial traditions; social consequences; entanglement of science, religion and politics | Social drama, symbolic ownership of the “viral body” by the state, liminality and grief, death traditions |
Ali et al. [59] | Pakistan | Mental health, perceptions | Local community | When COVID-19 enters in a community setting: an exploratory qualitative study of community perspectives on COVID-19 affecting mental well-being—Anxiety and fear, social, financial and religious crises and distress. Coping: becoming closer to God and family, participating in mental health sessions, and resetting lives | Qualitative, descriptive |
Amir [60] | Uganda | Stigma and mental distress | Recovered COVID-19 patients | COVID-19 and its related stigma: A qualitative study among survivors in Kampala, Uganda—Narratives of stigma experiences, social rejection, labeling and distress | Qualitative, descriptive, narrative |
Asiimwe et al. [61] | Ghana | Perceptions of contact tracing | Contact tracers, contacts, and supervisors | Stakeholders’ perspective of, and experience with, contact tracing for COVID-19 in Ghana: A qualitative study among contact tracers, supervisors, and contacts—Perceptions of utility and effectiveness of COVID-19 contact tracing among implementing bureaucrats and recipients; generally positive experiences and expressed concerns of stigma associated with home visits | Phenomenology, narrative, Lipsky’s street-level bureaucrats theory |
Bahagia et al. [62] | Indonesia | Local wisdom, food security and livelihoods | Community leaders | Local wisdom to overcome the COVID-19 pandemic of Urug and Cipatat Kolot societies in Bogor, West Java, Indonesia—Food redistribution, collective action through nujuh bulanan, instigating taboos, Indigenous knowledge that combats “life perturbations” | Qualitative, ethnography of local knowledge (ceremonies, taboos, rituals), descriptive |
Bhatt et al. [63] | Nepal | Perceptions, understanding, and prevention | Local community | Perceptions and experiences of the public regarding the COVID-19 pandemic in Nepal: a qualitative study using phenomenological analysis—Knowledge measures, social isolation, inadequate PPE, disorganized public sector | Phenomenology, lived experience |
Ekoh et al. [64] | Nigeria | Effects of social restrictions | Above 60-aged community | Digital and physical social exclusion of older people in rural Nigeria in the time of COVID-19—The elderly are digitally and socially excluded due to pandemic restrictions, leading to loneliness and lack of coping | Qualitative, descriptive |
Ghani and Sitohang [65] | Indonesia | Knowledge and responses of community | Remote Indigenous community | How people in remote areas react to the COVID-19 pandemic in the early phase—Hoaxes predominate and circulate widely; with limited access to reliable information, there is a need to improve access to reliable information and quell hoaxes | Digital vicious cycle, “illusory truth effect”, bullet theory of communication |
Jones [66] | Sierra Leone | Experiences of state-led COVID-19 measures | Urban and rural communities | An ethnographic examination of people’s reactions to state-led COVID-19 measures in Sierra Leone—Adaptation, non-compliance, passive, and active resistance; heterogeneous responses by communities | Adaptive capacity, compliance, passive, active resistance theories; social and financial capital |
Kumari et al. [67] | India | Psychosocial functioning | Peripartum women | Impact of COVID-19 on psychosocial functioning of peripartum women: a qualitative study comprising focus group discussions and in-depth interviews—Peripartum women experienced distress, anxiety due to pandemic confinement, and social restrictions during and after pregnancy | Qualitative, descriptive |
Kwaghe et al. [68] | Nigeria | Stigma, trauma | Frontline HCWs | Stigmatization, psychological and emotional trauma among frontline health care workers treated for COVID-19 in Lagos State, Nigeria: a qualitative study—Knowledge assessed for biomedical understanding; experienced stigma and social reactions from family and community; insights into improving health care quality based on experiences | Colaizzi’s phenomenological method |
Newton et al. [69] | Ghana | Health-seeking behavior | Above 60-aged community | Understanding older adults’ functioning and health-seeking behavior during the COVID-19 pandemic in Ghana—Reporting physical and emotional health during the pandemic; challenges of loneliness and health-seeking restrictions and health provider attitudes | Qualitative Thematic Analysis, descriptive |
Nicoletti et al. [70] | Bolivia | Patient experiences | Rural patients with epilepsy | The impact of COVID-19 pandemic on frail health systems of low- and middle-income countries: The case of epilepsy in the rural areas of the Bolivian Chaco—Patients with epilepsy in remote Bolivia experienced drug stockouts and lack of access to health care; 75% had inconsistent medication use during COVID-19 lockdowns | Qualitative, descriptive |
Okediran et al. [71] | Nigeria | Experiences and perceptions | Frontline HCWs | The experiences of healthcare workers during the COVID-19 crisis in Lagos, Nigeria: a qualitative study—Four themes identified around responsibilities, challenges and coping strategies, experiences of distress and pleasure, and recommended needs for further material and social support | Qualitative, descriptive |
Østebø et al. [72] | Ethiopia | Religious and secular perspectives | Local community | Religion and the “secular shadow”: responses to COVID-19 in Ethiopia—Conflations of science and religion, tradition and modernity in the Ethiopian context as local perceptions are considered in the development of public health interventions, exploring epistemic tensions | Qualitative, ethnographic, Latour, coexisting epistemologies, modernity |
Prajitha et al. [73] | India | Government responses | Government bureaucrats | Strategies and challenges in Kerala’s response to the initial phase of COVID-19 pandemic: a qualitative descriptive study—Five themes emerged in reflecting on government responses, recognizing key components of social capital, a robust public health system, participation and volunteerism, health system preparedness, and challenges | Qualitative, descriptive, social capital, SDH |
Prasetyo et al. [74] | Indonesia | Civil society participation | Task Force members | Civil Society participation in efforts to prevent the spread of COVID-19—Four task forces engaged: public education, controlling mobility via gate system, hand washing, and food needs/suspected patient monitoring, etc. Lack of funds and lack of public awareness were the main obstacles | Civil society engagement |
Prasetyono et al. [75] | Indonesia | Leadership and local governance | Village heads | Patron-client relationship between village heads and their residents during the COVID-19 pandemic—Village leaders influence public opinion and awareness, consolidate volunteers and information, facilitate social assistance. Patron-client relationship between village head and residents, seen as a “father protector” | Qualitative, patron–client theories, power relations in bureaucracy |
Samuelsen and Toé [76] | Burkina Faso | Ruptures in politics and life | Local community | COVID-19 temporalities: Ruptures of everyday life in urban Burkina Faso: Investigated community responses to government-led restrictions as prevention prior to the advent of COVID-19 in Burkina Faso, placed within the socio-economic, political, and fragile security contexts at the time | Qualitative, anthropology, Giddens “time-space distanciation”, outbreak narratives |
Sari et al. [77] | Indonesia | Social protection with village fund | Community and leaders | The Effectiveness of Tri Hita Karana-based traditional village management in COVID-19 prevention in Bali—Experience in managing the village fund for social protection during COVID-19, using traditional Tri Hita Karana philosophy. Local wisdom provides positive outcomes for village resource distribution and social protection | Tri Hita Karana Hindu philosophy |
Sharma et al. [78] | India | Information, media, andpsychosocial experiences | Local community | Panic during COVID-19 pandemic! A qualitative investigation into the psychosocial experiences of a sample of Indian people—Misinformation causes panic and anxiety; quarantines and social restrictions created cognitive dissonance | Qualitative, descriptive, social psychology, grounded theory |
Sukmawan [79] | Indonesia | Traditional rituals | Local community | Tradition-responsive approach as a non-medical treatment in mitigating the COVID-19 pandemic in Tengger, East Java, Indonesia—Nambak lelakon, an adaptation of traditional tolak bala ritual in East Java, used to maintain and protect human life through the collective non-medical mitigation of COVID-19. Use of this ritual instills harmony in the community and is a form of prayer and surrender to God | Qualitative, psychosocial, religious |
Sumesh and Gogoi [80] | India | Stigma, discrimination | Recovered COVID-19 patients | Collecting the “Thick Descriptions”: A pandemic ethnography of the lived experiences of COVID-19-induced stigma and social discrimination in India—Embodied experience of stigma; former patients discriminated against and criminalized; social process of stigma analyzed | Pandemic ethnography, lived experience, grounded theory, Geertz, Goffman, narrative |
Tan and Lasco [81] | Philippines | Local knowledge | Traditional community | ‘Hawa’ and ‘resistensiya’: local health knowledge and the COVID-19 pandemic in the Philippines—Ethnographic study of “contagion” and “immunity” framing in illness understanding and explanatory models for COVID-19; multiple ontologies/traditional knowledge | Ethnography, postcolonialism, risk theory, political economy |
Wibisono et al. [82] | Indonesia | Religious exclusion and xenophobia | Muslim community | Turning religion from cause to reducer of panic during the COVID-19 pandemic—Explored ways to reduce social exclusion and reactions via religious cohesion in a traditional community | Collaborative auto-ethnography, Weber’s verstehen, Geertz |
3. Results
3.1. Reactive Responses
3.1.1. COVID-19 Biomedical Knowledge and Misinformation
Believe it or not. This afternoon, did anyone hear the thunder when it was hot (not raining)? There was a true incident from Popay today. A baby was born this afternoon, and before the attendants could cut the umbilical cord, it spoke and said, “To avoid the coronavirus, you must boil an egg”. Immediately after, a strong thunderclap was heard and the baby began crying [65].
3.1.2. Social and Psychological Effects
3.1.3. Impacts of Social and Mobility Restrictions
3.1.4. Pandemic Governance and Health System Challenges
3.2. Adaptive Responses
Community Cohesion and Adaptive Governance
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Topic | Inclusion Criteria (Met All) | Exclusion Criteria (Met Any) |
---|---|---|
Scope | Focus on COVID-19 impacts using social research methods Primary qualitative data collection from community or participatory settings Research conducted in LMICs | Studies conducted in non-LMICs Quantitative methodology Emphasis on virtual, digital, or distance data collection, such as phone or teleconferencing interviews or online surveys Methodologically low rigor |
Type | Peer-reviewed journal articles publishing data from empirical studies | Grey literature, systematic reviews, published protocols, or commentaries |
Language | English terms used for database search | Non-English articles |
Timeline | Published after December 2019 through August 2021 | Data collected prior to December 2019 |
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Raymond, C.B.; Ward, P.R. Community-Level Experiences, Understandings, and Responses to COVID-19 in Low- and Middle-Income Countries: A Systematic Review of Qualitative and Ethnographic Studies. Int. J. Environ. Res. Public Health 2021, 18, 12063. https://doi.org/10.3390/ijerph182212063
Raymond CB, Ward PR. Community-Level Experiences, Understandings, and Responses to COVID-19 in Low- and Middle-Income Countries: A Systematic Review of Qualitative and Ethnographic Studies. International Journal of Environmental Research and Public Health. 2021; 18(22):12063. https://doi.org/10.3390/ijerph182212063
Chicago/Turabian StyleRaymond, Christopher B., and Paul R. Ward. 2021. "Community-Level Experiences, Understandings, and Responses to COVID-19 in Low- and Middle-Income Countries: A Systematic Review of Qualitative and Ethnographic Studies" International Journal of Environmental Research and Public Health 18, no. 22: 12063. https://doi.org/10.3390/ijerph182212063