2021-09-30-全球发展中心-新冠病毒与中低收入国家的妇女和女童健康（英）_19页_460kb

Overview

This review analyzes the updated evidence on how the COVID-19 pandemic has impacted women's and girls' health in low- and middle-income countries (LMICs), based on 247 studies published between January and March 2021. It highlights that women generally bear greater burdens, including disruptions to health services, worsened mental health, and differential impacts on morbidity and mortality.

Methodology

The review examined empirical studies, including peer-reviewed papers, pre-prints, and working papers, specifically focusing on gendered health outcomes in LMICs. Searches were conducted across databases like EconLit, PsycInfo, and PubMed using keywords related to COVID-19 and gender health impacts. Most studies used cross-sectional designs, primarily from East Asia, the Middle East, South Asia, and sub-Saharan Africa, with a concentration in upper-middle-income countries.

Key Findings

Sexual and Reproductive Health

• COVID-19 disrupted access to sexual and reproductive health services, leading to reduced contraceptive use in some regions. However, some studies indicated increased use of long-acting methods and factors like economic instability influenced utilization.
• Stress and anxiety during the pandemic negatively affected female sexual function in certain contexts.

Maternal and Child Health

• Pregnant women faced barriers to antenatal care and skilled birth attendance due to factors like fear of COVID-19, transportation costs, and service disruptions. Evidence shows mixed effects on birth outcomes, with some reductions in adverse outcomes but increases in stillbirths in other areas.
• Multifactorial barriers, including resource reallocation and infection risks, contributed to decreased healthcare utilization.

Mental Health

• Women experienced worse mental health outcomes, including higher rates of depression, anxiety, and post-traumatic stress disorder, compared to men. Contributing factors include economic risks, care burdens, job loss, and lockdown restrictions.
• Female health workers reported higher levels of anxiety, depression, and distress, but some studies, particularly from low-income settings, showed no significant gender differences.
• Pregnant women showed heightened anxiety and depression during the pandemic, driven by fears of infection and socioeconomic stress.

COVID-19 Morbidity and Mortality

• Evidence indicates gender disparities in COVID-19 severity and mortality, with men generally at higher risk. However, not all studies confirm this, and results vary by region.
• Research gaps exist, particularly for low-income countries, and post-COVID-19 complications show inconclusive data.

Knowledge, Attitudes, and Practices

• Women often demonstrated higher knowledge and adherence to COVID-19 preventive measures, though evidence varies. Factors like education and media exposure influenced practices.
• Mixed findings emerge, with some studies showing lower preventive behaviors among women, and disparities in knowledge based on region and income.

Conclusion

The COVID-19 pandemic has disproportionately affected women's health in LMICs through disruptions in essential services and worsened mental health. Research gaps, particularly in low-income settings, and a lack of focus on mitigation strategies highlight the need for more comprehensive, evidence-based policies to address these gendered impacts.