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What is the overall impact of the COVID-19 pandemic on the daily lives of adolescents in low- and middle-income countries? Researchers Astha Ramaiya (Johns Hopkins Bloomberg School of Public Health) and Rosalijn Both (Rutgers) show us how the mental, physical, sexual and reproductive health impact of the pandemic on adolescents, vaccine perceptions, social relationships, education and socio-economic disparities are all connected. What can we learn from this unprecedented time?
“A lot of studies into the impact of COVID-19 were focused on specific outcomes, such as mental health or education amongst adolescents,” starts Astha Ramaiya, lead researcher for this new study, a rapid literature review. “However, none of them combined the global evidence across different impact areas. Looking at this research, one of the most important things that we see is that all these outcomes, are connected and influence each other.”
Connecting the dots: Interconnectedness of impact areas
The results indicate that, where there has been research, almost all findings have been linked to worse mental health during the pandemic. Overall, remote education was seen as a negative experience. The ramification of school closures on future aspirations, in particular early school leaving, highlights the importance of prioritising education during future pandemics based on the situation within the country. Gender and other disparities have made marginalised adolescents vulnerable to the economic ramifications of containment measures.
“The fact that so many outcomes pointed towards mental health really stuck out to me, especially when looking through the (gender) disparity lens. Married girls were saying that even before Covid happened, their social spheres were constrained because once they are married, they are restricted by what their husband or parents tell them. During Covid they were stuck at home and experienced violence because their husband or parents didn’t have jobs or were at home because of lockdowns. They were not able to go out, were not able to meet their peers in their school or social circle so their “usual” coping mechanisms were not available to them. This led them to feel isolated, which also led to anxiety and depression. So, we saw a clear interconnection between social relationships, individual mental health and violence.”
What needs to happen now?
“There is an urgent need to place adolescents at the centre of post-pandemic recovery efforts and prioritise their health agendas. It is essential to integrate preparedness measures into existing health systems to ensure the continuous provision of essential services to adolescents. During the pandemic, access to routine healthcare and menstrual products was severely affected, disproportionately impacting poorer individuals and those with disabilities.”
“Health providers, whether they are nurses or counselors in schools, and educators need to be connected to each other because all domains are linked to mental health.”
“One significant impact of the pandemic, especially in Africa, has been the disruption of education, leading to learning loss and early entry into the workforce for many adolescents. Schools and employers must work together to minimize learning setbacks and provide opportunities for continuing education, even for those who start working at an early age.”
Prioritising adolescents: Establishing post-pandemic health agendas
The study highlights the importance of involving adolescents themselves in establishing their health priorities and designing effective programmes. “Results like these highlight the interdisciplinary work of agencies like the UN, governments and NGOs and most importantly adolescents themselves. The voices and perspectives of young people should guide decision-making processes, ensuring that solutions are tailored to their needs.”
“My work with and for adolescents is very dear to my heart. We learn so much as researchers by how we engage with them. And there are so many ways we can work with young people to come up with solutions that fit them. In the end, our work is for their future trajectories. ”Astha Ramaiya, researcher Johns Hopkins Bloomberg School of Public Health
Senior researcher at Rutgers, Rosalijn Both: “We need more attention for the disparities we drew out in the findings. In the global research, we saw certain groups of adolescents are affected more than others, but there wasn’t enough data available to clearly highlight that vulnerability of those groups in different countries. We need to continue to monitor the long-term impact of COVID-19 on vulnerable youth to understand how some of the adverse effects have evolved over time. And we need to bring in youth advocates to speak out on solutions and actions.”
About the research
The involvement of Rutgers in this project came after our publication of a study into the impact of COVID on the sexual and reproductive health and rights of young people. Others, like GEAS, GAGE (Gender and Adolescence: Global Evidence) and the Population Council also researched the effects of COVID. The WHO brought all these parties together. The findings that we found in one country we can see similar findings in other countries, you can see happening throughout the world and we have the evidence of that. This is such a powerful outcome.
A total of 89 articles were included in the review. Three major topics emerged in more than half the articles: mental health (72%), education (61%) and socio-economic ramifications (55%). Astha Ramaiya, was lead researcher for this rapid literature review.
