Assessing the impact of Covid-19 on nurturing care in Nairobi slums

Findings from 5 rounds of cross-sectional telephone surveys

Bibliographic Data

ID19593702
AuthorsRobert C Hughes (0000-0002-1345-3063, London School of Hygiene & Tropical Medicine, corresponding author), Silas Onyango (0000-0001-9066-6065, African Population and Health Research Center, corresponding author), Nelson Langat (0000-0003-2434-1953, African Population and Health Research Center, corresponding author), Ruth Muendo (African Population and Health Research Center, corresponding author), Rachel Juel (0000-0002-7724-4770, London School of Hygiene & Tropical Medicine, corresponding author), Elizabeth Kimani-Murage (African Population and Health Research Center, corresponding author), Zelee Hill (0000-0002-5949-6448, University College London, corresponding author), Burton Kirkwood (0000-0001-5274-6072, London School of Hygiene & Tropical Medicine, corresponding author), Betty Kirkwood, Sunil Bhopal (0000-0003-1229-781X, London School of Hygiene & Tropical Medicine, corresponding author), Sunil S Bhopal, Patricia Kitsao-Wekulo (0000-0003-4206-9746, African Population and Health Research Center, corresponding author)
EditorsMarie A Brault (0000-0002-7152-785X)
Year2025
Volume5
Issue5
Pagese0003286
Publication date2025-05-28
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0003286
PMID40435155
OpenAlexW4410810993
LanguageEN
References cited26

The Covid-19 pandemic and mitigation measures had widespread societal impacts. Young children are particularly vulnerable yet the ways the pandemic affected children in informal settlements (slums) are not well described. This study aimed to investigate the impacts of the pandemic on early childhood in three Nairobi informal settlements. Five rounds of cross-sectional computer assisted telephone surveys (with 578–774 respondents in each) in three settlements (Kibera; Mukuru-Viwandani; Kawangware) over 13 months, correlating with different phases Covid-19 restrictions. Impact was assessed through comparing changes in summary statistics on responses to survey questions on each domain of Nurturing Care over time. Survey results found significant disruptions in healthcare services, particularly in early rounds with missed vaccinations (reported by 1 in 5 parents of infants) and therapeutic healthcare seeking (missed by up to 21% of families). Persistent food and nutrition insecurity, with a large majority of families struggling to feed their children (72% in Round 1) due to financial constraints. Economic shocks were near-universal; 99.7% of respondents reporting earning less since the start of the pandemic. Use of paid childcare initially plummeted but showed a resurgence over time (up to 21% by Round 5) as pandemic control measures evolved. Young children were commonly left alone in all rounds, but especially earlier ones; underscoring the enduring challenges in providing nurturing care in these settings. Very few (

Cross-sectional study · Disease · Economic growth · Environmental health · Health care · Pandemic · Child Nutrition and Water Access · Global Maternal and Child Health · Medicine · Poverty, Education, and Child Welfare

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