{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T15:43:12Z","timestamp":1786549392667,"version":"build-2736575974"},"reference-count":57,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"International Development Research Centre\u2019 Women RISE Initiative","award":["#110013"],"award-info":[{"award-number":["#110013"]}]},{"DOI":"10.13039\/501100000024","name":"The Canadian Institutes of Health Research","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"crossref"}]},{"name":"The Social Sciences and Humanities Research Council"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Public Health Research"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The world appears to be experiencing more than its fair share of shocks: climatic disasters, pandemics, wars and political events that have far-reaching consequences for vulnerable populations globally. One such example was the COVID-19 pandemic, which resulted in both direct and indirect impacts on older women, especially those residing in Sub-Saharan Africa, due to the already fragile economic and health care systems in place, as well as the lack of infrastructure for public services. While substantial literature now exists documenting the impact of COVID-19 on vulnerable populations, less attention has been paid to building back better.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and Methods<\/jats:title>\n                    <jats:p>Using the feminist political ecology of health framework, this research investigated the impacts of the COVID-19 pandemic on health and wellbeing among older women residing in Kenya (n=231) and Uganda (n=211) and how they are \u2018building back better\u2019. Using survey data, we used a generalized linear model with a complementary loglog link function to identify factors associated with wellbeing, emotional distress and self-reported health status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Only 17.7% of older women in Kenya and 14.7% in Uganda experienced an improvement in wellbeing post-COVID compared to during the pandemic. Further, there remains a sustained impact on emotional distress levels. Several factors, such as WASH insecurity and no health insurance, negatively impacted wellbeing, emotional distress and self-reported health status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Overall, this research documents how older women in Uganda and Kenya have been and continue to be impacted by the COVID-19 pandemic, despite declining case counts. Several policy recommendations have been outlined.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/22799036261474131","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T23:00:41Z","timestamp":1786143641000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["The lingering impacts of COVID-19 on older women in Kenya and Uganda: A quantitative analysis of health, wellbeing, and WASH insecurity"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2642-7200","authenticated-orcid":false,"given":"Satveer","family":"Dhillon","sequence":"first","affiliation":[{"name":"University of Waterloo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaiah","family":"Omondi","sequence":"additional","affiliation":[{"name":"University of Waterloo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justine","family":"Nagawa","sequence":"additional","affiliation":[{"name":"Reach One Touch One Ministries (ROTOM)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elijah","family":"Bisung","sequence":"additional","affiliation":[{"name":"Queens University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Dickin","sequence":"additional","affiliation":[{"name":"Uppsala University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Mugayehwenkyi","sequence":"additional","affiliation":[{"name":"Reach One Touch One Ministries (ROTOM)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Karanja","sequence":"additional","affiliation":[{"name":"Community Health Support Programme"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan J.","family":"Elliott","sequence":"additional","affiliation":[{"name":"University of Waterloo"},{"name":"United Nations University Institute for Water, Environment and Health, Richmond Hill, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13031-022-00484-8"},{"key":"e_1_3_6_3_2","volume-title":"COVID-19 deaths|WHO COVID-19 dashboard","author":"World Health Organization","year":"2025","unstructured":"World Health Organization. COVID-19 deaths|WHO COVID-19 dashboard. World Health Organization, 2025. [cited 2025 Jun 18]. Available from: https:\/\/data.who.int\/dashboards\/covid19\/deaths"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12081295"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2020.113369"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/24694452.2021.1997567"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-7568(20)30010-6"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s41182-024-00614-3"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.923097"},{"key":"e_1_3_6_10_2","unstructured":"HelpAge International. Older women\u2019s lived experiences of gendered ageism. Available from: https:\/\/www.helpage.org\/silo\/files\/older-womens-lived-experiences-of-gendered-ageism.pdf (2023)."},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1332\/29767202Y2024D000000015"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17072347"},{"key":"e_1_3_6_13_2","first-page":"74","article-title":"Long-term Care and Caregiving for Older Adults in Africa","volume":"2021","author":"Agyemang FA","year":"2021","unstructured":"Agyemang FA. Long-term Care and Caregiving for Older Adults in Africa. AARP International 2021; 2021: 74\u201381. https:\/\/doi.org\/10.26419\/int.00051.020","journal-title":"AARP International"},{"key":"e_1_3_6_14_2","unstructured":"WHO Regional Office for Africa. Assessing the impact of Covid-19 on older people in the African Region: a study conducted by the World Health Organisation Regional Office for Africa. 2021. https:\/\/iris.who.int\/bitstream\/handle\/10665\/351134\/9789290234548-eng.pdf?sequence=1&isAllowed=y"},{"key":"e_1_3_6_15_2","volume-title":"UN Research Roadmap for the COVID-19 Recovery","author":"United Nations","year":"2020","unstructured":"United Nations. UN Research Roadmap for the COVID-19 Recovery. United Nations, 2020. https:\/\/www.un.org\/en\/pdfs\/UNCOVID19ResearchRoadmap.pdf"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0003691"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s41134-022-00229-w"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.75541.1"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12571-023-01412-1"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30353-3"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wss.2025.100243"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610220003312"},{"key":"e_1_3_6_23_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1158716"},{"key":"e_1_3_6_24_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610220004081"},{"key":"e_1_3_6_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthplace.2021.102651"},{"key":"e_1_3_6_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.geoforum.2011.01.004"},{"key":"e_1_3_6_27_2","unstructured":"The Republic of Uganda Ministry of Gender Labour and Social Development. The State of Older Persons in Uganda: Situational analysis report. https:\/\/www.developmentpathways.co.uk\/wp-content\/uploads\/2020\/10\/ESP-OP-Study-Final-12-Oct.pdf (2020)."},{"key":"e_1_3_6_28_2","unstructured":"UNFPA Kenya. Drupal. Policy Brief on COVID-19 and Older Persons COVID-19 How Safe are Kenya\u2019s Older Persons May 2020. [cited 2024 Dec 15] : https:\/\/kenya.unfpa.org\/en\/publications\/policy-brief-covid-19-and-older-persons-covid-19-how-safe-are-kenyas-older-persons-may (2020)."},{"key":"e_1_3_6_29_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0001494"},{"key":"e_1_3_6_30_2","unstructured":"Africa CDC. Africa CDC. Finding the Balance: Public Health and Social Measures in Kenya: https:\/\/africacdc.org\/download\/perc-finding-the-balance-public-health-and-social-measures-in-kenya\/ (2020)."},{"key":"e_1_3_6_31_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-06726-4"},{"key":"e_1_3_6_32_2","unstructured":"ROTOM. (2026). https:\/\/reachone-touchone.org\/ug"},{"key":"e_1_3_6_33_2","unstructured":"COHESU. (2026). https:\/\/www.cohesu.com"},{"key":"e_1_3_6_34_2","unstructured":"Oxfam. Oxfam 2016. Who is growing? Ending Inequality in Uganda: https:\/\/oi-files-d8-prod.s3.eu-west-2.amazonaws.com\/s3fs-public\/file_attachments\/oxfam_in_uganda_inequality_report_compressed.pdf"},{"key":"e_1_3_6_35_2","unstructured":"County Government of Kisumu. County Government of Kisumu 2020. Gender Mainstreaming Policy: https:\/\/www.kisumu.go.ke\/wp-content\/uploads\/2021\/12\/Kisumu-County-Gender-Mainstreaming-Policy.pdf"},{"key":"e_1_3_6_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.worlddev.2020.105158"},{"key":"e_1_3_6_37_2","unstructured":"Goldberg DP. The detection of psychiatric illness by questionnaire; a technique for the identification and assessment of non-psychotic psychiatric illness. Oxford Univ. Press 1972. (Maudsley monographs no. 21)."},{"key":"e_1_3_6_38_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291796004242"},{"key":"e_1_3_6_39_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-054839"},{"key":"e_1_3_6_40_2","doi-asserted-by":"publisher","DOI":"10.1080\/13607863.2025.2451101"},{"key":"e_1_3_6_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pecinn.2023.100187"},{"key":"e_1_3_6_42_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0144686X17000502"},{"key":"e_1_3_6_43_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-019-1116-0"},{"key":"e_1_3_6_44_2","doi-asserted-by":"publisher","DOI":"10.1177\/17455057221122618"},{"key":"e_1_3_6_45_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-023-02792-4"},{"key":"e_1_3_6_46_2","doi-asserted-by":"publisher","DOI":"10.1111\/dpr.12758"},{"key":"e_1_3_6_47_2","article-title":"How do you cope with a global health emergency in the absence of water? Investigating the impacts of COVID-19 on wellbeing in Kenya","author":"Omondi I","year":"2026","unstructured":"Omondi I, Musuva RM, Karanja D, et al. How do you cope with a global health emergency in the absence of water? Investigating the impacts of COVID-19 on wellbeing in Kenya. Submitted to International Journal of Community Wellbeing 2026.","journal-title":"Submitted to International Journal of Community Wellbeing"},{"key":"e_1_3_6_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wasec.2024.100180"},{"key":"e_1_3_6_49_2","doi-asserted-by":"publisher","DOI":"10.3389\/fgwh.2021.686984"},{"key":"e_1_3_6_50_2","doi-asserted-by":"publisher","DOI":"10.1080\/13545701.2023.2174566"},{"key":"e_1_3_6_51_2","doi-asserted-by":"publisher","DOI":"10.1093\/jae\/ejac041"},{"key":"e_1_3_6_52_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-023-04079-7"},{"key":"e_1_3_6_53_2","doi-asserted-by":"publisher","DOI":"10.1002\/wat2.1461"},{"key":"e_1_3_6_54_2","doi-asserted-by":"publisher","DOI":"10.1177\/09730052231202567"},{"key":"e_1_3_6_55_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wdp.2023.100549"},{"key":"e_1_3_6_56_2","doi-asserted-by":"publisher","DOI":"10.1029\/2022WR033374"},{"key":"e_1_3_6_57_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2022.115394"},{"key":"e_1_3_6_58_2","first-page":"2752535X2513176","article-title":"\u2018We\u2019re More Prepared than Before: Understanding the Strategies Used by a Non-governmental Organization During the COVID-19 Pandemic in Sub-Saharan Africa","volume":"46","author":"Dhillon S","year":"2025","unstructured":"Dhillon S, Luginaah I, Elliott SJ, et al. \u2018We\u2019re More Prepared than Before: Understanding the Strategies Used by a Non-governmental Organization During the COVID-19 Pandemic in Sub-Saharan Africa. Community Health Equity Research & Policy 2025; 46: 2752535X251317651. https:\/\/doi.org\/10.1177\/2752535X251317651","journal-title":"Community Health Equity Research & Policy"}],"container-title":["Journal of Public Health Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/22799036261474131","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/22799036261474131","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/22799036261474131","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T11:19:31Z","timestamp":1786360771000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/22799036261474131"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":57,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/22799036261474131"],"URL":"https:\/\/doi.org\/10.1177\/22799036261474131","relation":{},"ISSN":["2279-9036","2279-9036"],"issn-type":[{"value":"2279-9036","type":"print"},{"value":"2279-9036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"article-number":"22799036261474131"}}