Stigma, Violence And Mental Wellbeing Among Covid-19 Survivors In Ghana: A Prospective Longitudinal Cohort Study

Since the confirmation of the first two coronavirus disease (COVID-19) cases in Ghana on 12th March 2020, a total of 10,201 cases have been confirmed as at 10th June 2020. The number of deaths stood at 48, whereas a total of 3,755 persons have recovered from COVID-19. Just like any other infectious disease outbreak, COVID-19 is reportedly associated with stigmatization, violent/aggressive practices and mental health consequences that can hinder the fight against the pandemic. Individuals who have recovered from COVID-19 are resourceful agents as they navigate the sociocultural context that define and shape responses to the pandemic. Insight into their experiences could be added to the gamut of programs and interventions designed to expand public education and prevention of COVID-19. However, despite the growing interest in COVID-19 research, we do not know of any study from Ghana and Africa that has examined stigmatization, violence encounters and mental health from the perspective of COVID-19 survivors. This crucial knowledge gap, with significant promise for COVID-19 mitigation policy interventions and programs, will be addressed in our project. To accomplish our task, we propose a prospective longitudinal cohort study where we would recruit individuals who have recovered from COVID-19 and follow them for 12 months. We will collect data at four different waves, with 3 months interval between the waves, using sequential mixed-method data collection approach consisting of surveys, individual in-depth interviews (IDI) and focus group discussions (FGDs). The survey data will come from questionnaires measuring the study variables, including stigmatization, mental health, violence experience and coping strategies. The questionnaires will be designed and hosted on SurveyMonkey, an online research platform, or administered via telephone to maintain social and physical distancing protocols. These would be complemented by two waves of IDIs and FGDs conducted through videoconferencing - Zoom and telephone. The project would generate empirical evidence on the stigmatization, violence experiences and mental wellbeing of survivors of COVID-19. We will engage stakeholders, researchers and practitioners to assess the implications of the findings for the design of interventions to reduce COVID19 associated stigmatization and mental health problems Expected Outputs First, the project would generate empirical evidence on the stigmatization, violence experiences and mental wellbeing of survivors of COVID-19 in Ghana. As the first of its kind in Ghana and perhaps in Africa, the findings are expected to deepen our understanding of the prevention and management of COVID-19 from the perspective of survivors. Among the expected knowledge output will be the development of COVID-19 survivors' tool kits containing salient information on mental health problems, stigma, violence and coping experiences for distribution among all COVID-19 holding centres. This will help to achieve four-fold objectives; (1) serve as a guide for educating health workers whose domain of work interface with COVID-19 survivors such as counsellors and clinical psychologists; (2) serve as framework for developing pre-discharge orientation guide for would-be COVID-19- survivors; (3) manual for developing anti-stigma public education and advocacy programs, and (4) resource package for survivors to enable them to engage in self-directed reintegration processes. The project will bring at least 40 key policy makers, practitioners and researchers to attend a policy workshop to discuss the results from the project. Two workshops have been proposed. The first workshop will be organized upon completion of data collection and analysis for wave one. This will give stakeholders, practitioners and policy makers the opportunity to assess the findings for possible short-term interventions to address the pressing concerns of COVID-19 survivors, reduce stigmatization and promote community reintegration. The second workshop will be held upon the completion of all waves of data collection and analysis. This engagement is anticipated to help build the foundation for formulating long term national policy interventions and programs on integrating survivors into their respective communities as well as promoting community acceptance of COVID-19 survivors. Other anticipated potential impact of the study findings includes (1) facilitate the formation of COVID-19 survivor mutual help groups to serve as critical resources to augment mainstream efforts; (2) organize workshops and training programs for select groups (e.g., the faith-based leaders, local chief and queen mothers, non-governmental organizations, the media, and community leaders) to build their capacities for gatekeeping roles in their respective communities. These individuals are well respected in their various communities and so would contribute to contextually relevant public education and awareness campaign to support the integration of COVID-19 survivors into the communities. Non-governmental or community-based organizations have good working relationship with their respective communities and so have good understanding and knowledge of the dynamics of their communities to deliver impactful awareness and education on COVID-19. The findings of this protect will be disseminated through open access scientific peer reviewed outlets to share knowledge with wider audiences.