Pandemics and mental health among adolescents and adults: The effect of Covid-19 school closures in Mozambique

Depression is the third largest cause of death from non-communicable disease worldwide and preliminary evidence suggests that the Covid-19 pandemic has the potential to meaningfully increase the prevalence of both depression and depression-related health challenges. The objective of this project is to undertake a comprehensive and large-scale survey of mental health during the Covid-19 pandemic in a school-based setting, implementing a broad survey of ten grade seven students and two teachers, the school principal, and the deputy school principal in a sample of 160 primary schools in Nampula province in Mozambique. Most children both in sub-Saharan Africa and around the world have experienced school closures due to Covid-19, and this is clearly among the most significant and devastating shocks that children have faced. In Mozambique, schools closed early in the school year on March 23, 2020 and will open in March 2021, at which point the survey will be undertaken. In addition to measuring children's response to this unprecedented shock, analyzing the effects of the crisis on school staff is important in light of the crucial role these staff play in students' educational and psychosocial development, as well as their role in the transition back to education. The first objective of this study is to generate comprehensive data on mental health among a rural school-based population in Nampula province, and in particular, generate estimates of the prevalence of clinical depression, anxiety, Covid-related fears, and community and institutional trust (or lack thereof) among adolescents (both male and female) well as school staff. The second objective is to identify correlates of depression, anxiety, Covid-related fears, and trust among male versus female adolescents by collecting additional information on their dropout status, their engagement in work and/or other household activities during and following Covid-related school closures, and their exposure to risks of pregnancy and early marriage, particularly for girls. The third objective is to identify correlates of depression, anxiety, Covid-related fears, and trust among adult school staff. Another substantial challenge will be the reenrollment of children in school. The Mozambican government has specified that there will be automatic promotion to the next grade. While a student may have been enrolled in grade two at the start of 2020, they will be promoted to grade three even though they did not receive grade two teaching. They will only have had one year of teaching. Consequently, we will also measure dropout rates and reasons for dropout. We hope to inform government policy regarding the management of mental health of adolescents and school staff to promote this aspect of human capital development. Expected Outputs There will be three outputs produced by this research. The first will be two (anonymized) data sets: one for seventh grade students and another for school staff. The data sets will include demographic variables and the measurements of mental health. Anonymized data will be appropriately cleaned and made publicly available with required documentation in a public repository maintained by IFPRI to facilitate further analysis by interested researchers and policymakers in Mozambique and around the world. The second output will be an academic paper reporting on the findings of the study that will be produced in 2021. While the appropriate venue for the paper will be identified later, the research team commits to publishing in an open-access journal, or to ensure that the article is open access to render the findings accessible to the broadest possible audience. The third will be a policy brief directed at policy makers summarizing the paper and translated into Portuguese and Emakhuwa. This brief will be shared with the central government, the provincial government, the local government, teacher training colleges, ZIPs (Zona de Influência Pedagógica), school staff in the sample schools, and parents. This will enable all stakeholders to be aware of the findings. The brief will also explore some potential recommendations around policies that can address the observed challenges: e.g., resources to address mental health challenges in the classroom, and organizations that respond to these challenges. Policy recommendations will include potential preliminary methods by which to include post-Covid measures regarding mental health into the planned revision by MINEDH to the school curriculum, and into pre-service and in-service teacher training.