Assessing Sociodemographic Factors Associated with Household Hardships During the COVID-19 Pandemic in Manhiça, Mozambique Using Data Collected Between April 2021 and February 2022

Background COVID-19 resulted in vast disruption to life in the 21st century. To quell the disease spread, national governments implemented several containment measures like state of emergency, curfews, and lockdowns that likely created hardships for households. To improve knowledge of the negative consequences of these lockdowns, we examine the extent to which the pandemic period was associated with hardships at the household level and assess factors associated with household vulnerability to these hardships. Methods We conducted a cross-sectional survey between April 2021 and February 2022 among households residing in the district of Manhiça through a survey questionnaire fielded in the Health and Demographic Surveillance System (HDSS) operating in Manhiça, Mozambique. Logistic regression was used to analyze associations between the head of household and household characteristics with specific household hardships (business closure, food price increase, household member detained, input inflation, job loss). Results Households headed by individuals with lower education and employed in non-agricultural occupations as well as households that were larger in size or poorer in asset ownership compared to other households were generally at greater risk of experiencing a larger variety of hardships. Conversely, households that owned “distance demolishing technologies” such as motorcycles were less likely to experience these hardships, presumably as they were able to transcend local conditions. Conclusions These results identify at-risk groups according to a social determinants of vulnerability framework and will help inform future policies and practices that aim to mitigate the negative consequences of COVID-19 as well as future disease outbreaks. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This work was supported, in whole or in part, by grant OPP1126780 from the Bill & Melinda Gates Foundation. CISM is supported by the Government of Mozambique and the Spanish Agency for International Development (AECID). ISGlobal receives support from the Spanish Ministry of Science and Innovation through the "Centro de Excelencia Severo Ochoa 2019-2023" Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study was conducted according to the guidelines in the Declaration of Helsinki; all procedures involving research study participants, including digital data collection using tablets that were programmed with the corresponding survey instruments, were approved by the Institutional Ethics Review Board for Health (CIBS) approval reference number No Ref:CIBS-CISM/15/2021. Written informed consent was obtained for participants who were able to read and write. For participants who were unable to read or write, the informed consent statement was read, and oral informed consent from the participant was obtained, documented, and witnessed. These procedures for obtaining written or oral informed consent were approved by the Institutional Ethics Review Board for Health (CIBS), a review board affiliated with the National Bioethics Committee for Health (CNBS). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes