Abstract:
COVID-19 is an active pandemic that likely poses an existential threat to humanity. Frequent handwashing,
social distancing, and partial or total lockdowns are among the suite of measures prescribed by the World Health
Organization (WHO) and being implemented across the world to contain the pandemic. However, existing inequalities in access to certain basic necessities of life (water, sanitation facility, and food storage) create layered
vulnerabilities to COVID-19 and can render the preventive measures ineffective or simply counterproductive. We
hypothesized that individuals in households without any of the named basic necessities of life are more likely to
violate the preventive (especially lockdown) measures and thereby increase the risk of infection or aid the spread
of COVID-19. Based on nationally-representative data for 25 sub-Saharan African (SSA) countries, multivariate
statistical and geospatial analyses were used to investigate whether, and to what extent, household family
structure is associated with in-house access to basic needs which, in turn, could reflect on a higher risk of COVID-
19 infection. The results indicate that approximately 46% of the sampled households in these countries (except
South Africa) did not have in-house access to any of the three basic needs and about 8% had access to all the
three basic needs. Five countries had less than 2% of their households with in-house access to all three basic
needs. Ten countries had over 50% of their households with no in-house access to all the three basic needs. There
is a social gradient in in-house access between the rich and the poor, urban and rural richest, male- and femaleheaded households, among others. We conclude that SSA governments would need to infuse innovative genderand age-sensitive support services (such as water supply, portable sanitation) to augment the preventive measures prescribed by the WHO. Short-, medium- and long-term interventions within and across countries should
necessarily address the upstream, midstream and downstream determinants of in-house access and the full
spectrum of layers of inequalities including individual, interpersonal, institutional, and population levels
