Leaving No Women Behind: Evaluating the Impact of the COVID-19 Pandemic on Livelihood Outcomes and Inequities in Access to Health Services and Necessities in Kenya and Ethiopia

The COVID-19 pandemic has revolutionized the way we live and has brought about the twin crises of sickness and the need for an optimal mix of policies crafted to alleviate its impact on the population. There is little evidence on the impact of the pandemic on livelihood outcomes and inequities in access to health services and necessities and on whether female-headed families fare worse compared to their male-headed counterparts in Kenya and Ethiopia. We use data from high frequency phone surveys conducted in Kenya and Ethiopia to examine the aggregate impact of the pandemic on incomes, consumption patterns, food insecurity, and inequities in access to health services and necessities. Overall, the pandemic resulted in dramatic increases in food insecurity, reduced incomes and consumption, and increased inequities in access to health and necessities, especially for women living in female-led households. For example, living in a female-headed household was associated with an approximate 10% increase in the probability that an adult would go hungry, 9.88% increase in the likelihood of skipping a meal, and 17% increase in the prospect that a child would skip a meal in the seven days leading to the phone survey in Kenya. In Ethiopia, living in a female-headed household was associated with an approximate 24.35% increase in the probability that an adult would go hungry, 18.89% chance that an adult would skip a meal, and 26.67% probability of running out of food. Families with children and of low socioeconomic status prior to the pandemic experienced even worse outcomes. Inequities in access to health services were mostly pro-rich and appeared to be larger among female-headed families even though the difference between groups did not appear to be statistically significant in Kenya. Additionally, female-headed families from low socioeconomic positions had greater difficulty accessing necessities during the pandemic in both countries. These findings are mostly explained by the decreases in incomes due to COVID-19 alongside the pre-existing differences in socioeconomic status among the population. These results have important implications to public policy and planning for future pandemics in Kenya and Ethiopia.