Evidencing the need for psycho-socio-economic action to support the rural upskilled youth to cope with the COVID-19 health crisis: a state-wide audit

Introduction

The impact of the COVID-19 pandemic, a public health emergency (WHO, 2020), is beyond morbidity and mortality, and there will certainly be massive social, psychological and economic ramifications for a large population around the world (Li et al., 2020; Wang et al., 2020; Xiao et al., 2020a; Xiao et al., 2020b). Pandemic-related actions such as social distancing and contact restrictions have hampered daily schedules, collapsed many industries and lowered GDP, which has further resulted in financial distress, job loss, job insecurity, temporary/permanent unemployment, unavailability of community services, social isolation, poor mental health outcomes and so on (Cao et al., 2020; Kar et al., 2020; Panchal et al., 2020; Pulla, 2020; Rubin & Wessely, 2020). It has also put a halt to emergency medical services and transportation facilities (The Indian Express, 2020), causing social disruptions worldwide. Concerns around the exacerbation of pre-existing mental health issues and greater difficulty in accessing health support and services have also been reported (The Academy of Medical Sciences, 2020). In addition, an increase in domestic abuse and violence against women is also widely prevalent (Qantarade, 2020).

The impact is much more disastrous for low and middle-income countries like India where more than 90% of the population depends on daily wage jobs or represent the informal job sector (Buheji et al., 2020). The economic loss imparted by pandemic related restrictions further imposes major mental health problems of depression, anxiety, and even suicidality for the people within the low-income group (Panchal et al., 2020). The quarantines and economic shutdowns speed up unemployment, leading to poverty and a minimum standard of living. A recent UN study pointed out that global poverty could increase for the first time since 1990, posing a major threat to the UN Sustainable Development Goal of ending poverty by 2030 (Sumner et al., 2020). To minimize the crisis, the world should aim to overcome the negative impacts of COVID-19 by focussing initially on the poorer communities (Buheji et al., 2020).

This study is conceptualized in the context of the Deen Dayal Upadhyaya Grameen Kaushalya Yojana (DDU-GKY) program of the Government of India (GoI). DDU-GKY is one of the clusters of initiatives of the Ministry of Rural Development (MoRD), spread across 28 states of India, with 1575 projects, implemented through 771 Project Implementing Agencies (PIAs), which seeks to promote rural livelihoods by upskilling the rural youth (aged between 15- 35), who are poor, and provide them jobs with regular monthly wages.

The current study is the first to describe the grouping of modifiable factors within the different domains of impact for youth belonging to impoverished backgrounds engaged in the unorganized work sector. The aim of DDU-GKY involves training unemployed youth from rural poor households with employable skills (DDUGKY, 2020). Measures are built into the guidelines to ensure exclusivity in the recruitment of the poor and the vulnerable for participation in the program. It is for the first time that the Participatory Identification of Poor (PIP) strategy has been used to identify vulnerable groups. Additionally, support strategies including placement services, placement counselling and job tracking for one year after course completion are mandated in this scheme (DDUGKY, 2020). This process is facilitated by PIA driven call centres. PIAs are further coordinated through state and district coordinating agencies of DDU-GKY. This audit is an attempt to optimize its ecosystem to achieve its well-defined goals. In addition, our study helps to identify the key issues faced by the participants in the context of pandemic, thus helping to make a positive difference in the lives of the youth and their families by reengaging this productive workforce into the economic system for their improved economic outcomes.

Methods

Results

Issues specific to vulnerable populations

Figure 1 demonstrates major issues expressed by vulnerable populations among the respondents. Some of the major issues expressed by pregnant women were concerns regarding their health, concerns about the baby, potential COVID-19 infection during check-ups and other hospital engagements, poor financial background and loss of income due to the pandemic. The major issues expressed by participants who were living alone included loss of income, poor financial backup, fear of the future in the context of the epidemic, future job concerns and loneliness. Food scarcity was reported by 24.5% of the respondents who were living alone. People with comorbid health conditions had fears of the future, concerns regarding COVID-19 infection, loss of income, poor financial backup, conflict with family, future job concerns and job insecurity.

Figure 1. Major issues expressed by vulnerable participants.

Discussion

This research has the potential to identify the felt needs of socially and economically vulnerable youth in the context of the COVID-19 pandemic. This inquiry was developed based on a resilience and strength perspective, which assumes that even though people have existing strengths and motivations, there are situations where they might need a helping hand in solving problems in their life. Recent research found that youth from rural areas, families without a steady income, and people living alone were associated with increased COVID-19 related impacts (Cao et al., 2020). Therefore, the information gathered from the current study on the needs of the vulnerable youth will guide service navigation, helping them to better cope with the pandemic situation.

A total of 14430 upskilled youth from DDU-GKY centres across Kerala participated in this audit and shared their issues. A range of 28 major issues were identified. All these issues were further grouped under five different domains. Firstly, were issues were related to financial toxicity, such as loss of income (32.99%), poor financial backup and debt (31.29%), concerns regarding future job opportunities (23.92%) and fear of losing their current job (14.75%). The second group of issues were related to health, which included anxiety about health (27.55%) and concerns about the fast spread of COVID-19 (22.20%). The other three domains were the adjustment to pandemic situations, family and social relationships and psychological distress. These five domains and their subcategories demonstrate the complexity of the range of issues participants faced. These study findings are in agreement with the findings of recent studies conducted in similar areas, where almost 25% experienced psychological issues and perceived COVID-19 as a threat to their existence (Chakraborty & Chatterjee, 2020). The study highlights that unmarried male youths had higher levels of financial, employment, and psychological concerns, whereas young females were more concerned about their own and their family member’s health. These concerns included issues related to both physical health as well as difficulty in accessing different health care services. Previous studies also found that females experienced greater psychological impacts due to the pandemic (Varshney et al., 2020; Wang et al., 2020).

Financial crunches and concerns regarding future job opportunities and the security of current jobs were the major reasons for financial and employment-related worries among the participants, as most of these youth are working in sectors, such as aviation, travel, hospitality, retail, manufacturing, and automotive, which are most affected by the COVID-19 pandemic (Thomas, 2020; Wang et al., 2020). The economic domain was the most affected domain of the married participants. Consistent with our findings, Chakraborty & Chatterjee (2020) also revealed that the major reason for the concern is current as well as future job opportunities.

In agreement with other studies, the situational stressors like fear of infection and rampant spread of the virus were worrisome for many. Chakraborty & Chatterjee (2020) also found that the majority of participants were "preoccupied with the idea of getting infected with COVID-19”. Additionally, those with physical comorbidities had concerns regarding their own health, resulting in increased distress. This coincides with previous findings (Fu et al., 2020; Varshney et al., 2020). In addition, Cao et al. (2020) reported that those with a relative or an acquaintance infected with COVID-19 were more likely to experience severe anxiety. Inadequate access to hospital care, as a result of the halt to emergency medical services and transportation facilities, was also found to be an area of worry (The Indian Express, 2020), which was found to be a cause of distress in all participants, but especially female participants, of this study.

Mass quarantine and nation-wide lockdown have wide consequences on mental health and well-being, especially for vulnerable populations. A lack of supplies of basic essentials, financial crunches, job related uncertainties and families needing separation (Brooks et al., 2020; Dubey et al. 2020; Hawryluck et al., 2004; Maunder et al., 2003) were some of the significant contributors of stress. Stressors like living alone, conflicts with extended family members, marital issues resulting in increased worry were also found in this study and it is consistent with previous findings that social support reduced psychological pressures during epidemics (Cao et al., 2020; Chen et al., 2020). These findings propose an ecosystem framework which acknowledges the socio-economic environment of the students (Green & McSermott, 2010), and consequently adds value to the DDU-GKY program. It advocates for positive change by initiating early economic and social engagements. This proactive empathetic engagement has twin benefits; this initiative gives this program a positive support service reputation, where the students and families maintain their long term trust in the institution and the program. Secondly, it helps the staff members to be sensitive to the needs of the students and become responsive to their needs through developing pathways of care. They become empowered to voice students’ needs to the concerned authorities and advocate for them in mobilizing internal resources as well as external community resources for achieving the goals of this program.

Our study also has its limitations. The current study explored the various domains of issues from the perspective of the researcher. A qualitative study on the experience of the DDUGKY participant is necessary for a clearer understanding of the issues from the participant’s perspective.

Conclusion

This staff engagement facilitates speedier reengagement of students through the navigation of both formal and informal support systems, to address their psycho-socio- economic needs. This proactive engagement is a unique model that encourages the PIAs to engage with their alumni to offer support to sustain them in their jobs. This cost-effective support model can be replicated to similar programs to ensure their sustainability and to achieve stipulated goals and objectives.

Data availability