A Mixed Methods Exploration of Young Women’s Agency and Mental Health during COVID-19 in Low-Income Communities in Mumbai, India

TL;DR

This study explores how the pandemic affected young women's mental health and agency in low-income Mumbai communities.

Contribution

The paper provides new insights into how pandemic-related stressors and opportunities impacted young women's mental health and agency.

Findings

Limited agency during lockdowns was linked to higher depression and anxiety in young women.

Financial resources and new employment opportunities reduced anxiety among participants.

Community violence and education access were key stressors for young women during the pandemic.

Abstract

Introduction: Adolescent girls and young women (AGYW) in India face additional health inequities compared to their male peers, as gender norms constrain agency for prevention and self-care. The onset of the COVID-19 pandemic and associated lockdowns deepened health inequities and often worsened mental health, but the impacts on agency are unclear. This exploratory sequential mixed methods paper examined mental health and COVID-19 elements that exacerbated or mitigated adverse consequences for AGYW in low-income communities in Mumbai. Methods: We conducted semi-structured interviews with AGYW (aged 15–25 years; N = 60) and adults (parents, healthcare providers, community-based organization representative; N = 30). We administered a structured survey to AGYW (N = 150) to assess health concerns, depression and anxiety symptoms (using the PHQ-8 and GAD-7 scales), and experiences during COVID-19. We analyzed qualitative data using the constant comparative approach in Atlas.ti, and quantitative data using R and SPSS. Results: Qualitative data revealed that AGYW faced stressors and had limited agency during lockdowns due to limited access to education, financial insecurity, and community violence. Quantitative data indicated that limited agency in the context of COVID-19 was significantly associated with depression and anxiety. Financial resources to address COVID-19 created new employment and leadership opportunities for AGYW to become COVID educators and preschool teachers; participation in these opportunities was associated with less anxiety. Discussion: Pandemic stress was difficult for low-income AGYW in Mumbai. Mitigating programs for COVID-19 control helped address acute needs and enable capabilities. Exploring similar themes among a broader population of youth can help design strategies and opportunities for young people in low-income communities during health emergencies.