Prepared by Prapti Barooah 29th IAFFE Annual Conference 25th June 2021

1. Emotional well-being during the COVID-19
pandemic:
Insights from India and Nepal
Prapti Barooah
International Food Policy Research Institute
29th IAFFE Annual Conference
25th June 2021

2. Part I: Overview
Image from Microsoft Office

3. Study Context and Data
• Panel phone surveys to understand the impact of COVID-19 pandemic
• Information areas: Economic impact, impact on mobility, intra-household decision-making, experiences
with household food insecurity, water insecurity, and emotional well-being

4. Study Design and Methodology
9 districts-
Kutch,
Surendranagar
Patan,
Ahmedabad,
Gandhinagar,
Mehsana,
Aravalli,
Anand,
Chhota Udaipur
India:
• Sample size- 489 women in round 3
• SEWA members
• Longitudinal study- 5 rounds planned
• 4 completed; refers to data from round 3
• Quantitative survey using structured questionnaires
• Phone survey using SurveyCTO CATI features
• Duration- 30-35 minutes
• Incentive: Food kits/Phone credit
4 municipalities-
Lamahi, Shantinagar, Dangisharan and Rapti (134 villages)
Nepal:
• 421 women and 161 men in round 3
• Physical listing exercise in Feb-Mar 2020
• To identify agriculture decision makers from summer maize
growing households

5. Part II:
Respondent and
Household
Characteristics
Image courtesy: Ramanshu Ganguly

6. Respondent Characteristics-1/2
Average age
India: Female- 41 years,
Male- 48 years
Nepal: 35 years
Marital status
• Majority (91%-India and 93% women
and 98% men in Nepal) were married
• Unmarried- 2% in India and 1-3% in
Nepal
• Remaining were
separated/divorced/widowed
0
20
40
60
80
100
Self Spouse Others
%
of
respondents
Respondents' relationship to household
head
India Nepal- Female Nepal- Male
0
20
40
60
80
100
India Nepal- Female Nepal- Male
%
of
respondents
Highest level of education for respondents
No formal schooling Primary or less
Secondary or less Greater than secondary
0
50
100
India Nepal- Female Nepal- Male
%
of
respondents
Agency over personal income
Respondent alone
Respondent along with other household member
Respondent was not involved

7. Respondent Characteristics-2/2
0
20
40
60
80
100
Agriculture Labour Services Vendor Home-based
worker
Private job Do not work
%
of
respondents
Primary occupation- India
Respondent Spouse
0
20
40
60
80
100
Respondent Spouse Respondent Spouse
Female Male
%
of
respondents
Primary occupation-Nepal
Agriculture Casual labor Wage/salaried job
Self-employed Do not work

8. Household Characteristics
Agricultural land
• India- 48% own agricultural land; average
landholding -6 Ha
• Nepal - 97% own agricultural land; average
landholding – 14 Ha
Livestock ownership
• India- 43% owned livestock
• Nepal- 96% owned livestock
Migration
• India- 3% households had migrant members
• Nepal- 45% households had members who
were living away from home (Nepal and
abroad) for work
Average household size
• India- 6 members
• Nepal- 5 members
46%
28%
10%
16%
Caste composition of households- India
General Caste
Scheduled Caste
Scheduled Tribes
Other Backward Classes
12%
40%
6%
6%
36%
1%
Caste composition of households- Nepal
Brahmin
Chhetri
Dalit
Hill Janjati
Terai Janjati
Muslim

9. Part III: Challenges
faced by households in
India and Nepal
Image Courtesy: Arunabh Saikia

10. Economic Challenges
0
20
40
60
80
100
India Nepal
%
of
respondents
Household suffered income loss due to COVID-19
Yes No
0
20
40
60
80
100
Used savings Sold assets Borrowed
money
Received
Government
transfers
Received NGO
transfers
%
of
respondents
Coping mechanisms used to deal with income loss
India Nepal- Female Nepal- Male

11. Food Insecurity-1/2
0
20
40
60
80
100
Worried about not
having enough food
Unable to eat healthy
and nutritious food
Had to skip a meal Ate less than required Was hungry but did
not eat
%
of
respondents
Experiencing food insecurity in the past 2 weeks
India Nepal- Female Nepal- Male

12. Food Insecurity-2/2
0
20
40
1 2 3 4 5 6 7 8
%
of
respondents
Number of food groups consumed in the last 24 hours
Minimum Dietary Diversity for Women (MDD-W)-
India
0
20
40
1 2 3 4 5 6 7 8 9 10
%
of
respondents
Number of food groups consumed in the last 24 hours
Minimum Dietary Diversity for Women (MDD-W)-
Nepal
MDD-W=0
82%
MDD-W=1
18%
MDD-W=0
32%
MDD-W=1
68%

13. Water Insecurity
0
10
20
30
40
Worried about not having
sufficent water
Changed plans due to water
scarcity
Drank less water Reduced frequency of washing
hands
%
of
respondents
Water insecurity in the past two weeks
India Nepal- Female Nepal- Male

14. Part IV: Emotional Well-
being

15. Why is Emotional Well-being Important?
Vulnerable groups
(low-income,
women, etc.) –
lower capacity to
deal with COVID-
19 impacts
Decreased emotional well-
being - poor mental health
Poor physical
health leading to
more severe
negative impacts

16. Emotional Well-being during COVID-19
Center of Epidemiology Scale for Depression (CES-D)
• 20 questions- depressive symptoms
• Standard cut-off of 16
0
20
40
60
80
100
India Nepal Female Nepal Male
%
of
respondents
Probable depression
Not categorized as suffering from depression
Categorized as suffering from depression
Avg score=22
Avg score=11.75 Avg score=7.55
Avg score=23.9
Avg score=6.64
Avg score=25.07

17. Predictors of Probable Depression (CES-D) - 1/3
Probable Depression
(score>16)
Individual
Characteristics
Household
Characteristics
Situational
factors
Caste Wealth Index
Age Marital status
Primary
occupation
Food insecurity
score (2 weeks)
Water insecurity
score (2 weeks)
Income loss due
to COVID-19
Minimally adequate diet
diversity- MDD-W (24 hours)
Experienced health
shocks (7 days)

18. Predictors of Probable Depression (CES-D) - 2/3
INDIA (Women) NEPAL (Women)
Water insecurity
score
Marital status
Food insecurity
score
➢ Married women had 50%* and 52%** lower odds of being
depressed in India & Nepal, respectively
➢ Food insecurity- increases the odds of suffering depression
for women by 49%*** in India and 63%*** in Nepal
➢ Water insecurity- increases the odds of suffering depression
for women by 64%*** in India and 23%* in Nepal
*** indicates significance at 99% confidence level, ** indicates significance at 95% level, * indicates significance at 90% confidence level
# Regression results have been provided in detail in Appendix Table 1
Caste
Wealth Index
Primary
occupation
➢ In India, women from households belonging to General caste
category had 70%** higher odds of being depressed than
OBC
➢ Women from economically better-off households had higher
odds of being depressed (79%-279%)
➢ Women who worked as vendors had higher odds (1030%**)
of being depressed
Income loss
MDD-W
Health shocks
➢ In Nepal, women from households that suffered income loss
had 39%*** higher odds of being depressed
➢ Women from households that reported sickness in the past
week had 128%*** higher odds of being depressed
➢ Women who achieved MDD had 61% lower odds of being
depressed***

19. Predictors of Probable Depression (CES-D) - 3/3
NEPAL (Men) NEPAL (Women)
➢ Women from households that suffered income loss had
39%*** higher odds of being depressed
➢ Married women had 52%** lower odds of being depressed
➢ Women who achieved MDD had 61% lower odds of being
depressed***
Income loss
MDD-W
Marital status
Water insecurity
score
Food insecurity
score
Health shocks
*** indicates significance at 99% confidence level, ** indicates significance at 95% level, * indicates significance at 90% confidence level
# Regression results have been provided in detail in Appendix Table 1
➢ Food insecurity- increases the odds of suffering depression
for women by 63%*** and men by 863%** in Nepal
➢ Water insecurity- increases the odds of suffering depression
for women by 23%* and for men by 285%***
➢ Women from households that reported sickness in the past
week had 128%*** higher odds of being depressed while for
men it was 217%**
Caste
Wealth Index
Primary
occupation
➢ Men from households belonging to more privileged caste
category had 597%*** higher odds of being depressed
➢ Men from economically better-off households had lower
odds of being depressed (79%***- 95%**)
➢ Men who worked as casual labor and salaried worker had
higher odds (1051%*** and 2233%***, respectively) of being
depressed as compared to those involved in agriculture

20. Part V: Way
Forward
Image courtesy: Ramanshu Ganguly

21. Way Forward
Facilitate stronger behavior change communication & interventions around
mental health
• Will help address stigma & lack of awareness around mental health
Enhance availability & access to mental health support services
• Will promote greater discussion around mental health
Gather gender-disaggregated data on mental health impacts
• Will generate deeper insights on differential implications of mental health
Better social protection measures
• To help builder stronger and more resilient communities

22. For further thoughts, ideas, questions, or comments, please
contact us:
Prapti Barooah, Research Analyst, IFPRI
Email: p.barooah@cgiar.org
Muzna Alvi, Research Fellow, IFPRI
Email: m.alvi@cgiar.org
Shweta Gupta, Research Analyst, IFPRI
Email: Shweta.Gupta@cgiar.org
Thank you!
Image courtesy: Ramanshu Ganguly

23. Annexure- Tables
Categorized as being depressed
India (Women) Nepal (Women)
Odds
Ratio P>|z|
95% Conf.
interval
Odds
Ratio P>|z|
95% Conf.
interval
Marital status- Married as compared to
being single/separated/widowed 0.5 0.065 0.24 1.04 0.48 0.024 0.26 0.9
Food insecurity score 1.49 0.002 1.15 1.94 1.63 0.000 1.28 2.08
Water insecurity score 1.64 0.002 1.19 2.27 1.23 0.05 0.99 1.53
Household belongs General caste
category (OBC - excluded) 1.7 0.048 1 2.89
Household wealth index (1 is the poorest)
- excluded
2 1.79 0.086 0.92 3.5
3 2.27 0.036 1.05 4.88
4 3.79 0.001 1.66 8.65
5 is the richest 3 0.019 1.19 7.56
Primary occupation- vendors as
compared to home-based workers/private
jobs/unemployed/others 11.3 0.019 1.48 85.77
Household suffered income loss due to
COVID-19 1.39 0.001 1.13 1.7
Household member unwell in the last 7
days 2.28 0.000 1.84 2.82
Achieved MDD-W 0.39 0.000 0.24 0.63
Categorized as being depressed
Nepal (Men) Nepal (Women)
Odds
Ratio P>|z|
95% Conf.
interval
Odds
Ratio P>|z|
95% Conf.
interval
Marital status- Married as compared
to being single/separated/widowed 0.48
0.02
4 0.26 0.9
Food insecurity score 9.63 0.025 1.32 70 1.63
0.00
0 1.28 2.08
Water insecurity score 3.85 0.002 1.66 8.93 1.23 0.05 0.99 1.53
Household belongs to a more
privileged caste group 6.97 0.000 5.78 8.4
Household wealth index (1 is the
poorest) - excluded
2 0.48 0.366 0.1 2.33
3 0.37 0.523 0.01 7.56
4 0.21 0.006 0.06 0.64
5 is the richest 0.05 0.03 0.003 0.74
Primary occupation (farming/livestock-
excluded)
Casual labor 11.51 0.000 7.42 17.86
Salaried worker 23.33 0.000 5.42100.32
Household suffered income loss due
to COVID-19 1.39
0.00
1 1.13 1.7
Household member unwell in the last
7 days 3.17 0.015 1.25 8.05 2.28
0.00
0 1.84 2.82
Achieved MDD-W 0.39
0.00
0 0.24 0.63