INTRODUCTION:
USAID funding historically supported health, education, entrepreneurship, poverty reduction and other social development programs in African countries. The catastrophic health effects of USAID-funded HIV, TB and immunisation program closures have been widely reported. This presentation aims to document the gendered psychosocial effects of socio-economic development program closures due to USAID funding withdrawal, about which less is known.

METHODS:
Ethnographic methods (participant observation and interviews) were used to collect data from 12 women aged 21-66 years, who were former participants in, or employees of, USAID funded social development programs, in a township community in Eswatini, southern Africa. The data were analysed thematically informed by the health capability framework defining the psychosocial effects of USAID closure.

RESULTS:
All participants reported detrimental psychosocial effects (theme 1), including stress, sadness, loss of hope and reduced social support and connection, due to the sudden and unforeseen closure of USAID-funded programs they participated in. Coping with the psychosocial impact (theme 2) of the program closures centred on soliciting support from middle-class community-based individuals, small businesses and church leaders, in desperate and unsustainable ways. For example, several participants increased time spent at churches in the hope of receiving economic support. One 66-year-old woman begged for and accepted expired food from grocery businesses, and dead chickens from a poultry farm, to serve at a soup kitchen for orphaned and vulnerable children. The psychosocial impact of program closures and strategies for coping undermined health capabilities (theme 3), for example emotions, respectful affiliation and bodily health.

CONCLUSIONS:
USAID-funding cuts had detrimental psychosocial effects for former program participants, which they coped with in unsustainable ways. These undermined capabilities needed to support future health and wellbeing.