Monitoring Social and Economic Impacts of COVID-19 on Refugees in Uganda: Results from the High-Frequency Phone Survey- Second Round Second round (December 2020) World Bank Poverty and Equity Practice March 26, 2021 Contents Contents ........................................................................................................................................................ 2 List of figures ................................................................................................................................................. 3 List of tables .................................................................................................................................................. 4 Acknowledgments......................................................................................................................................... 5 Key messages and findings ........................................................................................................................... 7 A. Background ......................................................................................................................................... 10 B. Economic activities.............................................................................................................................. 10 a. Labor market and farm activities .................................................................................................... 10 b. Changes in income since lockdown ................................................................................................ 13 c. Impact on poverty and food security .............................................................................................. 14 d. Social assistance .............................................................................................................................. 15 C. Knowledge and behavior .................................................................................................................... 16 D. Access to food, health, and education................................................................................................ 17 E. Coping strategies to socioeconomic shocks ....................................................................................... 20 F. Concerns, intentions to return and interactions with hosts ............................................................... 22 G. Bibliography ........................................................................................................................................ 26 H. Annex .................................................................................................................................................. 27 a. Sampling.......................................................................................................................................... 27 b. Profile of respondents and households .......................................................................................... 28 2 List of figures Figure 1. Employment status of respondents by region in rounds 1 and 2, (% of all respondents)........... 11 Figure 2. Average working hours and change in working hours since March, (among working respondents) .................................................................................................................................................................... 11 Figure 3. Status of family business in round 2 and before March 2020, (% of all refugee households) .... 12 Figure 4. Evolution of family business before and after March 2020 by economic sector, (% of refugee households who ever had business before or/and after March) ............................................................... 12 Figure 5. Household worked on household farm in rounds 1 and 2, (% of refugee households) .............. 13 Figure 6. Household who were able to sell products last week in rounds 1 and 2, (% of refugee households) .................................................................................................................................................................... 13 Figure 7. Key income sources during last 12 month across regions in rounds 1 and 2, (% of refugee households)................................................................................................................................................. 13 Figure 8. Households with more or the same income levels in round 1 (since March) and round 2 (in the last month), (% of refugee households) ..................................................................................................... 14 Figure 9. Households with more or the same level of income as before the outbreak in round 2 (% of refugee households) ................................................................................................................................... 14 Figure 10. Food security during last 30 days in the household in rounds 1 and 2, (% of refugee households) .................................................................................................................................................................... 15 Figure 11. Types of social assistance in rounds 1 and 2, (% of refugee households) ................................. 15 Figure 12. Types of social assistance in rounds 1 and 2 across regions, (% of refugee households) ......... 15 Figure 13: Acceptance to be vaccinated if approved vaccine to prevent coronavirus was available right now at no cost in round 2, (% of refugee respondents) ............................................................................. 16 Figure 14: Prevalence of safe practices in rounds 1 (since March) and round 2 (last week), (% of respondents) ............................................................................................................................................... 16 Figure 15: No access to selected basic goods and services when needed last week in rounds 1 and 2, (% of refugee households) ................................................................................................................................... 17 Figure 16: Access to main staple food when needed by regions and head of household gender in round 2, (% of refugee households) .......................................................................................................................... 17 Figure 17: No access to medical treatment when needed by regions and across round 1 (since March) and round 2 (last month), (% of refugee households) ....................................................................................... 18 Figure 18: Participation in any education or learning activities after schools’ closure in round 1 (since March) and round 2 (last 7 days), (% of refugee households with any member attending school before March 2020) ................................................................................................................................................ 19 Figure 19: Engaged only in activities with low learning potential such as studying alone, doing homework provided by parents, or/and studying agriculture (% of refugee households with any member engaged in learning activities) ....................................................................................................................................... 19 Figure 20: Number of shocks in last month in round 2, (% of refugee households) .................................. 20 Figure 21: Types of shocks in round 2, (% of refugee households) ............................................................ 20 Figure 22: Selected strategies to cope with socioeconomic shocks in round 2, (% of refugee households) .................................................................................................................................................................... 20 Figure 23: Incidence of borrowing money to face the COVID-19 emergency since March 2020, (% of households)................................................................................................................................................. 21 Figure 24: Main sources of borrowed money, (% of households) .............................................................. 21 Figure 25: Main purposes for borrowing money in round 2 by regions, (% of households) ...................... 21 Figure 26: Degree of threat from coronavirus pandemic to household’s finances, (% of refugee households)................................................................................................................................................. 22 3 Figure 27: Beliefs about having had COVID-19 and knowing someone who is or was infected in round 2, (% of respondents) ...................................................................................................................................... 22 Figure 28: Intentions to leave Uganda in round 2, (% of respondents) ...................................................... 23 Figure 29: Planned date to leave among those who wish to leave in round 2, (% of respondents) .......... 23 Figure 30: Reasons which would make refugees return among those who do not want to return, (% of respondents) ............................................................................................................................................... 24 Figure 31: Interaction with Ugandans in the last 7 days in round 2, (% of refugee households) ............... 24 Figure 32: Changes in frequency of interaction since outbreak, (% of refugee households) ..................... 24 Figure 33: Most trusted source of information about COVID-19, (% of respondents)............................... 25 List of tables Table H-1. Distribution of observations and population across strata in rounds 1 and 2 .......................... 27 Table H-2. Characteristics of respondents and households in the second round ...................................... 28 4 © 2021 International Bank for Reconstruction and Development / The World Bank 1818 H Street NW Washington DC 20433 Telephone: 202-473-1000 Internet: www.worldbank.org This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governments they represent. The World Bank does not guarantee the accuracy, completeness, or currency of the data included in this work and does not assume responsibility for any errors, omissions, or discrepancies in the information, or liability with respect to the use of or failure to use the information, methods, processes, or conclusions set forth. 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Any queries on rights and licenses, including subsidiary rights, should be addressed to World Bank Publications, The World Bank Group, 1818 H Street NW, Washington, DC 20433, USA; fax: 202-522-2625; e-mail: pubrights@worldbank.org. 5 Acknowledgments This project is possible due to collaboration between the World Bank, Uganda Bureau of Statistics (UBOS) and United Nations High Commissioner for Refugees supported by the Government of Uganda (GoU), particularly the Office of the Prime Minister (OPM). Phone survey data was collected by Laterite. This brief was written by a core team led by Aziz Atamanov and Nobuo Yoshida (World Bank), including Charles Alemi, Theresa Beltramo (UNHCR), John Ilukor (World Bank), Laura Abril Rios Rivera (World Bank), Ibrahima Sarr (UNHCR), Ally Hamud Said (UNHCR), Peter Waita (UNHCR), and Kazusa Yoshimura (World Bank). The report was prepared under the supervision of Antony Thompson (World Bank, Country Manager for Uganda) and Pierella Paci (World Bank, Practice Manager). Implementation of the survey was guided by Joel Boutroue (UNHCR Representative, Uganda) and Margaret Atieno (UNHCR Assistant Representative Protection, Uganda) from UNHCR. The authors are grateful to Stephen Baryahirwa, James Muwonge and Vincent Fred Ssennono from the Uganda Bureau of Statistics for collaboration. We are also thankful for excellent comments from Lilian Achieng, Zewditu Banteyehun Haile, Bo Hurkmans, Cara Ann Myers, Benjamin Christopher Reese, Shinya Takamatsu. Xiaomeng Chen and Dixita Gupta provided support in imputing consumption and estimating poverty among refugees. Kexin Zhang produced weights for the survey. Martin Buchara provided excellent administrative assistance. Finally, we would also like to thank all respondents of the survey. The State and Peacebuilding Fund (SPF) is a global fund administered by the World Bank to finance critical development operations and analysis in situations of fragility, conflict, and violence. The SPF is kindly supported by: Australia, Denmark, France, Germany, The Netherlands, Norway, Sweden, Switzerland, The United Kingdom, as well as IBRD. 6 Key messages and findings Employment, family business and family farming: ✓ The employment rate among respondents declined to 36 percent in December (round 2) compared to 43 percent in October/November (round 1) mainly due to a decline in employment in the West Nile region. This can be a temporary decline though as, in addition to 36 percent, about 12 percent of respondents in December indicated that they had a job to return to. Among them, almost half planned to return to this work within one month. ✓ Under-employment among refugees was widespread as they reported working about 27 hours per week. Almost half of refugees worked fewer hours in December than before the lockdown. ✓ Ownership of family businesses in December was far below the pre-COVID-19 level. The share of households with a family business dropped 10 percentage points from 37 percent before March to 27 percent in December 2020. ✓ Among those who had a business before or after the lockdown, 39 percent lost businesses after March, 16 percent opened a new business after March 2020, and the remaining 45 percent continued operating a family business since the lockdown. The closure of businesses after the lockdown was more likely to happen in non-agriculture sectors, whereas new businesses were more likely to start in agriculture. ✓ About 69 percent of refugee households worked on household farms in the first agricultural season; however, this share declined to 63 percent in the second season. The change was driven by shifts in the West Nile region, where the share of households working on farms declined from 78 to 66 percent. ✓ The share of households who needed to sell products from their farms declined compared to the first round but, the ability to sell deteriorated mainly West Nile. This may partly be explained by the harvest season in which demand for farm product is likely to decline as many households consume their own produce. Poverty, income and food security: ✓ Perceptions of income changes were more positive in December compared to October/November but, income levels were still far below the levels before the COVID-19 outbreak. More respondents in the second round reported that their income was either the same or higher compared to those interviewed in the first round (October/November). However, by December none of the key income sources from farming, family businesses, wage employment and humanitarian assistance reached pre-COVID levels. ✓ Compared to the round in October/November, in December, fewer households experienced the most severe forms of food insecurity such as going without eating for a whole day and not eating even when hungry. ✓ Preliminary estimates indicate that poverty among refugees declined slightly from 52 to 49 percent in the second round but remained higher than the pre-COVID-19 estimated level of 44 percent. Social assistance: 7 ✓ Social assistance remained at similar levels from October to December. Refugees in the South West region have received predominantly cash and non-food aid, while refugees in the West Nile region have received mostly food aid. Access to basic needs: ✓ The share of refugee households who could not buy main staple foods remained as high as 38 percent in the second round. However, significant regional differences have occurred. Whereas access to main staple foods improved in Kampala and the South West region in December, access declined in the West Nile region. Also, in the second round, female-headed households were less likely to be able to buy their main staple food compared to male-headed households. ✓ There was an increase in the share of households who could not access medical treatment when needed in the second round (25 percent) compared to the first round (20 percent). This was mainly driven by a substantial deterioration in access in the West Nile region where the lack of medicine in health facilities and the lack of money were the main reasons for inability to access medical treatment. ✓ There was an improvement in children’s participation in education and learning activities in round 2. In about 70 percent of households with household members attending school before closures in March, at least one member was engaged in any education or learning activities in round 2. This was 12 percentage points higher than in round 1 (58 percent). ✓ The increased participation in learning activities in the second round, however, was accompanied by a growing share of households whose members participated solely in the activities with the lowest learning potential, such as studying alone, doing homework provided by parents, and/or studying agriculture (rising to 28 percent in round 2 from 21 percent in round 1). Knowledge and behavior: ✓ Refugees almost universally agreed that using masks in public can reduce the risk of contracting coronavirus. Better educated and male respondents demonstrated stronger agreement. ✓ More than 90 percent of refugees would agree to be vaccinated if approved vaccines were available now at no costs. Acceptance rates were the highest among refugees in the West Nile region (95 percent), followed by the South West region (86 percent) and Kampala (82 percent). Agreement with getting vaccinated was the lowest among non-Somali refugees in Kampala (77 percent). ✓ There was a significant reduction in avoiding handshakes and groups of more than ten people in the second round compared to the first one. However, self-reported wearing of masks in public all or most of the time increased to almost 100 percent. Socio-economic shocks, coping strategies and social assistance: ✓ Every refugee household suffered at least one socioeconomic shock during the month preceding the interview in round 2, with increases in the prices of commonly consumed items being the most common shock. ✓ Reducing consumption, receiving assistance from NGOs, and engaging in additional income generating activities (IGAs) were the most common strategies used to cope with socioeconomic shocks. ✓ About 50 percent of refugee households had to borrow money to cope with the COVID-19 emergency. Acquaintances such as neighbors and friends were the main sources of lending, in 8 particular in Kampala, but savings groups and loan associations played an important role in the West Nile and South West regions. ✓ The two most frequent reasons to borrow money were buying food (67 percent of households) and paying for health expenses (35 percent), with some important regional variations. In all regions, buying food was the most frequent reason to borrow money. In Kampala, 88 percent of refugee households borrowed money to buy food. Paying for health expenses was important in the South West region where 45 percent of refugees borrowed money for this reason. In Kampala, paying rent was also an important reason to borrow money (41 percent). Concerns, intentions to return and interactions with hosts ✓ There was a slight decline in the share of respondents who perceived the COVID-19 pandemic as a substantial financial threat for their household between the first and second rounds: from 73 to 69 percent respectively. ✓ About 13 percent of respondents reported to know someone who has or had COVID-19. About 5 percent of refugees believed that they had COVID-19 themselves. This share was the highest among Somali refugees in Kampala (15 percent). Compared to those without formal education, refugees who completed secondary school and above, reported more often that they knew someone who is or was infected. ✓ About 37 percent of refugees wished to return to their country of origin. About 7 percent wished to move from Uganda to another country. Compared to refugees from other countries, South Sudanese refugees in the West Nile region were the most likely to report that they wish to return to their country of origin (61 percent). ✓ While nearly 8 in 10 refugees did not know when they would leave Uganda. 40 percent of refugees in Kampala intended to leave in one month. ✓ Among those who did not want to return, safety in terms of conflict and violence was the main condition that would make them return to their country of origin. About 46 percent of refugees indicated that they would never return to their country of origin. ✓ COVID-19 lowered the interaction between refugees and Ugandans with 42 percent of refugee households reporting less frequent interactions with their host community members since the COVID-19 outbreak. ✓ Radio and NGOs were mentioned as the most trusted sources of information about COVID-19 with some variations across regions and strata. Thus, refugees in Kampala trusted more to TV and friends and neighbors than radio and NGOs. Almost 55 percent of Somali refugees in the South West mentioned short message service as most trusted source. 9 A. Background 1. The High-Frequency Phone Survey for refugees in Uganda (URHFPS) tracks the socioeconomic impacts of the COVID-19 crisis on refugees. The World Bank (WB) in collaboration with the Uganda Bureau of Statistics (UBOS) and the United Nations High Commissioner for Refugees (UNHCR) launched and conducted the URHFPS. The URHFPS tracks the impacts of the pandemic on a monthly basis for a period of three months. Data collection for the first round of the URHFPS took place between October 22 – November 25, 2020. Data collection for the second round of the URHFPS took place between December 5-24, 2020. This brief discusses results from the second round of the URHFPS. Where possible and appropriate, results are compared across the two rounds.1 Detailed results from the first round are available in Atamanov et al. (2021). 2. The survey sample includes respondents with active phone numbers that were selected randomly from the Profile Global Registration System (ProGres) of UNHCR, and the refugee household survey carried out by UBOS and the World Bank in 2018.2 The targeted sample for the first round included 2,100 households and was representative at seven strata constructed as a combination of regions and different countries of origin: Kampala-Somalia, Kampala-other (Burundi, DRC, South Sudan), South West- Burundi (SW-Burundi), South West-DRC (SW-DRC), South West-South Sudan (SW-South Sudan), South West-Somalia (SW-Somalia), and West Nile-South Sudan (WN-South Sudan).3 The realized sample after the first round was 2,010 households. The second round of the phone survey tried to re-contact these same households from the first round and managed to reach 1741 of them. In order to reduce the impact of attrition on the survey results, additional new households were sampled, bringing the overall realized sample to 1852 observations for the second round.4 In order to reduce the bias related to only interviewing households with phone numbers and non-response, the data from the 2018 representative refugee household survey was used to produce and calibrate the weights for both rounds of the phone survey. B. Economic activities a. Labor market and farm activities 3. Employment did not show signs of recovery in December compared to October/November and the national rates declined mainly due to a lower employment rate in the West Nile region. In contrast to results from the national phone survey of Ugandans (World Bank 2020), the employment rate among refugee respondents did not recover and declined even further in the second round conducted in December 2020 (Figure 1). This was partly driven by a substantial reduction in employment among refugees in the West Nile region. Such a drastic decline may be associated with the end of the second agricultural season and higher dependence of refugees on farming in the West Nile region. Respondents in the second round who reported that they were not employed currently also indicated if they had a job they expected to return to. Overall, about 12 percent of all refugee respondents were expected to return 1 Results from the first round in this brief may be slightly different from reported in Atamanov et al. (2021) due to correcting demographic information for two households. 2 World Bank (2019). 3 Selected country of origins accounted for about 97 percent of all refugees in Uganda in 2020. 4 Upcoming holidays did not allow to increase the realized sample further. 10 to work, of whom 47 percent plan to return to work during the next week or within the next month. This may imply that a decline in employment in the second round was temporary. Figure 1. Employment status of respondents by region in rounds 1 and 2, (% of all respondents) Source: URHFPS second round, authors’ calculation. Note: In Round 1 a question about being temporarily out of work was not asked. 4. On average, employed refugees worked about 27 hours during the week with residents in Kampala working longer hours. On average, refugees did not report working full time during the week preceding the interview. At the national level, refugees worked an average of 27 hours per week (Figure 2). Refugees in Kampala reported working the longest average number of hours – 33 hours – which was higher than in the South West region (25 hours) and in the West Nile region (29 hours). Male respondents and those with higher education worked longer hours than female respondents and those with lower levels of education. 5. Refugees worked fewer hours in Figure 2. Average working hours and change in working hours December compared to hours worked since March, (among working respondents) before the lockdown in March 2020. In the second round, respondents were asked to compare how working hours changed since March 2020 (Figure 2). Almost half of respondents reported working fewer hours. This share was significantly higher in South West (64 percent) and Kampala (55 percent) compared to West Nile (32 percent). Source: URHFPS second round, authors’ calculation. 11 6. The share of refugee Figure 3. Status of family business in round 2 and before March households with a family business has 2020, (% of all refugee households) not reached pre COVID-19 levels. About 37 percent of households had a family business before March 2020, but by December this share has dropped to 27 percent (Figure 3). Considering that four percent of households reported to be temporarily out of business, and thus could reopen, six percent of households might have lost their family businesses permanently. Source: URHFPS second round, authors’ calculation. 7. Family businesses in non-agricultural sectors were more likely to close and the least likely to launch since March 2020. Respondents were asked about having a family business before and after March 2020. Among those who had a business during this period, 39 percent lost it after March, 16 percent opened a new business after March and the remaining 45 percent continued operating a family business during the whole time before and after the lockdown. Those who had a business in a non-agriculture sector were more likely to have closed it after March (43 percent) compared to those whose family business was in agriculture (21 percent). Creation of new businesses was more likely to happen in agriculture compared to non-agriculture (Figure 4). Figure 4. Evolution of family business before and after March 2020 by economic sector, (% of refugee households who ever had business before or/and after March) Overall Agriculture Non-agriculture 21 39 43 Business is closed after March Business is open before and after March Business is new after March Source: URHFPS first and second rounds, authors’ calculation. 8. Households were slightly less likely to work in their household farm in the second agricultural season compared to the first agricultural season, mainly in the West Nile region. About 69 percent of refugee households worked in household farms in the first agricultural season and this share declined to 63 percent in the second season (Figure 5). The change was driven by shifts in the West Nile region, where the share of households working in farms declined from 78 to 66 percent across the two survey rounds. There were no significant changes across agricultural seasons in the shares of those who had to change 12 livestock activities because of COVID-19 (11 percent of households in both seasons). There was a decline in the share of households who had to change planting activities due to COVID-19 from 10 to 6 percent across seasons. 9. There was a decline in the share of households who needed to sell products from their farms, but their ability to sell declined mainly in West Nile. Households were asked if they needed to sell any products from their farms between January-October 2020 in the first round and since last call between October/November and December 2020 in the second round. There was a significant reduction in the need to sell products in the second round from 20 to 13 percent probably mostly driven by recall period differences. Those who needed to sell were also asked if they were able to sell the products in a week preceding the interview (Figure 6). Households mainly in West Nile were less often able to sell their products in the second round compared to the first round. At the same time, households in South West improved their selling ability in the second round. Figure 5. Household worked on household farm in rounds Figure 6. Household who were able to sell products last 1 and 2, (% of refugee households) week in rounds 1 and 2, (% of refugee households) 90 90 80 80 70 70 60 60 50 50 40 40 30 30 20 20 10 10 0 0 West Nile West Nile South West South West Kampala Kampala Overall Overall South West South West Kampala Kampala West Nile West Nile Overall Overall First agricultural season Second agricultural season First round Second round Source: URHFPS first and second rounds, authors’ calculation. Source: URHFPS first and second rounds, authors’ calculation. b. Changes in income since lockdown 10. Humanitarian assistance Figure 7. Key income sources during last 12 month across continued to be the main source of regions in rounds 1 and 2, (% of refugee households) income in December, the share of 100 90 households reporting earning income 80 from business and wage employment 70 also rose. About 94 percent of 60 households at the national level reported 50 that they received income from 40 humanitarian assistance in December – 30 higher than the share who did in 20 October/November (Figure 7). Similarly, 10 more households also reported earning 0 Humanitarian Family farming Family business Wage income from family business and wages assistance in the second round. Round 1 Round 2 Source: URHFPS first and second rounds, authors’ calculation. 13 11. Perceptions of income changes tend to be more positive in round 2, but income levels are still far below the pre-COVID-19 levels. Respondents were asked how their household income had changed in the last month. More respondents in December reported that their income was either the same or higher compared to those interviewed in October/November (Figure 8). However, when current income levels were compared to the pre-March level, on average, none of the key income sources, including farming, family business, wage employment and humanitarian assistance, had fully recovered to pre- COVID levels. For example, only 25 percent of households in December reported that their family business income was higher or equal to the pre-COVID level. This share was higher for income from farming and wage employment – about 37 percent for both sources (Figure 9). Figure 8. Households with more or the same income Figure 9. Households with more or the same level of levels in round 1 (since March) and round 2 (in the income as before the outbreak in round 2 (% of refugee last month), (% of refugee households) households) 35 income is the same or above average before COVID-19 100 30 80 25 20 60 15 40 10 20 5 0 0 Family farming Non-farm family Wage Humanitarian Family farming Non-farm family Wage employment Humanitarian business employment assistance business assistance Round 1 (more or the same income since outbreak) National Kampala Round 2 (more or the same income since since last month) South West West Nile Source: URHFPS first and second rounds, authors’ calculation. Note: Regional results in figure 9 should be treated with caution given small sample size, in particular in West Nile. c. Impact on poverty and food security 12. Poverty among refugees is estimated to decline slightly from 52 to 49 percent in the second round. The URHFPS used a consumption model which was built by using the representative household survey of refugees and host communities conducted in 2018 to identify the strongest correlates of consumption. During the phone survey, information on the correlates were collected. This allowed imputing consumption in the phone survey using the Survey of Well-being via Instant and Frequent Tracking (SWIFT) methodology developed by Yoshida et al. (2015). According to the preliminary SWIFT estimation, poverty among refugees was estimated to decline from 52 percent in the first round to 49 percent in the second round. This is still higher than predicted pre-COVID-19 poverty of 44 percent. 13. There was a slight improvement with regards to the most severe forms of food insecurity in the second round. Respondents were asked about their food security situation among adults in the household during the 30 days prior to the day of the interview. There were fewer households in December who experienced the most severe forms of food insecurity such as going without eating for a whole day and not eating even when hungry, compared to October/November (Figure 10). 14 For one of the food security Figure 10. Food security during last 30 days in the household in rounds indicators - “ran out of food� which 1 and 2, (% of refugee households) was comparable to the 2018 refugee Adult(s) in HH went without eating for a whole day survey, the situation improved Adult(s) in HH hungry but did not eat substantially in the second round but, was worse than what was HH ran out of food reported in 2018. Refugees in Adults in HH ate less than they should Kampala had the worst situation on Adult(s) in HH skipped meal all three most severe forms of food insecurity. Female headed Adult(s) in HH ate only a few kinds of foods Adult(s) in HH unable to eat healthy and households were significantly more nutritious/preferred foods likely to experience the situation in Adult(s) in HH worried about not having enough food which adults in the household went 0 20 40 60 80 100 without eating for a whole day. 2018 Round 1 Round 2 Source: URHFPS first and second rounds, authors’ calculation. d. Social assistance 14. There were no substantial changes in the incidence of social assistance across rounds, with the only exception being in-kind (non-food) transfers, which fewer households reported to receive in the second round. There were fewer households receiving in-kind transfers in the second round which was probably related to different recall periods in the two rounds (Figure 11). Refugees in the first round were asked about social assistance between March and October/November, while in the second-round the recall period covered the month preceding the interview which was conducted in December. Refugees in the South West region reported getting predominantly cash and non-food aid, while refugees in the West Nile region reported getting mostly food aid (Figure 12). As a result of these regional differences in the type of aid, female-headed households (widespread among refugees in the West Nile region) were more likely to get food aid compared to male-headed households. Figure 11. Types of social assistance in rounds 1 and Figure 12. Types of social assistance in rounds 1 and 2 2, (% of refugee households) across regions, (% of refugee households) 70 100 60 80 50 60 40 30 40 20 20 10 0 0 Kampala South West Nile Kampala South West Nile Cash transfers In-kind Food No social West West transfers (no assistance food) Round 1 Round 2 Cash transfers In-kind transfers (no food) Round 1 Round 2 Food No social assistance Source: URHFPS first and second rounds, authors’ calculation. 15 C. Knowledge and behavior 15. Refugees universally agreed that using masks in public can reduce the risk of contracting coronavirus. About 58 percent of refugees strongly agreed and 38 percent agreed that the use of masks in public can reduce the risks of contracting COVID-19. Refugees with higher education and males were more likely to strongly believe in the usefulness of masks. 16. An absolute majority of refugees agreed to be vaccinated, with the highest acceptance rate in the West Nile region. Refugees were asked whether they would agree to be vaccinated if an approved vaccine to prevent coronavirus was available right away at no cost. About 95 percent of refugees in the West Nile region, 86 percent in the South West region and 82 percent in Kampala said they would agree (Figure 13). Acceptance was the lowest among non-Somali refugees in Kampala – only 76 percent who said they would agree. Among those who do not want to be vaccinated, an absolute majority mentioned safety concerns as the main reason not to be vaccinated. Those with the highest level of education also worried that vaccines would not work. Figure 13: Acceptance to be vaccinated if approved vaccine to prevent coronavirus was available right now at no cost in round 2, (% of refugee respondents) Kampala South West West Nile 3 3 4 0 15 10 82 86 95 Yes No Not sure Source: URHFPS second round, authors’ calculation. Note: Numbers may not add up to 100 percent due to rounding. In the second round, there was a significant Figure 14: Prevalence of safe practices in rounds 1 reduction in the prevalence of self-reported safe (since March) and round 2 (last week), (% of practices such as avoiding handshakes and respondents) 100 avoiding groups of more than ten people, 90 although mask wearing increased. Even though 80 the absolute majority of refugees reported more 70 frequent handwashing with soap in the week 60 50 preceding the interview in December, fewer 40 refugees reported avoiding handshakes or 30 physical greetings and avoiding groups of more 20 than ten people in the second round (Figure 14). 10 0 This decline was expected given that the recall More frequent Avoid Avoid groups of Wearing masks all or period for both questions covered strict lock- handwashing with handshakes/physical more than 10 soap greetings people most of the time down measures in the first round, whereas Round 1 Round 2 containment measures had been eased by the Source: URHFPS first and second rounds, authors’ calculation. second round. At the same time, the incidence of wearing masks in public a week preceding the 16 interview increased to almost 100 percent in the second round, already from a very high level of 86 percent in the first round.5 The observed decline in selected safe practices among refugees is consistent to what was observed among Ugandans as well (World Bank 2020). The, share of Ugandan respondents who avoided groups of more than 10 people declined from 91 percent in June to 61 percent in September/October. The share of those who avoided handshakes declined as well in the same period from almost 100 to 81 percent. D. Access to food, health, and education 17. Access to staple foods continued to be the most challenging goods and services to access, with declining access in the West Nile region and among female headed households. Refugees were asked whether they managed to access selected basic goods and services in the week preceding the interview. As in the first round conducted in October/November, almost 40 percent of households reported being unable to buy main staple foods in December 2020 (Figure 15). Despite no change at the national level, there were changes across regions. For example, the ability to buy food improved in Kampala and the South West region but deteriorated in the West Nile region. Female headed households reported lower access to main staple food compared to male headed households in the second round (Figure 16). Figure 15: No access to selected basic goods and services Figure 16: Access to main staple food when needed by when needed last week in rounds 1 and 2, (% of refugee regions and head of household gender in round 2, (% of households) refugee households) 40 80 35 70 30 60 25 50 20 40 15 30 20 10 10 5 0 0 Kampala South West West Nile Female Male No food No soap No water No mask Residence Gender of head Round 1 Round 2 able to access national average Source: URHFPS first and second rounds, authors’ calculation. Source: URHFPS second round, authors’ calculation. 5 Such a high prevalence of masks wearing in public can be overstated and additional indirect question will be asked in round 3 to triangulate the findings. 17 18. The lack of access to medical treatment increased between rounds, mainly driven by worsening access rates in the West Nile region. There was an increase in the share of Figure 17: No access to medical treatment when needed by households who could not access medical regions and across round 1 (since March) and round 2 (last treatment when needed from about 20 month), (% of refugee households) percent in the first round (between March to 35 October/November) to 25 percent (in the month preceding interview) the second 30 round in December (Figure 17). This was 25 mainly driven by substantial deterioration in access in the West Nile region. Among those 20 who were not able to access medical 15 treatment, more than 50 percent mentioned 10 lack of money as the main reason and 26 percent mentioned lack of medicine in health 5 facilities. Lack of medicine was a particular 0 issue in the West Nile (36 percent), while in Overall Kampala South West West Nile Kampala a lack of money was the main reason Round 1 Round 2 for an absolute majority of households (90 Source: URHFPS first and second rounds, authors’ calculation. percent). 19. There was a substantial increase in the share of households with members participating in education/learning activities in round 2. Before the lockdown, 81 percent of households (according to the first round) had at least one member attending school. After the lockdown, between March and October/November, only 58 percent of these households had at least one member engaged in learning activities (Figure 18). In the month preceding the interview in December though, this share increased to 70 percent. Improvements were observed in all regions. At the individual level, 69 percent of those who attended school before March were participating in education or learning activities in the second round. The average individual participation rate was lowest in Kampala (49 percent), followed by the South West region (57 percent) and the West Nile region (75 percent). No significant gender differences were observed. 20. Increased participation in learning activities was, however, accompanied by a higher share of members participating in the activities with the lowest learning potential. Respondents were asked about the types of education or learning activities the members in their household had been engaged in over the last week. In the first round, about 21 percent of households had members engaged solely in one or a combination of the three activities with lowest learning potential: studying alone, doing homework provided by parents, and/or studying agriculture. In the second round, the national average increased to about 28 percent of households, mainly due to the significant rise in the West Nile region (Figure 19). 18 Figure 18: Participation in any education or learning Figure 19: Engaged only in activities with low learning activities after schools’ closure in round 1 (since March) potential such as studying alone, doing homework and round 2 (last 7 days), (% of refugee households provided by parents, or/and studying agriculture (% of with any member attending school before March 2020) refugee households with any member engaged in learning activities) 90 45 80 40 70 35 60 30 50 25 40 20 30 15 20 10 10 5 0 0 Overall Kampala South West West Nile Overall Kampala South West West Nile Round 1 Round 2 Round 1 Round 1 Source: URHFPS first and second rounds, authors’ calculation. 19 E. Coping strategies to socioeconomic shocks 21. Every refugee household suffered at least one socioeconomic shock during the month preceding the interview in December, with variations by region. Households in Kampala were more likely to have experienced only one shock compared to those in the South West and West Nile regions (Figure 20). Price increases of the most highly consumed items was the most common shock, followed by: illness, injury or death of an income earning household member; disruption of farming, livestock and fishing activities; job loss, and non-farm business closure (Figure 21). While the number of shocks experienced in round 2 (December) decreased compared to round 1 (October/November), this may be due to differences in the recall periods. In round 1, participants reported shocks faced since March 2020 (a seven-month period), while in round 2, participants reported shocks faced in the preceding month. Figure 20: Number of shocks in last month in round Figure 21: Types of shocks in round 2, (% of refugee 2, (% of refugee households) households) 100 Nonfarm business closure West Nile 80 Job loss 60 South West Disruption of farming, 40 livestock, fishing activities Kampala Illness, injury, or death of 20 income earning member Price increase of 0 Overall consumed food items Overall Kampala South West West Nile 1 shock more than 1 shock 0 20 40 60 80 100 Source: URHFPS second round, authors’ calculation. Source: URHFPS second round, authors’ calculation. 22. Reducing food consumption, receiving Figure 22: Selected strategies to cope with humanitarian assistance, and engaging in socioeconomic shocks in round 2, (% of refugee additional income generating activities (IGAs) households) 30 were the most common strategies used to cope with socioeconomic shocks. Such 25 strategies were also those most used in round 20 1 (October/November). Notably, refugee 15 households in Kampala were the least likely to 10 have received assistance compared to 5 households in other regions (Figure 22). Engagement in additional IGAs was the most 0 Overall Kampala South West West Nile common in West Nile while receiving humanitarian assistance was more frequent in Endaged in additional income generating activities Reduced food consumption the South West. Received humanitarian assistance Source: URHFPS second round, authors’ calculation. 20 23. About 50 percent of refugee households had to borrow money to face the COVID-19 emergency and acquaintances such as neighbors and friends were the main sources, particularly in Kampala. About 66 percent of refugee households borrowed money in the South West region compared to 53 percent in Kampala and 38 percent in the West Nile region (Figure 23). The main sources were neighbors, friends and non-household members, Village Savings and Loan Associations (VLSAs) and saving groups (Figure 24). 24. Buying food was the main purpose for borrowing, but payment for medical expenses and rent were also significant in some regions. The main purpose for borrowing money for most households was to buy food (at a high of 88 percent in Kampala), followed by the payment of medical expenses (most significant in the South West region at 45 percent) and to pay rent (also highest in Kampala at 41 percent) (Figure 25). Possibly, the incidence of borrowing money to buy food may be lower in the West Nile region as households in that region reported to receive food rations more often than those in other regions or because of more prevalent agriculture activities. Figure 23: Incidence of borrowing money to face the Figure 24: Main sources of borrowed money, (% of COVID-19 emergency since March 2020, (% of households) households) West Nile West Nile South West South West Kampala Kampala Overall Overall 0 20 40 60 80 100 Neighbour/friend/non HH individual VLSAs Savings group 0 10 20 30 40 50 60 70 Source: URHFPS second round, authors’ calculation. Figure 25: Main purposes for borrowing money in round 2 by regions, (% of households) Rent Purchase of inputs/working capital for non-farm enterprise Buy other non-food consumption goods Pay for health expenses Buy food 0 20 40 60 80 100 West Nile South West Kampala Overall Source: URHFPS second round, authors’ calculation. 21 F. Concerns, intentions to return and interactions with hosts 25. In October/November 2020 most households reported that they perceived the COVID-19 pandemic as a substantial financial threat to their household and this perception continued in December 2020, albeit to a slightly lower degree. While the perceived substantial financial threat of the outbreak was maintained across rounds, a slight decline can be noticed. The share of households that perceived the outbreak as a moderate threat increased in round 2 (December), compared to round 1 (October/November). Compared to the West Nile region, more households in Kampala and the South West region considered the outbreak to be a substantial threat to their finances (Figure 26). Figure 26: Degree of threat from coronavirus pandemic to household’s finances, (% of refugee households) 100 80 60 40 20 0 Overall Kampala South West Nile Overall Kampala South West Nile West West Round 1 Round 2 A substantial threat A moderate threat Not much of a threat Not a threat at all Source: URHFPS first and second rounds, authors’ calculation. 26. More educated refugees and South Sudanese refugees in the South West region more commonly reported knowing someone who is or was infected with COVID-19. About 13 percent of respondents Figure 27: Beliefs about having had COVID-19 and knowing someone reported to know someone who has who is or was infected in round 2, (% of respondents) or had COVID-19. About five percent of refugees believed that they West Nile-South Sudanse themselves had caught COVID-19 at SW-South Sudan some point. Compared to those with no formal education, refugees who SW-Somalia Strata completed secondary school and SW-DRC above reported more often that they SW-Burundi knew someone who is or was infected Kampala - others (Figure 27). Compared to other strata, Kampala - Somalia Somali households in Kampala were Education Completed secondary & + more likely to believe that they have had COVID-19, followed by Somalis in No formal education Kampala. Furthermore, knowing Overall someone who is or was infected was 0 5 10 15 20 25 more often reported among South Believe they have had COVID-19 Know someone who is or was infected Sudanese refugees in the South West Source: URHFPS second round, authors’ calculation. region. 22 27. Perceived insecurity at home did not change much in round 2 (December) compared to round 1 (October/November). Perceived safety at home since the outbreak, as reported in October/November and in December 2020, was generally high with 54 and 55 percent of respondents reporting that they always felt safe at home in each round respectively. Perceived safety was the lowest among refugees in the South West region. Interestingly, South Sudanese and Somali respondents were the most likely to report always feeling safe at home in both rounds. 28. Nearly 4 in 10 refugees wished to return to their home but most were not sure when they would leave Uganda. Refugees were asked if they intended to return to their home or country of origin. About 45 percent wished to return either home or to a different country. South Sudanese refugees in the West Nile region had the highest intent to return home – 61 percent (Figure 28). This finding is in line with UNHCR’s research on South Sudanese refugees’ intentions to return. Most refugees in the South West region, Somalis in particular, did not want to leave Uganda while most of those who wanted to leave, would go to a different country than country of origin. In Kampala, a similar pattern was observed, and it seems to be driven by Somalis. However, the share of refugees in Kampala who wish to go to a different country is more than double that of refugees who would go back to their country of origin. As refugees in Kampala tend to be richer than those in other regions, such a difference in intentions to go to a different country may be partly explained by larger socioeconomic resources and social networks among refugees in Kampala compared to those in other regions. While nearly 8 in 10 refugees at the national level did not know when they would leave Uganda, 40 percent of refugees in Kampala intended to leave in one month (Figure 29). Figure 28: Intentions to leave Uganda in round 2, (% of Figure 29: Planned date to leave among those who wish to respondents) leave in round 2, (% of respondents) West Nile West Nile South West South West Kampala Kampala Overall Overall 0 20 40 60 80 100 0 20 40 60 80 100 Yes, to my country of origin Yes, but to a different country No In a month In 4-6 months In a year More than a year Not sure Source: URHFPS second round, authors’ calculation. 23 29. Lack of conflict and violence was the main Figure 30: Reasons which would make refugees return condition to make refugees want to return to their among those who do not want to return, (% of home country. Refugees who did not want to respondents) return to their home country were asked what would make them want to return home or to their Will never return West Nile country of origin. About 45 percent of refugees said that they would return if their home was safe Food security from conflict and violence (Figure 30). Secondary South West reasons such as availability of livelihoods Safety in terms of opportunities in their country of origin and food Kampala conflict and violence security were not as important. However, there Livelihood was a strikingly high share of refugees who did not Overall opportunities in my county want to return back home for any reason – 46 percent. This group was more pronounced in the 0 20 40 60 80 100 West Nile and South West regions and in particular Source: URHFPS second round, authors’ calculation. among South Sudanese refugees in the South West region. 30. Only about 55 percent of refugee households interacted with Ugandans in the week preceding the second-round interview, with the COVID-19 outbreak making interactions less frequent. Households with more educated respondents tended to interact more often than those with no formal education (Figure 31). The outbreak impacted the frequency of interaction between refugees and hosts especially in Kampala, where in 51 percent of households, refugees reported that they interact less often with Ugandans than before the outbreak. Even though more educated refugees interact more often with Ugandans than those with no formal education, they reported less interaction with hosts than before the outbreak. Therefore, the COVID-19 outbreak and restrictive measures to curb the spread of the virus might have important negative implications on social cohesion and integration efforts, at least temporarily. Figure 31: Interaction with Ugandans in the last 7 days Figure 32: Changes in frequency of interaction since in round 2, (% of refugee households) outbreak, (% of refugee households) Education Gender Female Education level of respondent Completed secondary & + Male Some secondary Some secondary No formal education West Nile Residence Complete primary and below South West Kampala No formal education Overall Overall 0 20 40 60 80 100 We did not interact and continue to do so Yes, less interaction 0 20 40 60 80 No, same interaction Yes, more interaction Source: URHFPS second round, authors’ calculation. Source: URHFPS second round, authors’ calculation. 31. Radio and NGOs were mentioned as the most trusted sources of information about COVID-19 with variations across regions and level of education. Almost half of refugee respondents viewed radio as the most trusted source of information about COVID-19. NGOs were on the second place (15 percent). 24 Among refugees in Kampala though the most trusted sources were quite different. About 28 percent selected TV followed by 20 percent trusting friends and neighbors and 18 percent trusting social media such as Facebook, Twitter and so forth. The trusted source differed among refugee with different level of education. Refugees without formal education were more likely to mention friends and neighbors as most trusted source of information (13 percent), while refugees with completed secondary education and above were more likely to mention social media (13 percent) and TV (10 percent). Interestingly that almost 55 percent of Somali refugees in the South West mentioned short message service as most trusted source. Figure 33: Most trusted source of information about COVID-19, (% of respondents) 60 50 40 30 20 10 0 South West Complete primary and below Kampala - Somalia Kampala SW-Somalia West Nile Some secondary SW-DRC SW-South Sudan Overall No formal education Completed secondary & + West Nile-South Sudanse Residence Education Strata TV SMS Social media NGOs Radio Source: URHFPS first and second rounds, authors’ calculation. 25 G. Bibliography Atamanov, A., Yoshida, N., Beltramo, T.P., Rios Rivera, L.A., Sarr, I., Waita, P. and Yoshimura, K. (2021). Monitoring Social and Economic Impacts of COVID-19 on Refugees in Uganda: Results from the High- Frequency Phone Survey - First Round (English). Monitoring COVID-19 Impacts on Refugees in Uganda Washington, D.C.: World Bank Group. Available from: http://documents.worldbank.org/curated/en/682171613766616044/Monitoring-Social-and-Economic- Impacts-of-COVID-19-on-Refugees-in-Uganda-Results-from-the-High-Frequency-Phone-Survey-First- Round Yoshida, N., Munoz, R., Skinner, A., Kyung�eun Lee, C., Brataj, M., Durbin, W. and Sharma, D. (2015). SWIFT Data Collection Guidelines. Version 2. Washington, DC: World Bank. World Bank (2019). Informing the Refugee Policy Response in Uganda: Results from the Uganda Refugee and Host Communities 2018 Household Survey (English). Washington, D.C.: World Bank Group. Available from: http://hdl.handle.net/10986/32511. World Bank. (2020). COVID-19 Impact Monitoring: Uganda, Round 3. World Bank, Washington, DC. 26 H. Annex a. Sampling The Profile Global Registration System (ProGres) served as a sample frame for the URHFPS. It was complemented by the data collected for the refugee household survey carried out by UBOS and the World Bank in 2018. The sample was selected from the pool of refugees with phone numbers. The targeted sample included 2,100 observations: 300 observations in each stratum. Four countries of origin were targeted in the survey: Burundi, Democratic Republic of Congo (DRC), Somalia and South Sudan. The combination of country of origin and region were used to create seven strata: Kampala-Somalia, Kampala- other (Burundi, DRC, South Sudan), South West-Burundi, South West-DRC, South West-South Sudan, South West-Somalia, and West Nile-South Sudan. The realized sample of data collection was 2,010 households in the first round and 1,852 households in the second round. The number of observations in the two rounds and population shares across strata are shown in Table H-1. Given that the refugee population with phone numbers may be fundamentally different from the population without phone numbers (e.g. more educated, affluent, living in urban areas and so forth), and also due to the issue of non-response, respondents in the phone survey may not be representative of the overall refugee population in Uganda. In order to reduce the potential bias and make results nationally representative, we developed a weighting procedure by producing weights using a reference nationally representative survey and calibrating obtained weights to make the phone survey nationally representative and resemble the distribution for the key variables of those from the reference survey. The refugee survey from 2018 was used as a reference in creating weights for the phone survey, while post-stratification was conducted to preserve to the extent possible regional population shares from the ProGres dataset as of November 2020. Table H-1. Distribution of observations and population across strata in rounds 1 and 2 Round 1 Round 2 Population Population number of number of Strata weighted weighted observations observations share share Kampala (Burundi, DRC, South Sudan) 292 3 269 3 Kampala-Somalia 340 2 300 2 SW-Burundi 284 3 271 3 SW-DRC 299 28 305 28 SW-South Sudan 312 5 293 5 West Nile-South Sudan 245 58 201 58 SW-Somalia 238 1 213 1 Total 2,010 100 1,852 100 Source: URHFPS first and second rounds, authors’ calculation. 27 b. Profile of respondents and households Table H-2. Characteristics of respondents and households in the second round Residence Overall Kampala South West West Nile Demographics Household size 5.4 5.3 5.0 5.8 Number of children, 0-14 3.1 2.2 2.8 3.3 Dependency ratio, % 54 37 53 57 Age of respondent 37 37 39 35 Male respondent, % 46 42 59 37 Male head, % 49 45 65 38 Education of respondent No formal education, % 21 28 27 16 Complete primary and below, % 36 17 36 38 Some secondary, % 31 22 22 38 Completed secondary & +, % 12 33 15 8 Year of arrival Before 2011, % 14 16 28 3 2011-2017, % 80 60 61 96 2018-2020, % 6 24 11 1 Country of origin South Sudan, % 61 4 15 100 DRC, % 27 39 62 0 Burundi, % 6 8 13 0 Somalia, % 6 49 10 0 Source: URHFPS second round, authors’ calculation. Note: All estimates are household weighted. 28