MONITORING IMPACTS OF COVID-19 ROUND 8 AND OTHER SHOCKS JUNE/JULY 2022 Publication Date Aziz Atamanov, Frédéric Cochinard, John Ilukor, Audrey Kemigisha, Talip Kilic, Andrew Mupere, and Giulia Ponzini BACKGROUND In June 2020, the Uganda Bureau of Statistics (UBOS), with the support from the World Bank, officially launched the Ugan- da High Frequency Phone Survey (UHFPS) to track the impacts of the COVID-19 pandemic monthly for a period of 12 UGANDA months. In June 2022, the scope of the survey was expanded to monitor economic sentiments and the socioeconomic impact of other shocks such as the Russia-Ukraine war and extreme weather events. The survey aimed to recontact the entire sample of households that had been interviewed during the Uganda National Panel Survey (UNPS) 2019/20 round and that had phone numbers for at least one household member or a reference individual. The first round (baseline) of the survey was conducted in June 2020 and interviewed 2,227 households. Subsequent seven rounds attempted to reach the same households. Table 1 contains the number of households interviewed and the time of each round. This brief pre- sents findings from the eighth round of the UHFPS. Table 1. Number of completed interviews by round Round 1 Round 2 Round 3 Round 4 Round 5 Round 6 Round 7 Round 8 (June 20) (July/Aug 20) (Sep/Oct 20) (Oct/Nov 20) (Feb 21) (Mar/Apr 21) (Oct/Nov 21) (June/July 22) Number of competed 2227 2199 2147 2136 2122 2100 1950 1881 interviews The timeline of the COVID-19 pandemic in Uganda includes the following key dates. All mass gatherings were suspended in Uganda and schools were closed on March 18-20, 2020. A nationwide curfew was announced on March 30, 2020. Re- strictions were eased on May 26th allowing private cars with only three people and general merchandise shops with strict social distancing. Vaccination campaigns began in March 2021. Uganda re-entered a partial lockdown starting on June 7th, 2021. The second lockdown was slightly longer than the first one, but less strict. A presidential directive banned travel between districts, restricted gatherings, and suspended schools. Many restrictions were eased early 2022 with all schools reopened. Figure 1 shows COVID-19 government response stringency index and the cumulative number of COVID -19 cas- es in the country since the beginning of 2020. The first and seventh rounds of the UHFPS were conducted after the first and second lockdowns, while the eighth round covered the period of least stringent restrictions since the start of pan- demic. On top of regular weather shocks, population in Uganda started to feel inflationary impact from the war in Ukraine during this period. Figure 1. Stringency index and cumulative number of COVID-19 cases in Uganda from January 2020 to July 2022 Source: WHO, Oxford COVID-19 Government Response Tracker, Blavatnik School of Government, University of Oxford. Note: Stringency index varies from zero to 100 with higher values meaning more stringent government policies. KEY FINDINGS • About 50 percent of households were moderately food insecure and 13 percent were severely food insecure in June/ July 2022. Food insecurity reached the highest levels in the Northern and Eastern regions. • More than 85 percent of respondents felt that prices had gone up a lot during last 12 months. More than 20 percent of respondents were not able to access such essential products when needed as beef, bread, gasoline, eggs, fish, and rice due to lack of money. Inability to access was much higher among the poorest households and those living in the Northern and Eastern regions. Many households were not able to buy desired amounts of essential food products and goods due to increased prices. © 2021 International Bank for Reconstruction and Development/The World Bank COVID-19 IMPACT MONITORING • Most respondents believed that their current financial wellbeing (69 percent) and country economic situation (90 percent) were worse than 12 months ago. • Share of working respondents remained at about 79 percent – the same as in October/November 2021. • Every second respondent indicates that extreme weather events will likely affect negatively household ’s financial wellbeing during next 12 months. Almost 70 percent of respondents experienced at least one of these shocks during the last 12 months: drought, irregular rainfall, or flood. The poorest and the rural residents were affected the most. • Extreme weather events affected most or all households in the community. Delayed rainfall and droughts resulted in loss of crops in most cases. Despite being rare, floods had much wider negative impact on households leading to loss of livestock, loss or property, displacement, injury and even death of household members. • Two third of households who needed and accessed health services had to pay out -of-pocket with an exceptionally large gap in average amounts paid between the poorest and the richest households. • School attendance in June/July 2022 reached the level before the lockdown in 2020. Children from the poorest quin- tile were less likely to be enrolled compared to those from the richest quintile (77 versus 90 percent accordingly). • About one third of all children aged 3 -18 lost at least one class because of the pandemic. Children from the Eastern and Northern regions were more likely to lose two classes compared to children from other regions who lost only one class. ECONOMIC SENTIMENTS The majority of respondents interviewed in June/July 2022 shared pessimistic views on household financial wellbeing and country economic situation during the last 12 months. For the first time respondents were asked multiple questions about economic sentiments. About 70 percent of respondents felt that their financial wellbeing got worse compared to 12 months ago with a higher share among respondents from the poorest pre-COVID-19 consumption quintile (76 percent) compared to those from the top quintile (60 percent). About 90 percent of respondents felt the economic situation got worse than 12 months ago and that prices went up a lot during the last 12 months. Regarding prospects for next 12 months, around one third of respondents believed that their financial wellbeing would be worse, and prices would go up even more compared to the current situation. Figure 2. Respondents’ economic sentiments about last 12 months re- Figure 3. Respondents’ economic sentiments about next 12 months ported in round 8 reported in round 8 Source: UHFPS. Note: “Do not know” answers were included in the analysis. Quintiles are based on pre-COVID-19 consumption per adult equivalent. Table 2. Future sentiments about household financial wellbeing conditional on the current ones future The same in 12 Worse in 12 Better in 12 months Do not know Total months months current Better than 12 months ago 79 12 3 6 100 The same as 12 months ago 43 31 11 14 100 Worse than 12 months ago 18 21 44 17 100 Future economic sentiments are correlated with the current views. Table 2 shows the distribution of future perspectives on household financial wellbeing depending on the current perceptions. Among those respondents whose current finan- cial wellbeing is better than 12 months ago (13 percent of all respondents), the absolute majority expect to be financially better off in 12 months’ time (79 percent). 2 COVID-19 IMPACT MONITORING Respondents with current wellbeing being worse than 12 months ago (the largest group of 69 percent) have also very pessimistic views about the future. About 21 percent of them do not expect any changes, while 44 percent expect wors- ening in their financial wellbeing in the next 12 months’ time. Perceptions about the economic situation in the country in five years are also correlated with the current views, but with larger uncertainty (Table 3). Thus, among the largest group of respondents who view the current economic situation worse than 12 months ago (90 percent of all house- holds), 36 percent expect situation to get worse in five years, 26 percent to be better, 25 percent do not know the an- swer and 13 percent expect it to be the same. Table 3. Future sentiments about country economic situation conditional on the current ones future Better in 5 years The same in 5 years Worse in 5 years Do not know Total current Better than 12 months ago 60 3 19 17 100 The same as 12 months ago 39 29 23 9 100 Worse than 12 months ago 26 13 36 25 100 EMPLOYMENT AND FAMILY BUSINESS The share of working respondents remained at around 79 percent in June/July 2022. There was no significant change in the share of working respondents in June/July 2022 compared to the previous round conducted in October/November 2021. It remained at the level of 79 percent with a slight reduction in the share of working in agriculture compared to Oc- tober/November 2021 (50 versus 54 percent accordingly). In the same period, there was a reduction in the share of households with operating non-farm family business. Every fifth closure was associated with fewer or no customer. Inabil- ity to access inputs was mentioned as the main reason for closure for about 20 percent of respondents. Figure 4. Share of working respondents across rounds, % Figure 5. Status of non-farm family business across rounds, % Source: UHFPS. Note: The same respondents across rounds are considered. IMPACT OF ECONOMIC SHOCKS Access to key products Access to many essential products was limited in June/July 2022 mainly due to low income. Respondents were asked about the need and access to essential products in the past seven days. Every fifth household was not able to access bread, beef, rice, eggs, fish, and gasoline when needed (Figure 6). Households from the poorest pre-COVID-19 quintiles had much lower access levels. For example, 56 percent of households from the poorest bottom quintile were not able to buy bread compared to 16 percent among households from the richest top quintile (Figure 7). For majority of households lack of money was the reason for being unable to access these products. Many households were not able to buy the desired amounts of essential products often due to increased prices. Those respondents who were able to access essential products were asked if they managed to buy the desired amounts. Many households reported difficulties in securing the desired amounts (Figure 8). For example, about 60 percent of households were not able to buy the desired quantity of cooking oil and soap. About 50 percent of households were not able to buy the desired amount of sugar. When asked about the reasons for being unable to buy desired amounts, the most frequently mentioned reason was increased prices for many products. COVID-19 IMPACT MONITORING Figure 6. Need and inability to access key food products conditional Figure 7. Inability to access key food products conditional on need on need in round 8, % among the poorest and the richest quintiles in round 8, % Source: UHFPS. Source: UHFPS. Note: Access is measured only for those who needed a product. Note: Quintiles are based on pre-COVID-19 consumption per adult equivalent. Selected products with remarkably high access rates were dropped from the figure. The highest increase in prices of selected products during last 30 days was observed for maize flour, salt, cooking oil and rice. Respondents were asked about community prices of food products at the time of interview and 30 days ago. Increase in average reported prices is shown in Figure 9. The average price of maize flour increased by 22 percent during the last 30 days. The average price of salt increased by 21 percent. The average prices of cooking oil and rice increased by 15 percent. Figure 8. Inability to buy desired amount among those who were Figure 9. Increase in average prices of selected food products as able to access essential products, % reported by respondents during last 30 days, % Source: UHFPS. Source: UHFPS. Note: Outliers were detected and replaced by the 1st and 99th percentile values in each rural and urban areas of four regions. 4 COVID-19 IMPACT MONITORING FOOD SECURITY Severe and moderate food insecurity indices (FIES) remained at remarkably high levels in June/July 2022. Figure 10 re- ports the dynamics of the FIES indices across different rounds of the UHFPS. About half of the national population were moderately food insecure, and 13 percent of population were severely food insecure in June/July 2022 – similar to the levels observed in October/November 2021. Figure 11 reports both indexes at the regional level. Food insecurity was par- ticularly high in the Eastern and Northern regions. At least partially, such a high level of insecurity might be related to in- creased food prices due to the war in Ukraine and weather effects. Figure 10. Trends in moderate and severe food insecurity indexes, % Figure 11. Severe and moderate food insecurity in round 8 by re- gions, % Source: UHFPS. IMPACT OF CLIMATE SHOCKS Most households expect extreme weather events to affect their households in the next 12 months. Figure 12 reports perceived likelihood of extreme weather events to affect negatively financial wellbeing of households. Overall, almost 60 percent of respondents believe that extreme weather events will likely affect them during the next 12 months. Rural households living in the Northern and Westerns regions and those from the poorest pre-COVID-19 quintile have higher expectations of being affected. The most anticipated shocks include droughts and delayed rains, followed by very high temperatures and floods. About 70 percent of households experienced at least one weather shock during last 12 months with the poorest and rural residences affected the most. Figure 13 reports incidence of droughts, delayed rains, floods, and incidence of any shock during last 12 month. Overall, about 69 percent of households experienced at least one shock during the last year. Almost everyone was affected at least once by a weather shock in the Northern region (93 percent). Incidence of any weather event was much higher among households from the poorest bottom pre-COVID-19 quintile compared to house- holds from the top richest quintile (83 versus 62 percent). Droughts and delayed rainfall were most frequent, while flood- ing was relatively rare event. Figure 12. Extreme weather events are likely to negatively affect Figure 13. Incidence of droughts, irregular rainfall, and flooding household financially during next 12 months, % during the past 12 months by area, region, and pre-COVID-19 con- sumption quintiles, % Source: UHFPS. Note: Quintiles are based on pre-COVID-19 consumption per adult equivalent COVID-19 IMPACT MONITORING Figure 14. Impact of shocks on households by type of weather Occurred weather shocks affected most or all house- shocks, % holds in the community with loss of crops being re- ported as the most widespread implication of shocks. Those respondents who experienced extreme weather events were asked about the spread of the shock. The majority of affected households felt that droughts, irregular rainfall, and flooding affected ei- ther most or all households in the community. When asked about exact implications, loss of crops was re- ported by about 90 percent of affected households regardless of the shock (Figure 14). Flooding had the most detrimental implications affecting not only crops but also leading to loss of livestock (53 per- cent), damage of property (60 percent), displacement (28 percent) and death/injury of household members (12 percent). Source: UHFPS. Note: *Small sample size. ACCESS TO EDUCATION AND HEALTH SERVICES Out-of-pocket payments for health services are widespread with the richest households paying at least four -time higher amounts in per capita terms compared to the poorest households. Respondents were asked about needs and access to health services among household members during last four weeks. About 45 percent of respondents indicated that at least one household member needed health services and about 94 percent of these households reported that at least one mem- ber managed to get it (Figure 15). Among those who accessed health services two third had to pay out-of-pocket with the incidence of payments much higher among households from the richest pre-COVID-19 quintile compared to the house- holds from the bottom quintile (68 versus 49 percent accordingly). Average amounts paid in per capita terms differed a lot based on residence and welfare status. The largest amounts were paid by households living the urban areas, the Western region and those from the richest pre-COVID-19 quintile (Figure 16). Figure 15. Need and access to health services during last four Figure 16. Incidence of out-of-pocket payments for health ser- weeks in round 8, % vices and amounts paid in per capita terms, % Source: UHFPS. Note: Incidence of out-of-pocket payments is calculated only for those who needed and were able to access health services. Average amounts paid are calculated only for those who had to pay. Quintiles are based on pre-COVID-19 consumption per adult equivalent. 6 COVID-19 IMPACT MONITORING Figure 17. School attendance among children aged 3-18 years Figure 18. Main reasons for not attending school among in round 8, % children aged 3-18 years in round 8, % Source: UHFPS. School attendance after full reopening of schools returned to the pre-COVID level, but many children lost one or two classes due to the pandemic. About 86 percent of children aged 3 -18 were studying in June/July 2022 (Figure 17). This is remarkably close to what was observed before school closure in March 2020. Current school attendance remains unequal with children from the poorest pre-COVID-19 quintile having lower chances (77 percent) to be enrolled compared to the children from the top richest quintile (90 percent). The main reasons for non-attendance included schools being expensive and children being too young. Some reasons were more prevalent in rural compared to urban areas: pregnancy/marriage, schools closed due to strike and schools being too far away (Figure 18). Respondents were also asked about the number of classes children missed out during the pandemic. Every third child lost at least one class during the last two years (Figure 19). Children from the Northern and Eastern regions were more likely to lose two classes (Figure 20). Figure 19. Share of children who lost at least one class among those Figure 20. How many classes were lost among children 3-18 age why are currently enrolled in round 8, % who reported lost classes in round 8, % Source: UHFPS. The reasons for losing classes during the pandemic varied across different regions. Figure 21 shows that at the national level 55 percent of children lost at least one class simply because schools were closed, about 26 percent did not pass the test, promotion was not offered for 15 percent and parents wanted to repeat classes for four percent of children. Failed tests played more important role in the Central and Northern regions. The role of parents, who wanted children to repeat the class, was more important in the Western region and did not play any role among children in the Eastern region. In the Eastern Uganda, most children did not go to school in two years of COVID-19 lockdown and as result schools did not offer promotion. COVID-19 IMPACT MONITORING Figure 21. Main reasons for losing classes in round 8, % Source: UHFPS. Note: Only those children who reported lost classes were considered. SAFE BEHAVIOR Figure 22. Prevalence of safe practices during last 7 days across rounds, % Prevalence of safe practices reached the lowest levels in June/July 2022 since 2021. As shown in Figure 22, there was a gradual decline in several safe behaviors among respondents of the UHFPS between June 2020 and June/July 2021. The de- clining trend slowed down after February 2021 and reversed, with more people practicing safe behaviors after March/April 2021 coinciding with the second lockdown and increasing number of COVID-19 cases. Shares of households practicing safe behavior reached the lowest levels in June/ July 2022 in line with the least stringent move- ment restrictions as shown in Figure 1. Source: UHFPS. Data Notes: the UGANDA High Frequency Phone Survey Seventh Round were implemented by the Uganda Bureau of Statistics (UBOS) in October-November 2021. This survey is part of a World Bank global effort to support countries in their data collection efforts to monitor the impact of COVID-19 and other shocks. A World Bank team from the Development Data Group and the Poverty and Equity Global Practice provided technical support. This survey is the eighth of a planned 12 waves of the High Frequency Phone Survey of households in Uganda. 2,421 suc- cessfully interview households from the 2019/20 Uganda National Panel Survey were contacted and 1,950 households in the Seventh Round were fully interviewed. In the Eighth Round, 1,881 households were successfully interviewed. These same households were and will be contacted in all subsequent waves of the High Frequency Phone Survey. The data are representative at the regional and national level and survey weights were calculated to adjust for non-response and undercoverage. For further details on the data, visit https://www.worldbank.org/lsms-covid19 8