MONITORING IMPACTS OF COVID-19 ROUND 13 AND OTHER SHOCKS JUL-AUG 2023 Publication Date Aziz Atamanov, Frédéric Cochinard, John Ilukor, Audrey Kemigisha, Cathrine Machingauta, Andrew Mupere, and Giulia Ponzini BACKGROUND In June 2020, the Uganda Bureau of Statistics (UBOS), in collaboration with the World Bank, officially launched the Ugan- da High Frequency Phone Survey (UHFPS) to track the impacts of the COVID-19 pandemic on a regular basis. In June UGANDA 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, Ebola outbreak and extreme weather events. In addition, the survey is also being used to collect perceptions on different development policies and programs. 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. Sample was refreshed in the latest 13th round conducted in July/August 2023 by adding households from the Uganda National Household Survey 2019/20. Timeline of each round is shown in Table 1. This brief focuses on socio-economic wellbeing of Ugandans as reported in July/August 2023. Table 1. Number of completed interviews by round R1 R2 R3 R4 R5 R6 R7 R8 R9 R10 R11 R12 R13 (June (July/ (Sep/ (Oct/ (Feb (Mar/ (Oct/ (June/ (Oct/ (Dec 22/ (Feb/Mar (Jul/Aug (Aug 22) 20) Aug 20) Oct 20) Nov 20) 21) Apr 21) Nov 21) July 22) Nov 22) Jan 23) 23) 23) Competed interviews 2227 2199 2147 2136 2122 2100 1950 1881 1738 1668 1666 1783 1765 KEY FINDINGS • Fewer respondents shared optimistic views on future household wellbeing and country economic situation in July/August com- pared to February/March 2023, especially among the poorest respondents. • Only 37 percent of respondents feel that they live well or fairly well. Half of all respondents think that total household income in July/August 2023 was lower than it was at the end of 2022. • Every third respondent believes that his/her household does not have adequate food consumption and health care. Respondents from the poorest pre-COVID-19 consumption quintile are least likely to have adequate food consumption, housing, clothing, and health care. • Sugar, salt, and maize flour prices increased in July/August 2023 compared to February/March 2023, while prices on fuel, fertiliz- ers and cooking oil declined substantially. • Moderate food insecurity increased in the Central and Western regions where fewer respondents engage in crop growing and existing farmers expect lower agricultural output from the first season of 2023 compared to second season of 2022. • About 25 percent of respondents did not eat any vitamin A -rich food during last week with the poorest and elderly showing the highest vitamin A deficiency levels. • More than 40 percent of respondents did not eat any iron-rich food during last week with the poorest and elderly showing the highest iron deficiency levels. Most respondents acquire iron rich products in the market in sharp contrast to protein -rich food acquired from their own production (mostly due to pulses/legumes/nuts group of products), especially in rural areas. • Yellow fever vaccination rate is found to be significantly higher in districts covered by the mass vaccination campaign conducted in June 2023. ECONOMIC INDICATORS Economic sentiments and subjective economic wellbeing Fewer respondents felt positive about household current and future financial wellbeing in July/August compared to February/March 2023. Figure 1 shows the share of respondents who have positive views on household current and fu- ture financial wellbeing compared to last 12 months. There was a decline in the share of respondents with positive views on current well-being from 24 percent in February/March to 16 percent in July/August 2023 and on the future well -being from 34 to 26 percent accordingly. The same figure also shows the share of respondents who believes household finan- cial wellbeing will be better during next 12 months. It fell as well from 34 percent in February/March to 26 percent in July/August 2023. There are notable differences in economic sentiments between the poorest and the richest households based on pre-COVID-19 consumption quintiles1. Households from the top quintile are more positive about the current and future household financial wellbeing. Respondents were less optimistic about future country economic situation. Figure 2 shows the share of respondents who have positive views on the current and future country's economic situation. 1 Quintiles in this round are produced by using consumption per adult equivalent spatially adjusted by poverty line. Creating quintiles is done in the phone survey sample using population weights. © 2021 International Bank for Reconstruction and Development/The World Bank MONITORING IMPACTS OF COVID-19 AND There is a slight increase in the share of respondents who think that the current economic situation has gotten better. It increased from 16 percent in February/March to 23 percent in July/August 2023. In contrast, there is a decline in the share of respondents who think that the country’s future economic situation will be better. It fell from 41 percent in Feb- ruary/March to 29 percent in July/August 2023. As with own household financial wellbeing, the poorest respondents have less positive views on the current and future economic situation in the country. For example, about 28 percent of respondents from the richest top quintile think that the future economic situation in the country will be better compared to 18 percent among the poorest bottom quintile. Figure 1. Positive views about household financial wellbeing Figure 2. Positive views about country economic situation now and now and in future across rounds 12 and 13, % in future across rounds 12 and 13, % Only 37 percent of respondents view their household living status as well or fairly well, while the majority live fairly or with difficulty. Several subjective wellbeing questions were asked in round 13. One question was about household living status. Results are reported in Figure 4. Only 37 percent of respondents view their household living status as well or fairly well, while the majority live fairly or with difficulty. Several subjective wellbeing questions were asked in round 13. One question was about household living status. Results are reported in Figure 4. One third of respondents felt they lived well or fairly well. About 43 percent lived fairly and the remaining 19 percent lived with difficulty. It is interesting to check sub- jective wellbeing indicators across objective monetary wellbeing status measured by pre-COVID-19 consumption quintiles. There is a relationship between two indicators, albeit imperfect. Households from the poorest consumption quintile were more likely to live with difficulty (27 percent) or fairly (51 percent) which was much higher than among the richest house- holds from the top quintile with 8 and 43 percent accordingly. Many respondents feel that their ability to meet minimum needs in food, clothing, health and housing are not satisfied. Respondents were asked if their household minimum needs in food consumption, health, housing, and clothing were satisfied (Figure 5). About 35 percent of respondents felt food consumption needs were inadequately met, 34 percent had inadequate health care, 26 percent had inadequate clothing and 21 percent had inadequate housing. Households from the poorest pre-COVID-19 consumption quintile have significantly higher shares of respondents with unsatisfied needs. Figure 3. Perceptions about household status of living, % Figure 4. Total household income compared to income at the end of 2022, % 2 MONITORING IMPACTS OF COVID-19 AND OTHER Half of respondents indicated that their total household income declined compared to income at the end of 2022 with the poor households being worse-off than the rich. On top of different subjective wellbeing questions, respondents were asked how total household income changed compared to 2022 (Figure 4). About 51 percent of households had total in- come either declined or fully lost. This share was higher among households from the poorest pre-COVID-19 consumption quintile compared to the top richest quintile: 59 versus 41 percent accordingly. Figure 5. Subjective perceptions about meeting minimum con- Figure 6. Share of households meeting less than adequate con- sumption needs, % sumption needs across pre-COVID-19 consumption quintiles, % Employment, prices and access to essential products Employment rates remained stable in July/August 2023 reaching 80 percent. Figure 7 shows the share of respondents working during the last seven days before the interview. It increased only slightly from 78 percent in February/March 2023 to 80 percent in July/August 2023. The increase came from higher employment in rural areas (onset of second agricultural season), while urban employment remained at the same level. Prices on sugar, salt and maize flour increased, while prices on fuel, fertilizer and cooking oil declined substantially. Changes in prices between July/August 2023 and February/March 2023 of some essential goods were not homogeneous (Figure 8). The average price of salt increased by more than 10 percent, the price of maize flour by six percent, the price of sugar by five percent, and the price of milk by three percent. At the same time a few other products became cheaper. For example, cooking oil prices fell by 13 percent, gasoline prices declined by five percent, and prices of fertilizers fell by al- most 30 percent. Figure 7. Working respondents across rounds, % Figure 8. Price index for selected products across rounds (May/June 2022 is a base) Note: Data is treated as cross-section. Note: For brevity price index for August 2022 is omitted from the figure. Prices on fertilizers, gasoline and diesel have been collected since August 2022 only. 3 MONITORING IMPACTS OF COVID-19 AND Access to many essential goods such as sugar, beans, beef, milk, bread and eggs deteriorated slightly, mostly due to the lack of income. Figure 9 shows the share of households who were not able to access either fully or desired amount of needed products. Almost half of households were not able to access rice, beef and bread when needed. Lack of income was mentioned as the most important reason for this with fresh beans being the exception here2. Lack of access to this product was to a larger extent driven by being out of stock. Access to these products and also sugar, fresh beans, and milk also got worse in July/August 2023 compared to February/March 2023. In contrast, access to cooking oil and gasoline has improved, which may be associated with a decline in prices as was shown earlier. Figure 9. Inability to buy essential products (fully or desired amount) when needed during last 7 days across different rounds, % Food insecurity and nutritional quality Moderate food insecurity increased in Uganda, mostly due households residing in the Central and Western regions, while sever food insecurity declined. Figure 10 tracks changes in moderate and severe food insecurity measure by food insecurity experience scale (FIES) indicators. Moderate food insecurity increased from 34 percent in February/March to 40 percent in July/August 2023, while severe FIES declined from seven to four percent accordingly (Figure 10). This implies that more people reduced the quality and/or quantity of their food and are uncertain about their ability to obtain food due to lack of money or other resources, but at the same time there was a reduction in the share of people who have run out of food and, at the most extreme, have gone days without eating. Increase in moderate FIES was to a large extent driven by worsening food security in the Central and Western regions (Figure 11). These regions historically had the lowest FIES indicators. There are two potential factors explaining these results. Firstly, the increase in moderate food insecurity was the highest in more urbanized regions which may not necessarily benefit yet from collected harvest. Secondly, as shown further, farmers in the Central and Western regions had much worse expectations about agricultural output in the first season of 2023 compared to the second season of 2022. This could potentially increase uncertainty about their ability to obtain food and increase moderate food insecurity. Vitamin A and iron deficiency is remarkably high among Ugandans, in particular among the poorest and elderly resi- dents. One important limitation of food security indicators is their inability to capture nutrition quality of food. Round 13 collected information about nutritional quality of food consumed by respondents focusing on three main nutrients such as vitamin A, protein and iron. Figure 12 shows the share of respondents who never consumed products rich in vitamin A, protein and iron during the last seven days. Iron deficiency is more prevalent compared to deficiency in vitamin A and pro- tein. Thus, 41 percent of respondents did not consume any iron-rich food (e.g. meat, fish) during the last seven days com- pared to 25 percent of respondents not consuming vitamin A rich food and five percent of respondents not consuming protein rich food. Iron deficiency is the highest among respondents from the poorest bottom pre-COVID-19 consumption quintile, among elderly respondents and residents of the Eastern region. Vitamin-A deficiency is also the highest among respondents from the poorest bottom pre-COVID-19 consumption quintile and among elderly respondents. In terms of the regional disparity, it is the Central region which has the highest share of respondents who never ate vitamin A rich food during last week. 2 One potential factor constraining households to access essential goods was return of children to school and the need to pay school fees. 4 MONITORING IMPACTS OF COVID-19 AND Figure 10. Food insecurity indicators across rounds, % Figure 11. Moderate food insecurity indicators across rounds, area and regions, % High level of iron deficiency may be related to the fact that iron rich products are acquired in the market and not ob- tained from home production. Figure 13 and Figure 14 show where households acquire food products across rural and urban areas. Iron rich products such as flesh meat, organ meat and fish are mostly acquired in the market in both rural and urban areas. This makes access to these food items highly dependent on household income. This is not the case for vitamin A and protein-rich food. For example, 65 percent of households in rural areas acquire orange fruits, which are rich in vita- min A, from own production. Figure 12. Share of respondents who never consumed protein, iron and Vitamin A rich foods during 7 days, % Figure 13. Places where food products are acquired in rural are- Figure 14. Places where food products are acquired in urban as, areas, % 5 MONITORING IMPACTS OF COVID-19 AND Agriculture in the first season of 2023 More than 70 percent of households engaged in cropping activities during the first agricultural season of 2023. About eight percent of households had a farm, but did not grow crops, while the remaining 19 percent did not have a farm. Resi- dents from the Eastern (84) and Northern (87) regions were more likely to grow crops compared to respondents from the Central (56) and Western (72) regions. Those households who had farms but did not grow crops mentioned such reasons for this as delayed planting, being sick and inability to acquire seeds. Delaying planting was particularly common in the Central and Western regions. In terms of the main crops, maize was grown by 38 percent of farmers, playing a particular important role in the Eastern region (52 percent). Beans were the second most important crop grown by 25 percent of farmers, playing the most important role in the Western region (48 percent). More farmers expressed negative expectations about agricultural output in the first season of 2023 compared to the second season of 2022. Figure 15 contains expectations about agricultural output. Many more farmers expected less than normal or bad agricultural output in the first season of 2023 compared to the second season of 2022: 42 versus 27 per- cent3. The most drastic changes in expectations across two seasons were observed among farmers from the Central and Western regions. For example, only 11 percent of farmers in the Central region expected less than normal/bad agricultural output after second season of 2022, but this share increased to 40 percent in the first season of 2023. The Eastern region was the only one where farmers had better expectations about agricultural output in the first season of 2023 compared to the second season of 2022. Despite negative expectations about agricultural output, more than 60 percent of farmers expect good or average sales of agricultural produce, but the poorest farmers and those from the Eastern and Northern regions have lower expecta- tions. Figure 16 shows the expectations of farmers on potential sales of their produce. Most of them expect sales to be good or average. Good expectations about agricultural sales are particularly high in the Central and Western regions where farmers have stronger negative expectations about production. The poorest farmers from the bottom consumption quintile have lower positive expectations compared to the farmers from the top richest quintile: 62 versus 79 percent. Figure 15. Expectations about harvest at the end of second Figure 16. Expectations about agricultural sales in first agricul- agricultural season 2022 and first agricultural season of 2023 tural season 2023 Figure 17. Usage of fertilizers during the first agricultural Usage of fertilizers in the first agricultural season of 2023 season of 2023 is low and skewed towards richest farms and those living in the Central region. Figure 17 shows that about 15 per- cent of farmers used any type of fertilizers in the first agri- cultural season of 2023. The share of farmers using fertiliz- ers grows across consumption quintiles with only eight per- cent of the poorest farmers from the first quintile using fertilizers compared to 24 percent among farmers from the top richest quintile. Usage of fertilizers is also much higher among farmers from the Central region (32 percent). 3 Second season is known to be short and not the main season for farming but is slightly more reliable in terms of rainfall distribution. 6 MONITORING IMPACTS OF COVID-19 AND Yellow fever vaccination Starting 2023 year, Uganda has been conducting a yellow fever preventive mass vaccination campaign targeting people up to 60 years old. In the first phase (9-13 June 2023), yellow fever vaccine was administered in Kabale, Kabarole, Lira, Arua, Gulu and Hoima. To explore how the vaccination went, a special module about yellow fever was added in round 13 of the phone survey. Several questions were asked including knowledge about the campaign, number of shots needed, actual vaccine incidence and so for. Results are split by districts involved and not involved in the campaign and are shown in Fig- ure 18. Figure 18. Yellow fever vaccination indicators across areas, % When compared to residents of districts not affected by vaccination campaign, respondents residing in districts covered by the campaign were found to know more about it: 92 versus 59 percent. They were more likely to know the correct number of jabs needed (one): 65 ver- sus 25 percent. Incidence of vaccination against yellow fever was also much higher in the districts covered by the campaign: 76 versus 29 percent. Almost 100 per- cent of vaccinated people in districts covered by the campaign were vaccinated in 2023. Note:+ Sample include respondents of 60 years old and younger. *** significant at 1 percent, **5 percent, *10 percent. Data Notes: the UGANDA High Frequency Phone Survey Thirteenth Round were implemented by the Uganda Bureau of Statistics (UBOS) in July/August 2023. 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 twelfth of a planned 12 waves of the High Frequency Phone Survey of households in Uganda. 2,421 successfully interview households from the 2019/20 Uganda National Panel Survey were contacted and 1,738 households in the Nineth Round. In the Tenth Round, 1,668 households were successfully interviewed. In the Eleventh and Twelfth Round, 1,666 and 1,783 households were successfully interviewed. In this Round 1,765 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