UNICEF Uganda Humanitarian Situation Report - January - December 2017
In 2017, UNICEF and partners worked with the Government to fulfil the rights of children affected by an unprecedented influx of refugees, disease outbreaks, natural hazards and food insecurity.
Nutrition, health, child protection, HIV/AIDS, education and WASH services were supported for affected children and women.
UNICEF reinforced systems at national and district levels to improve capacity to respond to emergencies, including scaling up high impact health and nutrition, WASH, education and child protection interventions.
Nearly 160,000 refugee children (95,740 boys and 63,028 girls) accessed psychosocial support through structured play, recreation, leisure and learning activities.
Hygiene and sanitation was strengthened through 182 hygiene promoters and the provision of latrine construction materials, which benefitted 163,494 refugees (of whom 90,960 are children).
Nearly 70,000 children from South Sudan, DRC and Burundi benefited from UNICEF Early Childhood Development (ECD) services in 30 ECD centres.
UNICEF is grateful to all donors for their contribution to the Humanitarian Action for Children that enabled timely response to humanitarian needs.
Situation Overview and Humanitarian Needs
Refugees: As of December 2017, Uganda was host to 1,400,218 refugees and asylum seekers of whom over 1 million refugees are from South Sudan, 230,358 from DRC and 39,289 from Burundi.
Following increased attacks against civilians, 7,185 refugees crossed into Uganda from DRC since 18th December 2017 to date. Uganda has become the largest refugee hosting country in Africa and one of the largest asylum countries in the world; an indication of fragility and conflict in the region. The increasing influx of South Sudanese refugees into Uganda continue to strain services and populations in the West Nile region. The Child protection working group reports that by the end of 2017, child protection services remain a high operational priority given that children represent 61 per cent of the total refugee population. The limited funding to the sector(81 percent underfunded) hindered the delivery of child protection services.
Negative social and cultural practices, such as child marriage, are prevalent both in refugee and host communities. In addition, secondary school locations are far away from homes, raising concerns about the safety of young girls.
UNICEF and UNHCR played a leading role in supporting the Ministry of Education to develop the multi-year Uganda Education Response Plan for Refugee and Host Communities and provided strategic, financial and political support to the scale up of education services for emergency-affected children. School age children represent at least 50 per cent of the refugee population and only 46 per cent of them have access to formal and informal education; including a significant gender gap in enrolment, especially at secondary level, where fewer girls are in school compared to boys. Insufficient learning facilities in settlements hosting South Sudanese refugees are also characterized by severe overcrowding in temporary schools. Lack of institutional latrines and limited number of qualified teachers pose significant challenges to the learning capacity, safety and dignity of children.
In 2017, the Ministry of Health increased its leadership role in the provision of health services within refugee hosting districts. The Health Facility Quality of Care Assessment conducted by UNICEF in 2017 reflects a health system with weaknesses exacerbated by the shock of an exponentially fluctuating population. Evidence exists of inequitable access by the population and inadequate quality of some basic services.
Preliminary findings from the October 2017 food security and nutrition assessment (FSNA) indicate high levels of malnutrition among children refugee communities, with those in the West Nile Region worse off. Five out of the seven settlements had Global Acute Malnutrition (GAM) levels above the WHO recommended threshold of 10 per cent. i.e. Arua (10.3 per cent; Adjumani 11.8 per cent; Palorinya 11.1 per cent; Palabek 12.3 per cent and Bidibidi in Yumbe district at 11.3 per cent). GAM levels were low and within the acceptable WHO threshold (below 5 per cent) for all Western Region settlements, with the exception of Kiryandongo that had 7.5 per cent. Contrary to GAM, stunting was highest among refugee children in the Western Region compared with the West Nile Regions. In the Western region, all (Nakivale 21.6 per cent; Orichinga 27.9 per cent, Kyaka II 22.3 per cent and Rwamwanja 25.0 per cent), but two settlements had stunting levels about 20 per cent, indicating medium severity of stunting according to the WHO classification. Palabek (21.9 per cent) is the only West Nile settlement that had GAM rates in the same range.
Anemia prevalence (Hb<11 g/dl) was between 25-40 per cent across the Western Region refugee settlements. Anemia was higher in the West Nile Region settlements with nearly five out of every ten children in Bidibidi (56.6 per cent) and Lobule (53.0 per cent) being anemic, exceeding the WHO threshold of 40 per cent. Among non-pregnant women of reproductive age, anemia was highest in Palabek (47.3 per cent) and lowest in Arua (24.5 per cent) in the West Nile settlements. The highest anemia prevalence from the Western Region settlements was in Kaka 11 (38.8 per cent) and the lowest in Oruchinga (27.0 per cent).
With respect to the children in the host communities, only Arua (10.7 per cent) and Palabek in Lamwo (10.1 per cent) had GAM rates above the WHO threshold. There were no regional variations in stunting between the host and refugee communities. Contrary to the refugee settlements, anemia prevalence exceeded the WHO threshold in with only two communities, Kamwenge (38 per cent) and Hoima (31.0 per cent), below the 40 per cent threshold. Contrary to the situation in children, anemia was lower than 30 per cent among women across all communities. Across all host and refugee communities, Vitamin A coverage was higher than 80 per cent.
As Uganda continues implement its open-door policy to all refugees, it is important to recognize the critical role played by the Government of Uganda and the local communities in hosting refugees. It is estimated that the Government of Uganda and local communities are spending over US$ 323 million a year on the protection, management of refugees and the provision of essential services.4 Over 83 percent of the cost is being incurred at the integration phase, implying the need to gear future assistance to this phase to lessen the burden on public expenditure and long term development of the country.
In 2017, Uganda held a Solidarity Summit on refugees and host communities hosted by President, H.E Yoweri Museveni and the UN Secretary General Antonio Gutierrez at which, the international community initially pledged $347.45 million, which is part of the $2 billion in aid sought by Uganda for 2017 to support 1.2 million refugees.
Uganda is a pilot country for the Comprehensive Refugee Response Framework (CRRF) and the secretariat was formally established in March 2017 under the patronage of the Office of the Prime Minister (OPM). The Secretariat is enhancing the collaboration among the Government, UN Agencies, World Bank, private sector and development partners in the planning and implementing of the Refugees and Host Population Empowerment (ReHoPE) strategy. The OPM role is critical in coordinating line ministries and District Local Government (DLG) to support the integration of humanitarian and development practices in basic service delivery.