In early 2021, the east of Ukraine will enter its eighth year of armed conflict. Civilian populations of Donetsk and Luhansk oblasts (collectively referred to as Donbas) continue to experience ongoing ceasefire violations along the 428 kilometres of the contact line. The protracted nature of the conflict has led to a significant loss of lives, concerns over the protection of civilians, and significant damage to critical infrastructure in conflict-affected areas. Eastern Ukraine has also become one of the most mine contaminated regions of the world, with the Organisation for Security and Cooperation in Europe’s Special Monitoring Mission to Ukraine (OSCE SMM) having observed more than 10,000 land mines on both sides of the contact line since 2018. Mines/explosive remnants of war (ERWs) are also the leading cause of civilian deaths since 2017 (81).
On the 22nd of July 2020, the Trilateral Contact Group on Ukraine (TCG) agreed on a ceasefire that took effect on the 27th of July, which was largely effective through the remainder of 2020. From the 1st of January 2020 to the 27th of July, there were 7,200 security incidences resulting in 77 fatalities. From the 27th of July to the 5th of December the number of security incidences decreased to 829 which resulted in 25 fatalities. In total, the Office of the United Nations High Commissioner for Human Rights (OHCHR) reports that, between April 2014 and July 2020, there were 3,367 civilian deaths due to the conflict and estimates the number of civilians who have been injured by the conflict at more than 7,000. From the beginning of 2021 the security situation started to deteriorate with an increase of military presense in the region, intensification of military clashes and use of heavy weapons, that may indicate a possibility of return to the pre-ceasefire conflict dynamic.
The ongoing conflict, coupled with the COVID-19 pandemic could exacerbate the situation that households living in proximity to the contact line are already in. As a primary effect of such ongoing conflict, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) estimated that 3.4 million people will be in need of humanitarian assistance in 2021. Secondarily, within the context of protracted conflict, many younger working-age people have left the region, leaving the area within 20 km of the contact line with a higher concentration of people with vulnerabilities than in other parts of the country.
Rationale and Methodology
To support an evidence base for the planning of humanitarian assistance as part of the Humanitarian Programme Cycle (HPC) for 2021, REACH conducted a Multi-Sectoral Needs Assessment (MSNA), building on assessments conducted in 2016, 2017, 2018 and 2019 in collaboration with the Humanitarian Country Team (HCT), the Inter-Cluster Coordination Group (ICCG), and OCHA.
The data was collected between 29 July and 15 August 2020, through a stratified sample of 1,610 households. The sample of households was selected to be statistically representative of populations in each settlement type (rural and urban) and by distance to the contact line (0-5 km and 5-20 km) with a 95% confidence level and 5% margin of error for each stratum (subsets may have a larger margin of error).
For an exploratory comparison of needs in different sectors between the different geopgraphic strata please see the interactive dashboard.
Data was analysed using an analytical framework proposed by REACH for 2020 MSNAs. The framework incorporated some elements of the draft Joint Inter-sectoral Analysis Framework (JIAF), functioning as an interim solution proposed by REACH for inter-sectoral analysis within the MSNA until the officially endorsed JIAF is available. The REACH analytical framework involved generating a Multi-Sector Needs Index (MSNI) score to estimate the severity of household needs by measuring their overall humanitarian conditions vis-à-vis their living standard gaps (LSGs). The approach involved categorizing households as either in minimal (1), stress (2), severe (3), or extreme (4) severity of need, with a higher MSNI score indicating more severe needs.
Across assessed areas within 20 km of the contact line, 31% of households (equalling an estimated 81,341 households) were found to have severe or extreme levels of multi-sectoral humanitarian needs corresponding to an MSNI score of 3 or 4. The MSNI captures what households are reporting (through the lens of Cluster-prioritised indicators) and does not directly capture some of the systemic effects of conflict.
A slightly greater proportion of households living within 5 km of the contact line were found to face severe or extreme levels of multi-sectoral humanitarian needs: 35% of households in 0-5 km urban areas and 33% in 0-5 km rural areas. The severity of needs was found to be somewhat lower in areas further from the contact line, with 29% of urban households and 20% of rural households between 5-20 km from the contact line experiencing severe or extreme levels of severity of need. Although the severity of need was more likely to be higher nearer to the contact line, the projected population affected appears to be lower.
Overall, severe and extreme needs were primarily driven by corresponding severe LSGs in Food Security and Livelihoods and Water, Sanitation and Hygiene (WASH). Twelve per cent (12%) of households overall were found to have severe or extreme LSGs in the two sectors, constituting 40% and 39% of households with an MSNI score of 3 or 4, respectively. There was, however, some variation between assessed areas in terms of primary drivers of severe or extreme need. In rural areas, while Food Security and Livelihoods was still the most common primary driver of high MSNI scores, health, instead of WASH, was the second most common sector to drive severe or extreme need.
Of the 31% of households with severe or extreme needs, no households had LSGs in all sectors combined, only 1% of households had LSGs in three sectors combined, 5% in two sectors combined, and 25% had an LSG in a single sector. Most households are covering most of their needs, and may face some gaps, but when there are gaps they are mostly in a single sector.
Demographic, socio-economic, and health-related vulnerability characteristics were found to affect considerable proportions of people living within the assessed area, amongst both heads of household and other household members. Nearly three-quarters (74%) of heads of household were found to have at least one vulnerability characteristic. Among these heads of household, the most commonly reported vulnerabilities were being an older person above the age of 60 (48% of household heads), having a chronic illness that affected their quality of life (46%), and having a disability (10%).
Only 28% of household members across the assessed area were reportedly engaged in paid work. Similarly, 67% of heads of household were reported being economically inactive. Through the lens of high rates of vulnerability, this suggests a relatively high household dependency ratio and a potential additional burden on economically active household members.
Protection & Security Needs
Shelling and small arms fire remained ongoing in the assessed area, particularly within 5 km of the contact line where 97% of armed clashes in the GCA occurred from January to December of 2020. On the 22nd of July 2020, the Trilateral Contact Group on Ukraine (TCG) agreed on a ceasefire that took effect on the 27th of July, and thus far has been effective. From the 1st of January 2020 to the 27th of July, there were 7,200 security incidences resulting in 77 fatalities. From the 27th of July to the 5th of December the number of security incidences decreased to 829 which resulted in 25 fatalities.
Households living within 5 km of the contact line are almost twice as likely to report knowledge of an incidence relating to mines/ERW in the twelve months prior to data collection than households in the 5-20 km area, similar to 2019. The proportion of households reporting that land mines do not affect their everyday lives has decreased since 2019, from 57% to 42% in 2020, while the proportion who reported their everyday lives were severely affected has doubled, from 9% to 18%.
With high levels of vulnerability and ongoing risks due to conflict, mental health and post-trauma rehabilitation services are also important considerations for those responding to the crisis. Only 24% of households reported being able to access mental health care services if needed and 27% reported being able to access post-trauma rehabilitation services if needed. This is important considering that the United Nations (UN) reports that more than one-in-five people in conflict zones suffer from a mental illness, including depression, anxiety and post-traumatic stress disorder. Of the households who reported mines/ERW severely affect their everyday lives, 86% stated the reason being for their psychological safety.
Food Security and Livelihoods Needs
Using the World Food Programme’s (WFP) Consolidated Approach to Reporting Indicators (CARI) as methodology for calculating Food Security Index, a slightly higher proportion of households were found to experience food insecurity in the assessed area than in 2019. Overall, 12% of households were found to be moderately or severely food insecure, up from 8% in 2019 (13% in 2018).
Households residing in 0-5 km rural areas were slightly more commonly found to be food insecure than households in remaining strata, at least six percentage points more. The higher proportion of food secure households in strata other than 0-5 km rural may potentially relate to improved access to arable land due to reduced conflict incidence further from the contact line, and access to functioning markets in urban areas.
The increase in the proportion of households that were found to be moderately or severely food insecure since 2019 could be reflected in the noticeable increase in the proportion of household expenditure on food, 22% in 2019 and 49% in 2020. However, given that data collection was conducted shortly after the nationwide COVID-19 restrictions, it is more difficult to interpret food expenditure share this year.
Food consumption patterns have stayed approximately the same since 2019, with 11% of households found to have poor or borderline Food Consumption Scores (FCS), a slight increase from the 9% found in 2019 in the assessed area, but a decrease from the 14% found in 2018.
In total, nearly half (43%) of households reported resorting to coping strategies categorised as Crisis or Emergency in the 30 days prior to data collection. However, it should also be noted that this assessment was conducted in July and August; with financial burdens on households generally being higher in winter periods, it can be forecasted that the use of such coping strategies might reasonably increase in that period. Notable livelihoods-related coping strategies used in the 30 days prior to data collection included reducing essential health care expenditures (38% of all households) and purchasing food on credit or borrowing food (28% of all households).
In the context of Ukraine, WASH concerns relate closely to public infrastructure and systemic insufficiencies, and therefore remain difficult to fully capture through a household-level survey. As the water system is integrated between GCA and NGCA, shelling along the contact line creates risks for millions of residents on both sides of the contact line regarding access to water. Indeed, according to a study by the WASH Cluster, there were forty-eight incidences that affected water and waste water infrastructure between January and June 2020. This risk is amplified as heating infrastructure in many urban areas relies on piped hot water, meaning that water cuts in winter periods could leave affected households without sufficient heating in a region that experiences harsh winter conditions.
On the household level, the proportion of households who reported experiencing a lack of drinking water supply in the twelve months prior to data collection was 35%, and 6% reported this happened on a daily basis. Within 5 km urban areas, 45% of households reported experiencing drinking water shortages. Due to integrated infrastructure across the contact line, water shortages in urban areas, where people commonly rely on a centralised system rather than a well or borehole, will likely remain a concern as long as shelling of critical infrastructure continues.
Regarding water safety, 41% of households reported treating their drinking water, an increase from 34% in 2019. Of households that reported not treating their water (59%), 85% reported there is no need, while 14% reported that they could not afford to. Twenty-four percent (24%) reported treating water by boiling, which is insufficient to address potential chemical contamination due to industry and farming.
Shelter/Non-Food Items (NFI) Needs
Twenty-six percent (26%) of households reported that their shelter lacked insulation from cold, with households in rural areas being more likely to state such, a significant proportion considering the harsh winters experienced in Ukraine. Conflict-related damage to infrastructure, including personal accommodation, continues to be reported in areas experiencing active conflict. Almost one-quarter (22%) reported that their primary shelter was damaged due to the conflict at some point, 6% of these stating that the damage was severe enough that they had to re-locate. Households in 0-5 km rural areas most commonly reported conflict-related damage to their shelter (47%) and having to re-locate due to the damage (11%).
Nearly half of households (46%) reported having experienced electricity shortages in the 30 days prior to data collection. However, 38% (of all households) stated that the electricity shortages they experienced were infrequent. Forty-one percent (41%) of households reported using wood for heating, while 32% reported using coal; the relatively high proportion of households using wood or coal for heating underlines the importance of winterisation aid to be provided to households, especially those in rural areas (just 2% use central heating) due to the higher costs of coal and other fuels.
Among those households with school-aged children (20% of all households), 14% reported that at least one of their children could not attend school for at least one month during the academic year (excluding closures due to COVID-19), with the majority stating that the main reason for absence were health-related issues. Twenty-five percent (25%) of households with school-aged children reported problems with distance learning (such as poor internet connection) due to school closures for COVID-19, the highest proportion being in 0-5 km rural areas, where 47% reported such. Finally, almost half (42%) of households that accessed education facilities reported being unable to buy all supplies needed by children in education, a notable increase from 27% in 2019.
Of the households with at least one member who tried to access healthcare in the twelve months prior to data collection (56%), 76% reported difficulties accessing healthcare, with households living in 0-5 km areas the most likely to report this. The stratum with the highest proportion of households reporting difficulty in accessing healthcare was households in rural areas within 5 km of the contact line, where 87% of households reportedly needing healthcare reported such problems. Three of the five most frequently cited difficulties in accessing healthcare were related to costs, with the cost of medicine remaining to be the most commonly reported barrier to healthcare, reported by 85% of households who tried to access health care in the 12 months prior to data collection throughout all strata.
Of note, 38% of households reported reducing spending on essential health care as a coping strategy, the same proportion as 2019.
Across the GCA region of Donetsk and Luhansk oblasts, 31% of households (equalling an estimated 81,341 households) were found to have multi-sectoral needs. Households within 5 km of the contact line were found to more commonly have such needs; 35% in 0-5 km urban areas and 33% in 0-5 km rural areas. The proportion of households with multi-sectoral needs was found to be somewhat lower in areas further from the contact line, with 29% of urban households and 20% of rural households between 5-20 km from the contact line experiencing severe or extreme severity of need. Although the higher severity of need was more likely to be more widespread nearer to the contact line, the projected population affected is lower. However, it should be noted that findings suggest no common experience of overlapping, co-occurring needs; no households had LSGs in all sectors combined, only 1% of households has LSGs in three sectors combined, 4% in two sectors combined, and 25% had an LSG in a single sector
Overall, severe and extreme needs were most frequently primarily driven by LSGs in Food Security and Livelihoods and WASH (40% and 39% of households with a MSNI score of 3 or 4, respectively). There was, however, some variation between assessed areas in terms of primary drivers of needs. In rural areas, while Food Security and Livelihoods emerged as the most common primary driver of high MSNI scores, Health was the second most common sector to drive needs, while WASH emerged as the second most common sector to drive needs in urban areas.
Protection continues to be an issue for most households, especially those with 5 km of the contact line. Households within 5 km of the contact line more commonly reported knowing of at least one incident related to mines/ERWs in their settlement, while they were also more likely to report that mines/ERWs severely affected the everyday life. Relatively low proportion of households reported being able to access mental health care and post-trauma rehabilitation services if needed.
Households’ economic situation also continues to be a concern, as in 2019, with a large proportion of households reporting cost of health care as an obstacle to accessing health care (for those who tried to access health care), cost of food as an obstacle to accessing food markets, cost of school supplies (for households with school-aged children), and households reporting reducing expenditure on essential healthcare, spending savings, and borrowing food as a coping strategy.