From the field: COVID-19 and the urban poor in Ethiopia – how is the pandemic and the response affecting poor and vulnerable groups? - Maintains

Collecting water from a pond. Dembi, Moyale District, Ethiopia, April 2006.
Credit: Daniel Cima/American Red Cross

Findings from qualitative exploratory interviews with Civil Society Organisations (CSOs)

Maintains is about to start an in-depth study of the impact of COVID-19 and control measures on poor households and vulnerable groups in urban settings in Ethiopia. In this blog, originally posted on the OPM site, Donna Harris and Zoma Mesfin describe findings from preliminary interviews with key informants, along with the key issues which emerged and how these will be explored in the upcoming Maintains study.

Key takeaways:

  • Many of the service users of the CSOs interviewed are among the most vulnerable groups, who live on their daily wages. Limited access to transportation and restrictions on their movement have seriously affected their ability to find income, directly impacting their food security. Women and children are struggling the most with the loss of income.
  • Although health institutions remain open and communities are able to access routine health services, many are avoiding these facilities for fear of contracting the virus. This is also true of maternity services, where some women are choosing to give birth at home without the presence of skilled birth attendants.
  • Although urban and rural communities are aware of how to mitigate the risk of spreading and contracting COVID-19, they are not able to put them into practice due to a lack of clean water and access to sanitation products.
  • All schools across Ethiopia will remain closed for the remaining academic year (Ethiopian academic year runs from September to July and schools are now closed until September 2020). While children from wealthier households who attend private schools are provided with ample resources and access to the education materials, children from poor households barely access any form of education.

The aim of this study was to explore the extent to which COVID-19 and associated government measures, such as physical distancing, movement restrictions and lockdowns, affected the ability of the urban poor and vulnerable to access health services, education and meet their food and nutrition needs.

Overall impact of movement restrictions and other government measures on poor and vulnerable groups

So far, movement restrictions have severely impacted the users of the CSOs questioned. The vast majority are among the most vulnerable populations and live on their daily income. Movement restrictions and limitations of transportation have severely affected their ability to find income, which has directly impacted their food security. All modes of transport have reduced seating capacity by 50%, and apart from buses, all have increased their fares by at least twofold. Buses are usually packed with passengers standing, doubling the number of passengers. Most low-income households use buses for their availability and low fares, but with capacity severely reduced without an increase in frequency, waiting times are now unimaginable. Vulnerable groups including the poor and internally displaced persons (IDPs) have had to limit their movement as they cannot afford the inflated transport costs or withstand the long waiting times. They have had to adapt and limit their movement to distances achievable on foot.

Knowledge and practice around COVID-19 and impact on health seeking behaviour, particularly women and children

Service users are quite well-informed on how to mitigate the risk of spreading and contracting COVID-19 through several mass media campaigns. Many respondents noted Ethio Telecom’s initiative of replacing the normal dial tone when calling to COVID-19 related messaging with themes including hand washing and the importance of social distancing. Although knowledge appears high, they are not able to put this into practice due to lack of water and expensive sanitary materials (e.g. hand sanitizer and soap). Social distancing has posed additional difficulties for the disabled communities, who need to be in close contact with others to live their daily lives. Social distancing has been especially hard on migrant communities, specifically daily labourers who often rent a single room between seven or eight people. Health facilities are open, and the community is able to access routine health services, yet many are choosing not to. This is mainly attributed to the fear of contracting the virus and subsequently being taken to a quarantine centre. Some women have chosen to give birth at home without a skilled birth attendant for this very reason.

Effects on education and the communities (religious practices, social norms, perception of outsiders and safety within the community)

All schools across Ethiopia are closed for the remaining academic year (the Ethiopian academic year runs from September to July and schools are now closed until September 2020). Both public and private institutions have tried to ensure their students are accessing education within their homes. Students who attend private schools are usually of more affluent households and during the pandemic are receiving tailored services including the provision of worksheets and educational material through messaging applications like Viber, WhatsApp, and Telegram. Students attending public school are most often from poor households and are not receiving tailored services, yet are able to access education through radio and television programs. There are two main challenges that public students are facing: first, a lack of access to both televisions and radios, and the second, that scheduling was only disseminated once and many are not aware of the stations and times of the programs.

In communities where social/physical distancing is being practised, social and religious norms are changing, particularly in how people solve conflicts, seek support and celebrate religious holidays. Both Christians and Muslims have adapted and celebrated both the Easter and Ramadan holidays in the confinement of their homes. Many people are frustrated because they are not able to fulfil their spiritual obligations. Many noted that the community is frustrated that religious institutions are closed, while cafes and restaurants are still open. During the pandemic, many have reported a lack of safety and security, a rise in crime has been attributed to the loss of jobs. Outsiders have been seen as potential threats; migrants – specifically domestic workers have faced difficulty finding employment.

What we have learned from this small study?

At the national level and compared to many other countries, Ethiopia seems to be coping rather well with the pandemic, with relatively small numbers of cases and only six deaths at the time of writing (4th June 2020). The government has not imposed a strict lockdown, at least not uniformly across the country, although there are movement restrictions in most places. Key findings that have emerged from our study suggest that these initial measures have already disproportionately affected the poor, especially women and those who rely on daily income. The rise in public transport fares and reduced seating capacity means people have to queue for a long time, making social distancing even more challenging and increasing the risk of the spread of the virus. Women and children are the biggest losers from COVID-19 as they lose income, resort to giving birth at home, skip routine immunisations, with children not getting the education they need. Moreover, even though poor people appear to be well-informed, they are not able to practice preventative measures such as handwashing due to lack of clean water and sanitation items being unaffordable. Many people do not follow social and physical distancing as the needs to secure income and maintain livelihoods outweigh the risk of contracting the virus. These are crucial findings in terms of the appropriateness and effectiveness of preventative measures amongst the poor and vulnerable groups and how policymakers may want to reflect and adapt their policies during the pandemic.

Future study

This preliminary study is part of a larger panel study (also funded by DFID) which will examine, in more depth, the impact of COVID-19 and government measures such as movement restrictions, physical distancing and others, on poor households and vulnerable groups (including refugees and IDPs) in urban areas of 10 cities in Ethiopia (Addis Ababa, Mekelle, Dire Dawa, Adama, Gambella, Bahir Dar, Jijiga, Bulehora, Logia and Semera). The larger panel study aims to conduct high frequency qualitative phone interviews, over a period of six months from June to November 2020 with around 300 households (urban poor that include daily labourers, small businesses, and IDPs and refugees where possible), CSOs/NGOs, local governments, health facilities and health workers across the 10 cities.

We will share all findings from the in-depth Maintains study in a series of reports and accompanying blogs. If you have a specific interest in this area and want to find out more, please email maintains@opml.co.uk.

Read the full exploratory study report here.

This exploratory study, funded by the UK Department of International Development (DFID) under OPM’s Building Resilience in Ethiopia (BRE) programme, was conducted with 15 participants from 10 Civil Society Organizations (CSOs) and five Hub Managers (in the Northern, Eastern, Western, Southern, and Central regions of Ethiopia) who are apart of DIFID’s Civil Society Protection Programme Phase 2 (CSPP2). 

This blog was written by Donna Harris, OPM consultant and Zoma Mesfin, a consultant on the Building Resilience in Ethiopia (BRE) Programme.

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