Health and development status of displaced women and children

HARON NJ IRU

CAPSTONE MENTORSPROF. LUCA ROSI

PROF. FRED COCOZZELL I

Health and Development status of Displaced Women & Children in

Kenya

College of Liberal Arts and SciencesCentre for Global Development

May 2013

Outline

• Introduction and Rationale

Part 1

• Objectives and Methodology

Part 2

• Findings

Part 3

• Conclusion

Part 4

WHO ARE WE TALKING ABOUT?THE NUMBERS

THE DISTRIBUTIONWHY WOMEN AND CHILDREN?

Introduction & Rationale

Who is a refugee?

A person who "owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his nationality, and is unable or, owing to such fear, is unwilling to avail himself of the protection of that country or return there because there is a fear of persecution..."

1951 Refugee Convention

Who is an IDP?

Persons or groups of persons who have been forced or obliged to flee or to leave their homes or places of habitual residence, in particular as a result of or in order to avoid the effects of armed conflict, situations of generalized violence, violations of human rights or natural or human-made disasters, and who have not crossed an internationally recognized State border.

Guiding Principles on Internal Displacement

Total population of concern [to UNHCR]

The 2011 Statistical Yearbook, UNHCR

UNHCR prote

cted/a

ssist

ed ID

PS

Refuge

es

Statele

ss pe

rsons

IDPs who

retur

ned h

ome

Others

of co

ncern

Asylum

seek

ers

Repatr

iated

refug

ees

-

2.0

4.0

6.0

8.0

10.0

12.0

14.0

16.0

18.0

15.5

10.4

3.5 3.2

1.4 0.9 0.5

Population of concern

Tota

l (m

illio

ns)

35.4 million

41.6 million

Women and Children

Women69%

Men31%

Children47%

Adults53%

84%Women & Children

The 2011 Statistical Yearbook, UNHCR

IDP and Refugee Global Trends

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 201110

15

20

25

30

25 26.4

16

15.2

IDPs Refugees

Year ending

Pers

ons

(Mill

ions

) 6%

5%

The 2011 Statistical Yearbook, UNHCR

4%

41.6 million

Kenya

Population: 40 million

Category Total % of Country Popln.Refugees 626,710 1.6%IDPs 280,000 0.7%Total 906,710 2.3%

Dadaab72%

Origin country Percent

Somalia 87.0

Sudan 4.8

Ethiopia 4.5

Others 3.7

Total 100.0

WHY AND HOW

Objectives and Methodology

Objectives

The health and development status of displaced women & children living in Kenya

1Understan

d

What is the situation?

What is being done?

2Compare

What should be happening

based on universal

expectations?

2Recommend

What should be done to address the

gaps?

Methodology

Health Development

Reproductive Health Education

Malnutrition Economic Opportunities

Communicable diseases Energy & Water sources

Mental health Housing

Child mortality rate Insecurity

Descriptive studySecondary data

10 Arbitrary indicators

HEALTH STATUS OF DWC• Reproductive health• Malnutrition• Communicable diseases• Mental health• Child mortality

Findings

Reproductive health

Family planningSafe motherhoodSexual and gender based violence

Low level of FP utilization (32%) Unintended pregnancies / attempted abortions 20% seek antenatal care Home deliveries (53% had at least 1) SGBV underreported

Reproductive health

Challenges Long distance to facilities

Immunization coverage (~ 80%) Language barrier Insecurity

No Minimum Initial Service Package (MISP)

Protocol on the Prevention and Suppression of Sexual Violence against women and children

Malnutrition

Young et al., 2004

Malnutrition

Prevalence of malnutrition in Kakuma

Communicable diseases

MalnutritionPoor sanitationCongestion Weak social networksReduced privacy

Malaria Diarrhoea RTIs Skin HIV (DRC) STIs0

10

20

30

40

50

60

7062

31

14.78 7.6 vs 3.1

4

Communicable diseases

Prev

alen

ce (%

)

Mental Health

Posttraumatic stress disorder RR for women = 3.8 75% children

¾ IDPs depressed

1:500,000 (psychiatrist to population)0.01% Ministry of health budget

Child mortality rates

Poor living conditions

DRC Chad NonDisplaced -

1.0

2.0

3.0

4.0

5.0

6.0

7.0

8.0 7.0

4.1

0.3

Dea

ths

/ 10,

000

child

ren

Kenya data not available

DEVELOPMENT STATUS OF DWC• Education• Economic opportunities• Energy and water sources• Housing• Insecurity

Findings

Education

Enrollment Dadaab: 68% Kakuma: 50% High school: 1/3 IDPs:?

Displaced children(90%)

Other

children

(10%)

Limited access to education (Globally)

Women’s Commission for Refugee Women and Children, 2004

Education

1989 Convention on the Rights of the Child1951 UN Refugee ConventionInter-Agency Network for Edu. in Emergencies stds

Every additional year of formal education for males reduces their risk of engaging in conflicts by 20%

Basic Education Coalition, 2004

Economic opportunities

High unemployment rates 40% nationwide Above 80% in camps Worse among displaced women

Income sources Casual work in farms and homes Sale of water and firewood Sale of food rations Early marriages Prostitution

Energy & Water

Most scarce commodities in camps: firewood/water Time consuming Exposure to risks

Rape, diarrhea, RTIs… Conflicts

Housing

60% of refugees have adequate dwellings Worn out tents Poor ventilation Occupancy: 8

UNHCR 2011 year book

IDP camp

Insecurity

UNHCR Jan. 2013

• Amongst themselves• Stress• Resources• Space

• To local communities• ~• Allegiance

“All refugees and asylum seekers living in urban areas [must] move to the camps in North Eastern and Rift Valley provinces.

Those from Somalia … to report to Daadab refugee camp… those from other countries … to Kakuma.”

TuesdayDecember 18, 2012

HAVE WE DONE OUR BEST TO PROTECT HEALTH AND PROMOTE DEVELOPMENT OF

DISPLACED WOMEN AND CHILDREN?

Conclusion

Conclusion

1. Essential services are missing or inadequate2. Whatever we provide we provide in isolation3. We are not spending enough to identify the gaps

0%

20%

40% 38%

20%14% 11% 10% 3% 3%

Bu

dg

et a

lloca

tio

n

IOM, 2012

IOM budget (2013)- Total USD 1.24 million- SSA: 36% - Kenya: 8.8%

Conclusion

4. Partial / no implementation of international standards

Why universal principles?

Focus on dignity of human lifeSolidarity with the poor & vulnerable emphasizedClear roles (e.g. CST principle of subsidiarity)Community participation (e.g. CRC)Minimum standards for refugees and IDPs

servicesEasier to monitor implementation

What should we urgently do?

1. Bridge the gaps Provide adequate shelter Provide basic health care Routine M&E

2. Prevent conflict recurrence3. Conduct more research4. Kenyanize universal principles

Thank you