Researchers

Daniel Stein, Heather Lanthorn, Emma Kimani, Rico Bergemann

Abstract

Little is known about the effects of large cash transfers in contexts of protracted displacement. This includes the influence of cash transfers on health behaviors during shocks such as the COVID-19 pandemic. IDinsight plans to develop evidence in this area by building on an on-going impact evaluation of GiveDirectly’s unconditional cash transfer program in Kiryandongo refugee settlement, Uganda. The team is gathering data on the COVID-19 public health measures that refugee households are implementing, the health services they are able to access, and their understanding of COVID-19 and preventative measures. By comparing refugee households who have already received their GiveDirectly cash transfer with refugee households who will receive their cash transfer in the near future, we will develop better evidence on how unconditional cash transfers influence refugee household knowledge, behaviors, and access to health services during a pandemic.

Project Outcomes of Interest

Health behaviors, Health services

Partners

IDInsight, Elrha, GiveDirectly, UK Foreign, Commonwealth & Development Office, Wellcome, UK National Institute for Health Research (NIHR)

Key Findings

Mini-Report (Round 1 of 3):

• Respondents were well-informed about key COVID-19 symptoms and protective behaviours.
• Most respondents had access to water, soap, and masks to prevent contraction of COVID-19.
• Most households reported experiencing increased food prices, job loss, business closure, or increases in prices of business or farm inputs between March and July 2020. Respondents also reported difficulties in accessing food. During this same time, food prices were elevated and monthly food and cash rations had been decreased. 
• Most respondents who needed to access health facilities were able to access them. However, some of the respondents noted challenges such lack of supplies in health facilities and lack of money to afford services or drugs.
• Most households reported being food insecure in July 2020. However, respondents who received USD 1000 unconditional cash transfer prior to the lockdown had marginally stronger food security than households who were randomly chosen to receive their transfers later and have not yet received them. 
• Respondents who received USD 1000 unconditional cash transfer prior to the lockdown had higher psychological wellbeing compared to yet-to-receive households. However, most respondents expressed feelings of sadness and fear. These feelings were associated with a lack of resources to provide for their households and fear of contracting COVID-19.

Mini-Report (Round 2 of 3):

• Respondents reported to have left home 3.2 days a week on average; one-third reported maintaining social distancing each time they left the house. Four-fifths reported wearing masks when out; mask- wearing was 6%-points higher in the treatment group than the control group.

• We did not detect higher food consumption in households with transfers relative to the control group. Overall weekly household consumption is 118.48 USD PPP (with 7 household members on average.)

• Respondents most commonly report burglary and water disputes as key community safety and security concerns. More than half of respondents also felt unsafe to go to the market and to fetch water. The majority of respondents (63%) reported that they had experienced, witnessed or heard of burglary (including theft and muggings) occurring in the settlement in the past seven days.

• Half of the respondents (51%) reported experiencing either quarreling, intimidation, or damaging of personal property among adults in their household while 30% of the households reported experiencing all three dimensions of intra-household conflict in the past seven days.

Mini-Report (Round 3 of 3):

• Perceived likelihood of contracting COVID-19 and mask wearing stayed steady over time (at 60% and 85% respectively in October 2020). However, recognition of asymptomatic transmission and self- reported social distancing dropped since July 2020, from 47% for both asymptomatic transmission and self-reported social distancing to 33% and 32%, respectively, in October 2020.

• Households that received cash transfers reported being less food insecure compared to households that are yet to receive cash transfers. However, most households across groups reported cutting down the size of meals or skipping meals in the last seven days.

• Overall, respondents had mixed opinions on whether and how alcohol consumption had changed since baseline or since lockdown. More male respondents (28%) reported consuming alcohol in the last month compared to female respondents (16%). There was no statistically significant differences in drinking behavior among treatment and control households.

• Respondents reported that they felt good about inter-refugee and refugee-host relations. Compared to October 2019, refugees reported that inter-refugee and refugee-host relations have improved. However, most respondents noted that overall, the host community treated refugees unfairly with the pricing of goods in markets run by Ugandans.

Link to Results

• Mini-Report (Round 1 of 3) for Preliminary Results (September 2020)
• Mini-Report (Round 2 of 3) for Preliminary Results (October 2020)
• Mini-Report (Round 3 of 3) for Final Results (December 2020)

Impact Goals

Project Data Collection Mode

Implementing Organization

IDInsight

Results Status

Results