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COVID19 and its prevention in internally displaced person (IDP) camps in Somalia:

Impact on livelihoods, mental health and wellbeing

​

Farah Isse Mumin�

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Background

  • In many African countries and zooming to HoA, apart from the lives lost, COVID19 had a serious socio-economic impact

​

  • Main livelihood means of people living in IDP (2.6 M) camps include
    • Humanitarian aid
    • Daily undertaking by traveling to the city markets and sea-ports
    • livestock and/or crops cultivation

​

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Problem

  • Government directives may negatively impact vulnerable communities living in the internally displaced camps
  • Because of their low economic status, handwashing practices can be challenging to observe
  • High risk that COVID19 may increase mental health burden and depression due to
    • Overlap of pre-existing economic, security and health challenges
      • Fears and movement restrictions

​

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Justification

  • There is an urgent need to understand how people in IDPs are coping with COVID19
  • There is always a lack of urgency in mental health support during crises
  • The evidence and the data generated will help
    • Government
    • NGOs
    • Donors and other stakeholders in the frontline

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OBJECTIVES

  1. Assessing COVID19 knowledge, attitudes and practices of Somalia’s internally displaced people
  2. Assessing the impact of COVID19 on livelihoods of internally displaced communities in Somalia
  3. Assessing the impact of COVID19 on the mental health and wellbeing of Somalia’s internally displaced people

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Methodology

  • Study Area
  • Target population

​

c

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Inclusion Criteria

  • Male and female breadwinners aged 18 years or above AND
  • Residents in selected IDP settlements in Mogadishu, Hargeisa, Garowe and Baidao

​

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Sampling design

 

CITY

IDP POPULATION

STUDY SAMPLE

No. households

Population proportional to size

No. settlements

Sample

Baido

58,907

0.36

5

195

Garowe

7,336

0.04

1

39

Hargeisa

28,473

0.17

3

117

Mogadishu

70,635

0.43

6

234

TOTAL

165,351

​

15

585

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Methods

  • A detailed semi-structured questionnaire
  • Mental health and wellbeing standardized tools
    • The World Health Organization Wellbeing Index (WHO-5)
    • Patient Health Questionnaire-9 (PHQ9)

Data collection tool

Server

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COVID-19 knowledge

  • Over 85% of the respondents heard COVID19 and correctly identified
    • Symptoms
    • Transmission routes

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Treatment options identified

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Decreased Services

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Livelihood Impact

  • Food price surged after COVID-19
  • >80% of households reached earn less than 10$ weekly

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Mental Health Impact

  • WHO-5
  • The mean WHO-5 score was 44.2 out of 100 (SD 24.4).
  • Seventy percent of participants had a raw score of ≤52, suggesting a majority were potentially experiencing clinical depression

​

PHQ-9 Category

Raw PHQ-9 score (minimum – maximum)

Percentage of respondents with raw score in range

None

0 – 4

0.3

Mild

5 – 9

4.8

Moderate

10 – 14

16.5

Moderately Severe

15 – 19

33.4

Severe

20 – 27

45

PHQ-9

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Mental health and hand hygiene

​

Response

High depressive symptoms

Low depressive symptoms

p-value

​

​

n

%

n

%

​

Handwashing practices and attitudes

Has the way you wash your hands changed since you learned about COVID?

Yes

321

70.5

86

68.0

0.66

No

135

29.5

40

32.0

Of those that reported a change: (i.e. positive behaviour change)

​

​

​

​

​

​

Wash hands more frequently

Yes

285

92.2

77

92.8

1

No

24

7.8

6

7.2

Wash hands for longer than before

Yes

195

63.0

58

70.1

0.3

No

114

37.0

25

29.9

Use soap now whereas before they did not

Yes

92

29.6

50

60.7

<0.001

No

217

70.4

33

39.3

Use jug to pour clean water whereas before used bowl (sharing with other people)

Yes

93

30.2

45

54.0

<0.001

No

216

69.8

38

46.0

Current practice (i.e. positive behaviour)

​

 

​

 

​

​

Wash hands with jug to pour clean water

Yes

209

45.6

74

58.3

0.012

No

249

54.4

53

41.7

Wash hands under running water

Yes

61

13.3

39

30.7

<0.001

​

No

397

86.7

88

69.3

Wash hands with soap

Yes

224

48.9

92

72.6

<0.001

No

234

51.1

35

27.4

Respondents reported that hand washing was not easy/difficult

Yes

124

27.1

59

46.5

<0.001

No

334

72.9

68

53.5

Impact of COVID-19/restrictions on purchasing power

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Mental health and purchasing power

​

Response

High depressive symptoms

Low depressive symptoms

p-value

​

​

n

%

n

%

​

Impact of COVID-19/restrictions on purchasing power

Because of COVID-19, I find it more difficult to pay rent 

Agree/strongly agree

174

47.9

70

62.8

0.007

Neutral/disagree/

strongly disagree

190

52.1

41

37.2

Because of COVID-19, I find it more difficult to buy food 

Agree/strongly agree

389

87.0

97

78.3

0.0218

Neutral/disagree/

strongly disagree

58

13.0

27

21.7

Because of COVID-19, I find it more difficult to buy medicine 

Agree/strongly agree

350

82.4

100

81.2

0.79

Neutral/disagree/

strongly disagree

75

17.6

23

18.8

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Conclusion

  • Significant COVID19 impact on
    • Household income
    • Humanitarian delivery
  • Severe to moderate depression symptomatology further complicated by the COIVD19 restrictions
    • Connection between hand hygiene practices and mental health
    • Paying rent, food prices surge and mental health

​

  • Durable solutions for livelihoods and mental health support are needed in IDP camps

​

​

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HORN Partners

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