COVID-19 IMPACT MONITORING ROUND 4-5 FEB 2021 Publication Date UGANDA BACKGROUND In June 2020, the Uganda Bureau of Statistics (UBOS), with the support from the World Bank, officially launched the High Frequency Phone Survey (HFPS) to track the impacts of the pandemic monthly for a period of 12 months. The survey aimed to recontact the entire sample of households that had been interviewed during the Uganda National Panel Survey (UNPS) 2019/20 round and that had phone numbers for at least one household member or a reference individual. The first round (baseline) of the survey was conducted in June 2020, the second round was conducted in July/August 2020, the third round was conducted in September/October, the fourth round was conducted in October/November 2020 and the fifth round was conducted in February 2021. Of the 2,421 households targeted, 2,227 households were interviewed in round 1, and 2,199 among them were interviewed in round 2, 2,147 households were interviewed in round 3, 2,136 households were interviewed in round 4 and 2,122 households were interviewed in round 5 representing a 95 percent response rate be- tween rounds 5 and 1. This brief presents findings from the fourth and fifth rounds of the HFPS. BEHAVIORS, KNOWLEDGE AND CONCERNS RELATED TO COVID-19 The prevalence of safe practices continued to de- were also less concerned about getting very sick from cline in rounds 4 and 5 accompanied by a decline in COVID-19 despite growing number of COVID-19 cases in concerns about getting seriously ill from COVID-19. Uganda during this period. Thus, the share of respondents Respondents were asked about preventive COVID-19 who were very worried about themselves or other mem- measures that they followed during last seven days. Figure 1 bers of family getting seriously ill from COVID-19 declined demonstrates a large decline in safe practices in rounds 5 from 58 percent in June 2020 to 26 percent in February and 4 vis-a-vis round 1. For example, the share of respond- 2021 (Figure 2). Elderly respondents (age 65+) were more ents who avoided large groups of people declined from 91 likely to be very worried compared to respondents younger percent in June 2020 to 41 percent in February 2021. Fe- than 44 years. male respondents were significantly more likely to follow safe practices than men in February 2021. Respondents Figure 1. Prevalence of safe practices in the last week across Figure 2. Respondents who were very worried about possibility about rounds, (% of respondents) themselves or other members getting seriously ill from COVID-19 by residence and across rounds, (% of respondents) 1 https://www.nigerianstat.gov.ng/ COVID-19 IMPACT MONITORING Respondents demonstrated high willingness to be vaccinated if safe and free vaccine was available and to be tested for COVID-19 for free. Share of respondents who would agree to be vaccinated if free and safe vaccine was available increased from high 84 percent in October/November 2020 to 88 percent in February 2021. Respondents were also asked in February 2021 about their willingness to get tested for free for COVID-19. About 93percent agreed to be tested for free (Figure 3). However, this share drops substantially to 63 percent if payment for test is required with a pronounced gap between the poorest and the richest households based on pre-COVID-19 consumption quintiles. Among those who agreed to pay for test, the average amount to be paid was about 10,800 Ugandan shillings (UGX) with larger amounts ready to be paid by urban residents (about 13,650 UGX) and among those living in the Western region (12,650 UGX) and those from the richest pre-COVID-19 quintile (about 13,830 UGX). Figure 4. Share of respondents who think that they have or had Figure 3. Share of respondents willing to get tested for free, willing COVID/19 and share of respondents whose friends/relatives/neighbors to pay to get tested and amounts ready to be paid in round 5, (% have been infected with COVID-19 in round 5, (%) and UGX) About seven percent of respondent believed that they had or had had COVID-19 and every fifth reported knowing a friend, relative or/and neighbor who have been infected with COVID-19. Respondents were asked if they had or had had COVID-19 regardless having done the test or not (Figure 4). In February 2021, about seven per- cent of respondents believed to have COVID with a slightly higher share in the Northern region (11%). Incidence of po- tential illness was correlated strongly with the level of education of respondent. Thus, among respondents without for- mal education the incidence was about one percent compared to ten percent among those with complete secondary edu- cation and above. Respondents were also asked about friends/relatives/neighbors who had been infected with COVID-19 (tested or not). About 19 percent of respondents knew someone infected with COVID-19 in February 2021. This share was substantially higher in urban areas (26%), the Central region (29%) and among those with higher education level (33%). MENTAL HEALTH About five percent of respondents had clinically significant depression according to the fifth round of the phone survey with much higher prevalence among respondents without formal education and elderly. Patient Health Questionnaire-8 was administered in the fifth round to screen and measure the severity of depression. The tool rates the frequency of the symptoms which factors into severity score and measures prevalence of depression. About five percent of respondents had depression1 in February 2021 (Figure 5). The incidence of depression was signifi- cantly higher among respondents without formal education (13%) and among elderly respondents (age 65+). Depression was also correlated with employment status and negative changes in business income. Thus, among those respondents who did not work during last seven days, 10 percent had depression compared to only 4 percent among those who worked. https://www.nigerianstat.gov.ng/ 2 COVID-19 IMPACT MONITORING Figure 5. Respondents with depression in round 5, (%) ACCESS TO EDUCATION About half of households had children between age three and eighteen engaged in any learning activities in round 5 with much higher prevalence among respondents from higher pre-COVID consumption quin- tiles and urban areas. In February 2021, about 50 percent of households with children between 3 and 18 years report- ed having them engaged in such any learning or education activities. Engagement in learning activities was different across pre-COVID-19 consumption per adult equivalent quintiles (Figure 6). Thus, the level of engagement reached 66 percent among the richest fifth quintile and dropped to 39 percent among the poorest first quintile. Substantial gap existed across residence as well. Households with children located in urban areas reported 59 percent engagement compared to 47 percent among rural residents. Parental support was widespread among respondents in February 2021, but with lower incidence of edu- cational activities (reading, counting) compared to other parental activities (singing, telling stories) and differences across pre-COVID-19 quintiles and residence. Respondents were asked if during the last 15 days they or any household members of age 15 and above spent time with children by playing, reading books, telling stories, bring- ing them outside, counting and drawing at home. Absolute majority of respondents (97%) reported at least one activity. However, selected activities such as counting and reading, which depended on parents’ education level had lower inci- dence. For example, only 26 percent of respondents read books or counted with children compared to 66 percent of respondents who played with children or 47 percent of respondents who sang songs. Reading and counting with children differed also across consumption quintiles and geographic locations with higher incidence among households from the top quintile and urban areas. https://www.nigerianstat.gov.ng/ 3 COVID-19 IMPACT MONITORING Figure 6. Households with children (age 3-18) engaged in any learning or education activities in round 5, (%) Adding more days to school calendar was the most tively) compared to Central and Eastern regions (39% and popular strategy among respondents to cope with 34% respectively). No significant differences were found lost time during the academic year. Respondents were across consumption quintiles and across urban and rural are- asked in the fifth round to report their opinion about the as. best strategy to catch up for the lost time and classes during the 2019/2020 academic year. Adding more days to school calendar (43%) and repeating the missed school period (31%) were the most popular strategies. Results were different across regions. The option of adding days was more popular in the Northern and Western regions (48% and 63% respec- SAFETY NETS & FOOD SECURITY INDEX Social assistance increased over the last two rounds from twelve to seventeen percent mainly composed of in-kind non-food transfers and covering almost half of households in the Northern region. The share of re- spondents received social assistance increased between the fourth and fifth round from 12 to 17 percent accordingly (Figure 7). In both rounds, households from the poorest pre-COVID-19 consumption per adult equivalent quintile were more likely to benefit from social assistance. Coverage by social assistance was the highest in the Northern region where almost half of households were getting social transfers. On average, 90 percent of the social assistance was composed of in -kind non-food transfers. The Government appears to be the main source of financial support, averaging around 90% of the social assistance over both rounds. Figure 8. Evolution of severe and moderate composite FIES Figure 7. Respondent access to social assistance across rounds 4 and 5 index among respondents across all rounds, (%) by quintiles and regions, (%) https://www.nigerianstat.gov.ng/ 4 COVID-19 IMPACT MONITORING Severe and moderate food insecurity indices (FIES) did not change between September/October 2020- February 2021 being the highest among the poorest households and those residing in the Eastern region in the fifth round. After a sharp decline in food insecurity in July/August 2020, there were not changes in the shares of se- vere and moderate food insecure households during last three rounds (Figure 8). About 22 percent of households were moderately insecure and about 2 percent of households were classified as severely food insecure in round 5. Moderate food insecurity was the highest among households in the Eastern region (33%) and among households from the poorest pre-COVID-19 consumption quintile (26%). EMPLOYMENT Employment among respondents reached the pre-lockdown levels in July/August and remained about 86- 89 percent afterwards with work stoppages mostly occurring in agriculture sector. Respondents were asked to report labor activities in the last seven days from round 1 (June 2020) to round 5 (February 2021). After significant job stoppages in June 2020, employment rates returned to the pre-lockdown level of 86 percent in July/August 2020 (Figure 9). Since then, employment rates have been changing slightly around 86-89 percent between September 2020-February 2021. During the strict lockdown period between March and July 2020, absolute majority of work stoppages were hap- pening in non-agricultural sectors (81%), while in round 5 conducted in February 2021 83 percent of work stoppages were in agriculture sector probably related to seasonal changes in the labor market (Figure 10). Figure 9: Respondents reporting working activities across rounds 1-5, Figure 10: Respondents stopped working by sectors across rounds 1, 4 (%) and 5, (%) Ownership of family business has been recovering since June 2020, but not fully especially with regards to business revenues. The share of households with open family business was increasing between rounds 2 and 4 but stagnated afterwards with about 10 percent of businesses still being temporarily closed (Figure 11). The same picture was observed with regards to business revenues which showed positive dynamics, but with a sizable share of businesses re- porting less revenues compared to the previous month in rounds 4 and 5 (Figure 12). Respondents with family businesses in the fifth round were also asked to compare revenues with the monthly average before the lockdown. Still about 50 percent of households reported business revenues to be lower than the average before the lockdown. Figure 11: Family business status across rounds 1 ,4 and 5, (% of Figure 12: Family business revenues in rounds 1 ,4 and 5 compared to previous month (% of households with business) households) https://www.nigerianstat.gov.ng/ 5 COVID-19 IMPACT MONITORING In terms of household income, more respondents before the pandemic started. As results are reported for the indicated closing the gap between the current in- key income sources, we can see the largest positive changes come levels and income before March 2020, but in- in non-farm business income in February 2021. However, come levels have not recovered for many households more than 50 percent of households still reported business yet. Respondents were asked how current income com- income to be lower compared to the pre-March level. Over- pared to the average monthly income during the 12 months all, income from farming and wage employment were closer period prior to the school closure in March 2020. Figure 13 to the pre-lockdown levels either because these two income shows the share of households who reported that current sources were affected the least or recovered faster. level of income was the same or above the levels observed Figure 13. Share of households with income in rounds 4 and 5 above or the same compared to the average monthly income during the 12 months period prior to the lockdown, (% of households receiving income) AGRICULTURE Only a small share of households had to change planting activities due to COVID-19 in October/ November 2020. Households engaged in planting were asked if they had to change planting activities because of changes in the country or community due to coronavirus (Figure 14). Compared to June 2020, when about 23 percent of households reported changing planting activities in the first agricultural season due to COVID-19, only five percent had to change planting in the second agricultural season as reported in October/November 2020 with the largest share in the Northern region (12%). Since almost 70 percent of households did not start planting in round 5 conducted in February 2021, the changes in planting activities are not reported for this round. Figure 14: Changes to crop planting activities in round 4, (% of households) 6 COVID-19 IMPACT MONITORING Ability to sell agricultural products improved slightly those who needed, the share of households who were not in February 2021 compared to October/November able to sell declined from 10 to 7 percent in rounds 4 and 5 2020 and was much better compared to the period accordingly mainly due to improved ability to sell in the Cen- from January-June 2020. Households, who normally sold tral and Eastern regions. Even though not strictly compara- their agricultural products, were asked if they had needed ble, households engaged in farming and livestock were asked and had been able to sell since last call any products from in June 2020 about the need and ability to sell since the be- their farms in rounds 4 and 5. About 53 percent of house- ginning of 2020. About 40 percent of them were not able to holds needed to sell agricultural products in October/ sell when needed which was much higher compared to November 2020 and this share increased to 77 percent in rounds 4 and 5. February 2021 (Figure 15). In terms of ability to sell agricul- tural products among Figure 15: Need and ability to sell agricultural products since last call in round 4 and 5 and since beginning of 2020 in round 1, (% of house- holds working on the farm in round 1/ normally sell their products in rounds 4 and 5) Data Notes: the UGANDA COVID-19 High Frequency Phone Survey Fourth and Fifth Round were implemented by the Uganda Bureau of Statistics (UBOS) in October-November 2020 and February 2021. This survey is part of a World Bank global effort to support countries in their data collection efforts to monitor the impact of COVID-19. A World Bank team from the Development Data Group and the Poverty and Equity Global Practice pro- vided technical support. This survey is the third of a planned 12 waves of the COVID-19 High Frequency Phone Survey of households in Uganda. 2,421 successfully interview households from the 2019/20 Uganda National Panel Survey were contacted and 2,136 households in the Fourth Round and 2,122 households in the Fifth Round were fully interviewed. These same house- holds were and will be contacted in all subsequent waves of the COVID-19 High Frequency Phone Survey. The data are representative at the regional and national level and survey weights were calculated to adjust for non- response and undercoverage. For further details on the data, visit https://www.worldbank.org/en/ programs/lsms 7