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Emergencies

Introduction

While Uganda has hosted refugees continuously since 1945, the last five years have seen unprecedented increases in the caseload, particularly regarding refugees coming from South Sudan. As of October 2017, Uganda is host to 1.38 million refugees, the majority (61 per cent) below the age of 17 and about 29 per cent females of reproductive age.[1] The refugees have been settled in 11 different locations in north western, mid-western and south-western Uganda, representing an average of 26 per cent of the population in hosting districts, with the proportion of refugees to nationals in West Nile reaching almost parity (47 per cent).[2]

 

National laws, policies and plans

Uganda has enshrined refugees’ rights within the 2006 Refugee Act and the 2010 Refugee Regulations. In addition, Uganda’s National Development Plan (NDP II 2015/16 - 2019/20) integrates refugees into national development planning through the Government of Uganda Settlement Transformation Agenda (STA). As a result, refugees live alongside host communities in settlements and have access to services on par with nationals.

 

Vulnerability and strained social services

Despite Uganda’s progressive refugee policy and the contribution of refugees to local economy, refugee-impacted areas remain vulnerable. The high rate of poverty among refugees and limited economic opportunities contribute to higher poverty levels in refugee-hosting areas, which are often remote and less developed. Refugees and host communities are disproportionately affected by changing livelihood patterns and pressure on the already constrained social services and resources such as land, water, housing, and education and healthcare services.[3] [4]

 

Shifting the paradigm

The perception that the needs of displaced persons can only be addressed through humanitarian means can impede or delay the achievement of sustainable solutions and lead to protracted displacements and a cycle of dependence on humanitarian assistance.[5] A framework for durable solutions must be put in place by providing both humanitarian and long-term development assistance to both refugee and host communities. The goal must be to strengthen their self-reliance and thereby increase their contribution to local development, decrease the need for long-term care and maintenance programs, and reduce the potential for conflict between hosts and refugees.[6] Health in particular has been identified as key area for joint refugee/ host provision.[7]

 

The New York Declaration and its aftermath

The 2016 New York Declaration for Refugees and Migrants consolidates a comprehensive multi-stakeholder response that strengthens the humanitarian-development nexus, facilitates cooperation across institutional mandates and, by helping to build self-reliance and resilience, lays a basis for sustainable solutions.[8] The Declaration set the basis for the Comprehensive Refugee Response Framework (CRRF) as a coordinated endeavor of the relevant States, UN agencies and other stakeholders that spans from reception and admissions to support for immediate and on-going needs, assistance for local and national institutions and communities receiving refugees; and expanded opportunities for solutions.[9]

 

In Uganda, the Refugee and Host Population Empowerment (ReHoPE) strategy, a multi-year joint framework for self-reliance and resilience programming for refugee and host communities in refugee-hosting districts, contributes to the implementation of the CRRF. The ultimate goal is to provide economic assistance and social service provision and for it to be mainstreamed through the district local governments in order to improve equity, relevance and cost effectiveness, in ways that support refugees and host communities without distinction. [10] [11]

 

The UNFPA approach

UNFPA’s engagement in development and humanitarian response derives from the International Conference on Population and Development (ICPD) Programme of Action (PoA), which placed women’s rights, empowerment and health at the center of development efforts.[12] The PoA affirmed that the right to sexual and reproductive health (SRH) and the right to live free of sexual and other forms of gender-based violence apply to all people at all times, including populations affected by or recovering from emergencies. Multiple international agreements and conventions, special sessions of the United Nations General Assembly, and Security Council Resolutions 1325, 1820, 1889, and 1960 reaffirm these rights and emphasize the central role of women in peace-building efforts and post-conflict reconstruction.

 

UNFPA Uganda’s engagement in development and humanitarian response is guided by the UNFPA Strategic Plan, 2018-2021 and its principle of strengthening cooperation and complementarity among development, humanitarian action and sustaining peace.[13] UNFPA Uganda is also guided by the Humanitarian Response Strategy, which mainstreamed humanitarian mechanisms across UNFPA programmes and operations for a coherent, well-coordinated, effective and sustainable response.[14]

 

The New York Declaration commits Member States to: “Ensure [that responses] mainstream a gender perspective, promote gender equality and the empowerment of all women and girls, combat sexual and gender-based violence, provide access to sexual and reproductive healthcare services, [taking] into consideration the different needs, vulnerabilities and capacities of women, girls, boys and men.”[15] Gender issues, particularly sexual violence and other forms of gender based violence (GBV) are often more acute in humanitarian, poor and vulnerable settings. The provision of emergency sexual and reproductive health and rights (SRHR) services is a key component of essential life-saving activities, as well as of the ongoing service provision that needs to be prioritized for vulnerable populations. This needs to be done in a manner that strengthens the resilience and addresses the needs of both refugee and host communities. 

 

In order to achieve this in the area of SRHR and GBV, UNFPA Uganda seeks to:

  1. Promote humanitarian preparedness within health and social sectors development planning at national and district levels;
  2. Support local and national ownership and capacity development of district local governments regarding service delivery in complex / mixed population settings, including transitioning of humanitarian health and social sector responses;
  3. Provide life-saving as well as ongoing response to SRHR and GBV needs of refugee and host populations through a continuum of response approaches across the humanitarian-development nexus that include the Minimum Initial Services Package (MISP), the GBV minimum standards, health system strengthening and delivery of services using pre-existing district structures;
  4. Strengthen multi-sectoral planning, programming and synergies, with a particular focus on integration of SRHR and GBV prevention and response in livelihood and other socio-economic interventions to enhance resilience-building for refugee and host populations;
  5. Improve data availability, accessibility and analysis on population dynamics, SRHR and gender equality across the humanitarian-development nexus for evidence-based decision-making;  
  6. Strengthen joint humanitarian-development coordination and institutional collaboration at national and sub-national level on SRHR and gender equality;
  7. Lead and foster evidence-based advocacy and policy support on strengthening of the humanitarian-development nexus in SRHR and gender equality, including regarding legislation, financing, efficiently implementation and evaluation across the humanitarian-development nexus.
  8. Foster the continued engagement of refugee and host communities in advocating, planning and monitoring SRHR and social sector service delivery in a participatory and empowering manner.

 

UNFPA’s approach to strengthening the humanitarian-development nexus in the area of SRHR and GBV is expected to deliver the following results:

 

Result 1: Increased access to, and utilization of, quality maternal and newborn health services

Response to reproductive health in crisis and vulnerable settings has been identified as a priority area for intervention within UNFPA’s Reproductive Rights and Sexual and Reproductive Health Framework (2008). UNFPA Uganda is therefore committed to coordinating and supporting the provision of basic but essential SRHR services in acute crisis while also setting foundation for the provision of a comprehensive set of SRHR services in the transition phase through investments in health system strengthening that include, among others, human resource investments for safe deliveries. Alignment of this strategy with the Global Programme to Enhance Reproductive Health Commodity Security (GPRHCS) facilitates pre-positioning of reproductive health commodities during preparedness, enhanced logistics support for timely delivery of commodities during crisis and sustainable comprehensive services in post-crisis situations. As part of disaster preparedness measures, UNFPA also supports national capacity building to integrate reproductive health and GBV prevention and response into disaster plans and responses. In particular, UNFPA has (1) trained OPM staff (as National Disaster Management Unit) and MOH on integration of SRH, HIV prevention, and GBV in disaster responses; (2) trained national trainers on the Minimum Initial Service Package for reproductive health in emergencies; (3) trained focal points in 13 Regional Referral Hospitals on MISP and (4) trained District Health Teams of selected districts on advocating and implementation of MISP for reproductive health in emergencies.  The country office through the Moroto DO has also provided technical support in the development of District Contingency Plans for the Karamoja region.

 

Result 2: Increased prevention of HIV and STIs, and enhanced access to quality HIV- and STI-prevention services especially for key populations at risk

Prevention of HIV and STIs and improved access to curative services especially for key populations in humanitarian and vulnerable settings has been identified as a priority area for UNFPA. UNFPA contributes to the coordinated efforts to respond to the HIV epidemic by providing emergency response through implementation of the Minimum Initial Services Package (MISP), while building the long-term capacity of the health system to prevent and treat HIV and STIs through training on clinical management of rape, other SRHR clinical areas, and logistical management and forecasting. In addition, UNFPA’s provision of equipment and supplies serves refugee and host populations from emergency to post-crisis situations. Finally, UNFPA plays an active role in HIV prevention and response coordination platforms for GBV and reproductive health, seeking to enhance synergies, continuum of care, and sustainability of the response.

 

Result 3: Advancement of gender equality and reproductive rights, particularly through advocacy and implementation of laws and policy

UNFPA spearheads efforts to determine the scope of sexual and other forms of gender-based violence affecting people in humanitarian and vulnerable settings, and to address them at every level. UNFPA Uganda spearheads a wide range of services, including counselling, post-rape treatment, legal support, assistance with livelihoods, and support through sexual and reproductive health programmes targeting both refugees and host communities. UNFPA also incorporates violence prevention in its humanitarian preparedness, emergency and post-crisis response, reaching out to vulnerable adolescents and youth, incorporating male and boy engagement in gender equality efforts, and working closely with faith-based networks and cultural leaders to reinforce support systems. UNFPA Uganda also works with partners to develop tools to help more effectively address gender-based violence in humanitarian and post-crisis contexts, including the National Gender Based Violence Database used across humanitarian and development settings.

 

Result 4: Improved data availability and analysis around population dynamics, SRHR and gender equality

Improved availability and integration of demographic, gender and health data across humanitarian and district-level development planning for more effective and sustainable response is a priority area for intervention for UNFPA Uganda. The UNFPA 2010 Guidelines on Data Issues in Humanitarian Crisis Situations provide a basis for strengthening data availability and utilization across preparedness, contingency planning, emergency response and recovery. In particular, UNFPA works to enhance the capacity of relevant national and district actors to ensure that timely and good quality data and information is produced, shared and used for decision-making for strengthened response across refugee and host communities and through all stages of humanitarian-development response.

 

Result 5: Improved coordination and sustainability of the humanitarian response in the area of SRHR and GBV.

UNFPA advocacy and programming in the areas of demography, SRHR and GBV are increasingly multi-year and multi-sectoral, support both host communities and refugees at household, community and systems level to increase resilience, strengthen the social service delivery system under government leadership, emphasize coordinated delivery through local governments, and foster active community participation. UNFPA’s approach is guided by the principles of the ReHoPE strategy. The nexus for the SRH and GBV integrated response is being strengthened across existing coordination mechanisms for refugee-hosting and other vulnerable areas where UNFPA plays an active role. This includes, in particular, government-led emergency tasks force activities including meetings and inter-agency joint needs assessments set up to respond to specific disasters and the Northern Uganda Recovery and Development (NURD) group.[16]

 

Result 6: Strengthen participatory approaches and innovative solutions that address the SRHR and GBV challenges faced by refugees and host communities across the humanitarian-development continuum

UNFPA Uganda is committed to leveraging innovation, whether related to technology, products and processes, new forms of partnership, and the use of the ideas and coping capacities of crisis-affected people (whether refugees or host communities) to adapt and improve the humanitarian and development response in vulnerable and refugee-hosting settings. In order to do so, UNFPA works in collaboration with Government and other relevant stakeholders to enhance the use of bottom-up user-centered design, indigenous innovation, and participatory methods to build on the capacities of affected populations. The 2014 OCHA report on Humanitarian Innovation: The State of the Art provides the guiding basis for UNFPA Uganda’s innovation in the areas of SRHR and gender equality, by putting affected communities and local systems at the heart of the innovation process.

 

Result 7: Enhance the identification of root-causes and implementation of long-lasting solutions through engagement of young people

UNFPA Uganda is committed to building peaceful, cohesive and resilient refugees and host communities across Uganda through the full and meaningful participation of young people in peacebuilding, as guided by the UN Security Council Resolution 2250 on Youth, Peace and Security. In order to do so, UNFPA works with government and other relevant stakeholders to enhance refugee and host community youth’s contribution to participation, partnerships, prevention and conflict resolution through capacity building and creation of opportunities that will enable young people to realize their full potential in life are a prerequisite for their engagement in civic affairs.

 

 

[1] OPM and UNHCR. (2017). Refugees and Asylum Seekers in Uganda: Demographic Breakdown by Country of Origin. 30 September 2017. Kampala: Registration Unit, UNHCR RO Kampala.

[2] GOU and UNHCR (2017). “Refugees and Nationals per District, October 2017.” Uganda Refugee Response Portal. Kampala.

[3] Walton, R. (2012). “Helpdesk Research Report: Preventing conflict between refugees and host communities.” Governance and Social Development Resource Center.

[4] UNCT and World Bank. (2016). Refugee and Host Community Empowerment (ReHoPE) Strategic Framework, Uganda. Kampala.

[5] UNHCR, UNDP and World Bank. (2012). Transitional Solutions Initiative. Concept note. Available at: http://www.unhcr.org/4e27e2f06.html

[6] Steputat, Finn (2004). “Refugees, security and development: Current experience and strategies of protection and assistance in the 'region of origin.'” DIIS Working Paper, No. 2004:11.

[7] OECD (2001). The DAC Guidelines: Helping Prevent Violent Conflict. Paris: Organisation for Economic Cooperation and Development.

[8] United Nations (2016). New York Declaration for Refugees and Migrants. New York: United Nations General Assembly, 13 September 2016.

[9] UNHCR (2016). Comprehensive Refugee Response Framework: From the New York Declaration to a Global Compact on Refugees. CRR Task Team.

[10] UNCT and World Bank. (2016). Refugee and Host Community Empowerment (ReHoPE) Strategic Framework, Uganda. Kampala.

[11] UNHCR (2017). UNHCR Uganda Factsheet, June 2017. Kampala.

[12] UN (2014). International Conference on Population and Development Programme of Action. New York: UNFPA. Available at: http://www.unfpa.org/sites/default/files/pub-pdf/programme_of_action_Web%20ENGLISH.pdf

[13] UNFPA (2017). UNFPA Strategic Plan, 2018-2021. New York: United Nations Population Fund.

[14] UNFPA (2012). Humanitarian Response Strategy “Second Generation”. New York: United Nations Population Fund.

[15] United Nations (2016). New York Declaration for Refugees and Migrants. New York: United Nations General Assembly, 13 September 2016.

[16] Development partner forum for coordination of the recovery process of northern Uganda and Karamoja region.