This document summarizes the health and development status of displaced women and children in Kenya. It finds that essential services are inadequate or missing, and standards are only partially implemented. Reproductive health services are underutilized due to barriers. Malnutrition, communicable diseases, and mental health issues are prevalent. Education enrollment is low. Economic opportunities and living conditions like housing, water, and security are poor. The conclusion calls for bridging gaps in services, preventing conflict recurrence, more research, and implementing international standards to better protect displaced populations in Kenya.

1. H A R O N N J I R U
C A P S T O N E M E N T O R S
P R O F . L U C A R O S I
P R O F . F R E D C O C O Z Z E L L I
Health and Development status of
Displaced Women & Children in
Kenya
College of Liberal Arts and Sciences
Centre for Global Development
May 2013

2. Outline
• Introduction and Rationale
Part 1
• Objectives and Methodology
Part 2
• Findings
Part 3
• Conclusion
Part 4

3. W H O A R E W E T A L K I N G A B O U T ?
T H E N U M B E R S
T H E D I S T R I B U T I O N
W H Y W O M E N A N D C H I L D R E N ?
Introduction & Rationale

4. 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

5. 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

6. Total population of concern [to UNHCR]
The 2011 Statistical Yearbook, UNHCR
15.5
10.4
3.5 3.2
1.4
0.9 0.5
-
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
18.0
UNHCR
protected/assisted
IDPS
Refugees Stateless persons IDPs who returned
home
Others of concern Asylum seekers Repatriated
refugees
Total(millions)
Population of concern
35.4 million

7. 41.6
million

8. Women and Children
Women
69%
Men
31%
Children
47%
Adults
53%
84%
Women & Children
The 2011 Statistical Yearbook, UNHCR

9. IDP and Refugee Global Trends
25 26.4
16
15.2
10
15
20
25
30
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Persons(Millions)
Year ending
IDPs Refugees
 6%
 5%
The 2011 Statistical Yearbook, UNHCR
4%
41.6 million

10. Kenya
 Population: 40 million
Category Total % of Country Popln.
Refugees 626,710 1.6%
IDPs 280,000 0.7%
Total 906,710 2.3%
Dadaab
72%
Origin country Percent
Somalia 87.0
Sudan 4.8
Ethiopia 4.5
Others 3.7
Total 100.0

11. W H Y A N D H O W
Objectives and
Methodology

12. Objectives
The health and development status of displaced women & children living in Kenya
1
Understand
What is the
situation?
What is being
done?
2
Compare
What should
be happening
based on
universal
expectations?
2
Recommend
What should
be done to
address the
gaps?

13. Methodology
Health Development
Reproductive Health Education
Malnutrition Economic Opportunities
Communicable diseases Energy & Water sources
Mental health Housing
Child mortality rate Insecurity
Descriptive study
Secondary data
10 Arbitrary indicators

14. H E A L T H S T A T U S O F D W C
• Reproductive health
• Malnutrition
• Communicable diseases
• Mental health
• Child mortality
Findings

15. Reproductive health
 Family planning
 Safe motherhood
 Sexual 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

16. 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

17. Malnutrition
Young et al., 2004

18. Malnutrition
Prevalence of malnutrition in Kakuma

19. Communicable diseases
 Malnutrition
 Poor sanitation
 Congestion
 Weak social networks
 Reduced privacy
62
31
14.7
8 7.6 vs 3.1
4
0
10
20
30
40
50
60
70
Malaria Diarrhoea RTIs Skin HIV (DRC) STIs
Prevalence(%)
Communicable diseases

20. 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

21. Child mortality rates
 Poor living conditions
7.0
4.1
0.3
-
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
DRC Chad NonDisplaced
Deaths/10,000children
Kenya data not available

22. D E V E L O P M E N T S T A T U S O F D W C
• Education
• Economic opportunities
• Energy and water sources
• Housing
• Insecurity
Findings

23. 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

24. Education
 1989 Convention on the Rights of the Child
 1951 UN Refugee Convention
 Inter-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

25. 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

26. Energy & Water
 Most scarce commodities in camps:
firewood/water
 Time consuming
 Exposure to risks
 Rape, diarrhea, RTIs…
 Conflicts

27. Housing
 60% of refugees have adequate dwellings
 Worn out tents
 Poor ventilation
 Occupancy: 8
UNHCR 2011 year book
IDP camp

28. Insecurity
UNHCR Jan. 2013
• Amongst themselves
• Stress
• Resources
• Space
• To local communities
• ~
• Allegiance

29. “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.”
Tuesday
December 18, 2012

30. H A V E W E D O N E O U R B E S T T O P R O T E C T H E A L T H
A N D P R O M O T E D E V E L O P M E N T O F D I S P L A C E D
W O M E N A N D C H I L D R E N ?
Conclusion

31. Conclusion
1. Essential services are missing or inadequate
2. Whatever we provide we provide in isolation
3. We are not spending enough to identify the gaps
38%
20%
14%
11% 10%
3% 3%
0%
20%
40%
Emergency,
Operations
and Post-
crisis
Migrant
Assistance
Immigration
and Border
Management
Labour
Migration and
Human
Development
Migration
Health
Migration
Policy and
Research
Multiregional
Budgetallocation
IOM, 2012
IOM budget (2013)
- Total USD 1.24 million
- SSA: 36%
- Kenya: 8.8%

32. Conclusion
4. Partial / no implementation of international standards

33. Why universal principles?
 Focus on dignity of human life
 Solidarity with the poor & vulnerable emphasized
 Clear roles (e.g. CST principle of subsidiarity)
 Community participation (e.g. CRC)
 Minimum standards for refugees and IDPs services
 Easier to monitor implementation

34. What should we urgently do?
1. Bridge the gaps
 Provide adequate shelter
 Provide basic health care
 Routine M&E
2. Prevent conflict recurrence
3. Conduct more research
4. Kenyanize universal principles
Thank you