Child & Family Tracker - UNICEF

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Child & FamilyTrackerTracking the Socio-Economic Impactof COVID-19 on Children andFamilies in NepalBaseline FindingsPhoto credit: UNICEF Nepal

Content This presents the first in a series The following are the findings of thefirst in a series of monthlyhousehold surveys to track thesocio-economic multi-sectoralimpact of COVID-19 on childrenand families in Nepal As such, this first survey issue,carried out at the end of May 2020,establishes the baseline for themonthly surveys to be carried outand issued over the coming months Where available, the monthlyhousehold survey data will besupplemented by relevant childrelated data from other sourcesHouseholdcharacteristics(gender, ethnicity, caste,place of residence,employment, income,disability)Livelihood lossesImmediate needs(Food, WASH, fueletc.)Access to socialprotectionAccess toNutritionAccess toWASHAccess toeducationChild exploitation(Child labour,trafficking, prostitution,child marriage)Access tohealth servicesViolence againstchildren (GBV,corporal punishment,mental health)COVID-19 awareness& behaviour

Survey Methodology 85% of municipalities were covered by the survey Sample size: 7,500 households with at least one child (survey covered 42,244 people-38%children) Data quality: Whipple’s index for age 123, which is good for telephone interviewing. Sample was nationally and provincially representative. Some findings can be disaggregated at the district level and some even for the ward level. Geospatial projections are also possible at municipality level.

Properties of the sample: ethnicity & provincial distributionDISTRIBUTION OF RESPONDENTS BY ETHNICITYThe sample can besegmented according to keydimensions such asethnicity, income group,province, place of residence,gender and disability status.DISTRIBUTION OF RESPONDENTS BY PROVINCE

Properties of the sample: employment & income groupingVARIATION IN % EMPLOYED IN SECTORS BY INCOME .00%20.00%20.00%10.00%0.00%0.00%Below 10K10-20K20-30K30-50KTrad. AgricultureSelf EmployedShop KeeperMigrant LaborModern AgrPvt IndustryServicesUnemployedUnskilled Labor50K % HOUSEHOLD MEMBERS EMPLOYED BY SECTOR DISTRIBUTION OF RESPONDENTS BY INCOME GROUPAgriculture employs 71% of the working population.27% of the households have members who had paying jobs (e.g. teacher,government job, NGO employee and other similar private organizations).21% of the households have members who are engaged in unskilled labour(e.g. daily wage labour, sweeper, household labour).Most of those engaged in unskilled labour and in traditional agriculturebelong to the bottom two quintiles. Those in public services are better off.Compared to other ethnic groups, Hill Brahmins have the highestrepresentation in the top income quintile.

Properties of the sample: Persons with disabilities14% of households have members who have functional limitations – prevalence varies by income group,province and place of residence. 1 in 5 family members with functional limitations are children.% REPORTING FUNCTIONAL LIMITATIONSBY INCOME GROUP% REPORTING FUNCTIONAL LIMITATIONSBY PROVINCE21%16%18%All14%Sub-Metropolitian City14%15%15%12%% REPORTING FUNCTIONAL LIMITATIONBY RESIDENCE12%12%12%12%12%10%15%Ages of household members withfunctional limitationsBelow the age of 2Between 2 and 5Between 5 and 18Above the age of 18SudurpaschimKarnaliProvince 5GandakiBagmatiProvince 2Province 1Rural Municipality13%MunicipalityBelow 10KN183817387910-20K20-30K30-50K50K Metropolitian City Families belonging to low income groups, living inKarnali or in rural municipalities, are more likely tohave someone with functional limitations.10%

Livelihood Losses55% of respondents reported earnings or livelihood losses due to lockdownProvince 2, those from the 2nd income group and those living in sub-metropolitan cities reportedthe highest rates of earning and livelihood losses77%55%55%% RESPONDENTS REPORTING EARNINGS ORLIVELIHOOD LOSSES (BLUE YES 55%)61%57%55%61%Rural Municipality% REPORTING EARNINGS OR LIVELIHOODS LOSSESBY PROVINCE54%AllSub-Metropolitian CityAllKarnali35%Province 5GandakiBagmatiProvince 236%48%Sudurpaschim59%48%Province %49%Metropolitian CityBelow 10K10-20K20-30K30-50K% REPORTING EARNINGS ORLIVELIHOOD LOSSES AND PLACE OFRESIDENCE50K % REPORTING EARNINGS OR LIVELIHOOD LOSSESBY INCOME GROUP51%MUNICIPALITIES WITH HIGHEST % OF RESPONDENTSREPORTING LOSSES (DARK BLUE)

Immediate Needs1/3rd of households reporting shortage of food, medicines, cooking fuel, soap and toothpasteDon’t Know 1%Others3%No shortage64%Cooking Fuel5%Medications8%Soap & Toothpaste10%Menstrual Hygiene Products2%Water for Handwashing/Hygiene2%Drinking Water1% Food28%0%10%20%30%40%50%60%70%IMMEDIATE NEEDS OF HOUSEHOLDS(% RESPONDING YES) 32%35%27%30%26%25%20%16%15% 10%5%0%Metropolitian CityMunicipalityRural Municipality Sub-MetropolitianCity% REPORTING FOOD SHORTAGE AND PLACE OFRESIDENCERural municipalityhouseholds havehigher need for foodcompared to otherresidence areas.Triple impact of premonsoons (lean season),lockdown supplydisruptions , demandand behaviour changedue to loss of earningsCoping mechanisms:using savings, copingthrough agriculturalwork, food rations beingprovidedRelatively earlystages of lockdown,needs might be moreacute nowSudurpaschim37%Karnali23%Province 522%Gandaki16%Bagmati25%Province 249%Province 118%% REPORTING FOOD SHORTAGE AND PROVINCEAvailability of ORS and paracetamol in thehouseholds50%35%ORSParacetamol

Immediate NeedsA large proportion of households are not able to confirm availability of key items of their regular diet.Constrained access to proteins, dairy products and some vegetables% REPORTING AVAILABILITY OF DIETARY ITEMSOil78%Salt83%Rice82%Eggs28%Beans, Peas, Lentils Foods from them77%Dark Green & Leafy Vegetables74%White potatos and other root foods76%Pumpkins, Carrots, Squash, Sweet Potato (Yellow inside)46%Milk, Yogurt, Cheese53%Wheat flourMeat, Fish, Chicken, Mutton, etc68%15%

Family Coping PatternsThe majority of families are borrowing or depleting their savings.This varies across income groups. Family and friends provide crucial support.76%75%66%57%55%46%43%42%29%20%16%Below 10K16%10-20K20-30KBorrowFINANCIAL COPING BEHAVIOR IN RESPONDENT’S HH (%REPORTING YES)15%Savings13%13%30-50KExpenditureCHANGES IN COPING PATTERNS ACROSS INCOMEGROUPS50K

Social Protection - Social Security AllowancesChild grantsDisability grantsOld age pensionsWidows 86%10.00%0.00%% DISTRIBUTION OF SSA RECIPIENTS ACROSS PROVINCESBelow 10K10-20K20-30K30-50K50K INCOME GROUP AND PERCENT OF RESPONDENTS RECEIVING DIFFERENTTYPES OF SOCIAL SECURITY ALLOWANCES IN THEIR HOUSEHOLDS 21% of households included in the survey received SP allowances. Only 12% of families reporting functional limitations receive disability allowances. More than half of the respondents receiving SP allowances came from Provinces 5,Sudurpaschim (7) and Province 2, implying a pro-poor slant in SSAs. Classifying the different types of social security allowances by income group of recipienthouseholds shows that child grants are more redistributive than other SSAs.

Social Protection31% of SSA recipients reported “greater difficulty” in receiving payments due to lockdownNepalOther excluded31%SudurpaschimTarai Janajati23%20%50K Tarai BrahminKarnali70%26%Tarai DalitProvince 529%GandakiBagmatiProvince 249%Province 131%Hill Dalit31%Hill Janajati32%31%25%Hill Brahmin26%30%% REPORTING DIFFICULTIES IN RECEIVING SSABY ETHNICITY 27% Child grantsDisability grantsOld age pensionsWidows pensions% REPORTED DIFFICULTIES IN RECEIVING SSA BY TYPE29%20-30K31%10-20K35%32%Hill Chetri28%% REPORTING DIFFICULTIES IN RECEIVING SSABY PROVINCE53%Hill Newari32%30-50K30%Tarai Madhesi21%26%30%Below 10K31%% REPORTED DIFFICULTIES IN RECEIVING SSABY INCOME GROUPThe largest number of those reporting difficulties belong to Province 2.Tarai Brahmins (70%) and Tarai Madhesis (50%) are significantly more likelyto experience difficulties underscoring the predominance of geography/placeof residence effect over caste.Respondents from 2nd income group are most likely to report difficulties needs further unpacking.

NutritionMore than 1 in 5 respondents indicated that their children are experiencing changes in dietary intake.Children in low income households are more likely to experience changes in dietary intake.Reduce amountof food at meals2%No food in 24hrs.0%% REPORTING CHANGES IN CHILDREN’S DIETARYINTAKE DURING LOCKDOWN BY INCOME GROUP32%30%No change74%25%22%Reducenumber ofmeals3%12%Reducevariety ofmeals21%CHANGES IN CHILDREN’S DIETARY INTAKE DURING LOCKDOWNBelow 10K10-20K20-30K30-50KThis is a key worrying observation indicating a behavioural response to increased hardship and uncertainty.Some of these changes could indeed be related to seasonal shortages.50K

Nutrition90% of mothers of children under two reported breastfeeding at the time of the survey (May 2020).Province 5 has significantly lower rates.Breastfeeding mothers from the lowest income group are most likely to reduce the number of mealsper day (16%) during lockdown.% Mothers not reducing Below 10K10-20K20-30K30-50K50K % OF BREASTFEEDING MOTHERS NOT REDUCING THE NUMBER OFMEALS DUE TO LOCKDOWNProvince 1Province 2BagmatiGandakiProvince 5VARIATION IN BREASTFEEDING PREVALENCE BYPROVINCEKarnali

Nutrition1 in 5 children are experiencing changes in the frequency of breastfeeding.Children under two in provinces 5, Karnali & Sudurpaschim are the most likely to face changes in thefrequency of breastfeeding 18% are breastfeeding more - apositive fallout from lack ofaccess to other foods - with thehighest percentage of mothersin Sudurpaschim and Karnalibreastfeeding more often. 5% breastfeeding less; moremothers in Gandaki feedingless. 77% breastfeeding with samefrequency; fewer mothers inSudurpaschim & Karnalibreastfeeding the same.CHANGES IN BREASTFEEDING FREQUENCY BY PROVINCE (% MORE, %LESS, % SAME)Sudurpaschim63%34%3%Karnali63%32%4%Province 573%Gandaki24%77%Bagmati16%80%Province 210%20%30%Feeding same40%6%4% 6%86%0%7%13%91%Province 13%11%50%Feeding more60%70%Feeding less80%90%4%100%

Access to WASHAccess to drinking water during lockdownAccess to water for cooking, handwashing andbathing during lockdown67%72%33%28%Households who did not have enoughHouseholds who had enough drinkingdrinking waterwaterN 462 Interactive Voice ResponsesHad difficultlesDid not have difficultiesN 434 Interactive Voice Responses- 33 % of households did not have enough drinking water during lockdown.- 28 % of households had difficulties getting water for cooking, handwashing and bathing dueto lockdown.Note: WASH findings are from Interactive Voice Response of an additional 400 households (a component ofthe telephonic survey)

Access to Health Services54% of respondents would seek treatment at health posts while another 35% would go for treatmentto a hospital in the city but there is variation by income and otherbackground characteristics66%57%51%46% 46%Neighborhoodpharmacy or healthclinic5%Will not go out1%53%37%36%31%24%DK1%Other4%Health Post54%Below 10K10-20K20-30KCity HospitalHome visit fromdoctor or nurse0%30-50K50K Health PostVARIATION BY INCOME GROUPCity 00%5.52%% RESPONDENTS SEEKING TREATMENT ATDIFFERENT FACILITIESMetropolitian CityMunicipalityCity HospitalRural MunicipalitySub-Metropolitian CityHealth PostVARIATION BY RESIDENCE

Access to Health Services83 per cent of the households with pregnant women had access to ANC but the average masksdifferences by province, residence and ethnic group.92%91%90%82%81%74%Other excluded80%73%Tarai JanajatiTarai Brahmin84%50%SudurpaschimKarnaliProvince 5GandakiBagmatiProvince 2Province 1Tarai Dalit% PREGNANT WOMEN WITH ACCESS TO ANC BY PROVINCESub-Metropolitian CityTarai Madhesi77%76%Hill NewariHill Dalit92%79%Hill Janajati84%90%Hill ChetriRural Municipality79%Hill BrahminMunicipality89%80%87%% PREGNANT WOMEN WITH ACCESS TO ANC BY ETHNICITYMetropolitian City88%% PREGNANT WOMEN WITH ACCESS TO ANC BY RESIDENCEPregnant women in Province 2, Rural Municipalitiesand Tarai Brahmins have the least access to ANC.

Education95% of respondents reported their children had stopped going to school.29% reported their children had access to distance learning but less than half were using it.Children in low incomehouseholds are less likely tostudy at schools that havebeen offering distancelearning and more likely notto be able to use ldren’s continued loss ofaccess to education in lowincome families might haveirreversible negative effects onthe country’s economy5%0%Below 10K10-20KHas DL20-30KHave & Using DL30-50K50K This will adversely affect thepotential of the country toensure equitable andsustainable development.VARIATION IN THE USE OF DISTANCE LEARNING (DL) BY INCOME GROUPS (% HAVING ACCESS TO DL AND % USINGDL)

EducationChildren in 52 % of households stopped studying during lockdown.93% of children who were studying during lockdown experienced various difficulties withstudying at the time of the 0.00%Below 10KHOW CHILDREN WERE STUDYING DURING LOCKDOWN10-20K20-30K30-50KOthersTime watching TV & PlayingLack of edu itemsNo access to schoolHH ChoresToo much internetLow interestLack of energy0.00%50K % REPORTING DIFFICULTIES IN STUDYING BY DIFFICULTY TYPE ANDINCOME GROUPIncreased screen time, low interest & energy plus stoppingstudying – emerging signs of distress?While 1/12 families report psychological distress in children,issue comes out more explicitly over educational activitiesVariation by income group: tv internet more likely to affectchildren in upper income groups

(Child) Protection70% of respondents know where to report domestic himKarnaliProvince 5GandakiBagmatiProvince 2Province 165%Below 10K10-20K20-30K30-50K50K % KNOWING WHERE TO REPORT DOMESTIC VIOLENCE BY PROVINCE79%% KNOWING WHERE TO REPORT DOMESTIC VIOLENCEBY INCOME GROUP78%71%62%Tarai BrahminTarai DalitTarai MadhesiTarai NewariHill NewariHill DalitHill JanajatiHill ChetriHill Brahmin54%59%54%53%Endangered67%66%Other excluded65%Tarai Janajati71%% KNOWING WHERE TO REPORT DOMESTIC VIOLENCE BY ETHNICITYKnowledge gap likely to be the highest inProvince 5, among the lowest two incomegroups, certain Tarai ethnic groups, otherexcluded ethnic groups and Hill Janajatis.To be read in conjunction with ProtectionCluster assessments pointing out to the factthat 65% of girls did not know GBVresponse mechanisms.

Child Protection1 in 10 respondents reported an increase in physical violence in the household.5% of respondents reported noticing an increase in violence towards children in their communities.All91%50K SudurpaschimKarnali92.31%Sub-Metropolitian City93.38%88%89%30-50K89.03%Rural MunicipalityProvince KProvince 289.86%91%91.14%89.29%89%Province 1% REPORTING NOT BEING INVOLVED INPHYSICAL VIOLENCE BY PROVINCE94%Below 10K89.43%% REPORTING NOT BEING INVOLVED INPHYSICAL VIOLENCE BY INCOME GROUPMetropolitian City86.53%% REPORTING NOT BEING INVOLVED INPHYSICAL VIOLENCE BY RESIDENCETo be read in conjunction with other protection data sets, including helpline data. Possiblyobserving exposure to personal violence in Sudurpaschim the 4th highest income group& in metropolitan cities compared to other areas; needs tracking

Child ProtectionSome children continue helping their families earn income even during lockdown.Percentage of households with children who work tohelp in earning income35%31%30%25%20%15%10%8%5%0%Children who helped their families Children who continue helping theirearn income before lockdownfamilies during lockdown 31 % of 7,500 respondents reported that theirchildren worked to help them earn income beforelockdown. During lockdown, children in 8% of thehouseholds were working at the time of thesurvey. Among currently working children, 76 % are thosewho worked before and continue working duringlockdown. 24 % of currently working children might havestarted to work to help their families earn incomedue to financial distress caused by lockdown.

Child ProtectionChildren’s contribution to HH income: disaggregation14%50K 30K% HHS WITH CHILDREN EARNING INCOME BY PROVINCE(SINCE LOCKDOWN)% HOUSEHOLDS WITH CHILDRENEARNING INCOME BY INCOME GROUP(SINCE LOCKDOWN)9.03%Sub-Metropolitian CityBelow 10KRural iProvince 5GandakiBagmatiProvince 210-20KProvince 17.22%5%Metropolitian City7%% HOUSEHOLDS WITH CHILDREN EARNINGINCOME BY RESIDENCE (SINCE LOCKDOWN)Respondents from Bagmati province, those in lower income groups and those living in ruralmunicipalities tend to report a higher share of children earning income during lockdown –also heavily correlated with loss of family earnings (trend analysis forthcoming).

Child Protection/ Child Mental Health ( to be monitored)Respondents’ assessments of whether children were experiencing psychological stress in theirhousehold suggests that 1 in 12 households had children who were experiencing at least one type ofstress.% RESPONDENTS SAYING YES FOR EACHCATEGORY Likely to be under reported. Respondents reported that fearand anger are the main stresssymptoms faced by children. Significant variation bybackground characteristics ofrespondent. Respondents with childrenworking in the household are morelikely to report children feelinganger or fear.

COVID-19 Awareness and ActionsDon’t knowDon't Know0%NothingOthers3%OthersCommunity committees (any)6%Use hand sanitizersHospitals and health centres28%Stay away from people when going outsideNewspapers and Magazines58%Wear masks when going outside78%Stay at homeWard officials or municipality office82%Wash hands with soap frequentlyMobile Ring Tone90%020406080100PER CENT RESPONDING YES FOR EACH ACTION (MULTIPLE RESPONSES ALLOWED)Family Members, Friends, %72%82%0 10 20 30 40 50 60 70 80 90PER CENT RESPONDING YES FOR EACH SOURCE (MULTIPLE CHOICESALLOWED)

Key Insights/ConclusionsLivelihood Losses54% of households reportedloss of earnings or livelihoodsSocial ProtectionImmediate Needsof households reportingshortage of food, medicines,cooking fuel, soap andtoothpaste1/3rdNutrition31% of social securityrecipients experiencedifficulty receiving them20% children experiencingchanges in dietary intakeEducation95% children not attendingschool, 30% of householdsreported schools offeringdistance learningEducationOnly 47% with access todistance learning actually useitDisability14% of households reportedhaving a family member with afunctional limitation; 20% ofthem are childrenCoping Mechanismsincurring debt and depletingsavings (55-44%)Social Protection20% of households reportedreceiving social securityallowancesWASH28 % of the same householdshad difficulties getting water forcooking, handwashing andbathing due to lockdown.Health- only 54% of hh soughttreatment at health centersViolence against children5% of respondents reportednoticing an increase in violencetowards children in theircommunities.Child ProtectionOver 8% of householdscontinue to depend onchildren for household IncomeCOVID 19 Awareness &Behaviour93% risk awareness of Covid1990% are hand washing

Lessons learnt andnext stepsAdvantages ofdigital solutions butalso caveats difficult to establishrapport withrespondents.Design of SMARTquestions (learningprocess).Only reportedsummary/descriptive findings ofbaseline (premonsoon lockdown).Forthcoming:Regressions geospatial mapping.S

Hill Newari Tarai Madhesi Tarai Dalit Tarai Brahmin Tarai Janajati Other excluded % REPORTING DIFFICULTIES IN RECEIVING SSA BY ETHNICITY 27% 30% 32% 31% Child grants Disability grants Old age pensions Widows pensions % REPORTED DIFFICULTIES IN RECEIVING SSA BY TYPE The largest num

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