COVID-19: perceptions of people in need in Iraq - Ground ...
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Round one: June 2020
COVID-19: perceptions of
people in need in Iraq
Government curfews were instituted across Iraq in mid-March, two weeks after the
first case of COVID-19 was detected in Najaf city, south of Baghdad. By 12 June,
there were 15,414 confirmed cases, and 426 people had died.¹
COVID-19 is compounding existing vulnerabilities for the country’s 250,000
refugees, 1.4 million internally displaced persons (IDPs), and the 4.6 million
people who have returned to their areas of origin. Government and UN officials
are concerned about the healthcare system’s capacity, weakened after decades
of instability and conflict. Restrictions have impacted livelihoods, making it difficult
to adhere to stay-at-home or social distancing policies.
In April and May, as a service to responders and authorities, Ground Truth Solutions
(GTS) – in partnership with the Iraq Information Centre (IIC) – conducted phone
interviews in Arabic with 556 returnees, refugees, and IDPs across Anbar, Dahuk,
Erbil, Ninewa, Salah al-Din, and Sulaymaniyah to gauge their perspectives on
information needs and channels, behaviours, trust, and the economic impact of the
virus. We found that:
• It has become more difficult for people to meet their basic needs.
• Most people (79% of respondents) feel informed about how to protect
themselves and their families from COVID-19, but half of all respondents still
say they need more information about the virus. Some feel unable to separate
fact from rumour.
• People find it difficult to shelter in place, wear facemasks, and practice social In partnership with:
distancing.
Supported by:
H 2H
Catalysts for Change
1
WHO, “Iraq: WHO coronavirus disease (COVID-19) dashboard,” https://covid19.who.int/region/
emro/country/iq.
1Information
The majority of survey respondents (79%) believe they are sufficiently informed about IDP (internally displaced person): refers
how to protect themselves from COVID-19, thanks to health and humanitarian actors’ to someone who was displaced from their
subdistrict between 2014 and 2017, and who
rapid action. In parallel to routine communication and dissemination of key messages
continues to reside in Iraq.
through the IIC and implementing agencies, in April a UNICEF-led campaign
reached nine million people across Federal Iraq and the Kurdistan Region (KRI) with
Refugee: refers to someone who fled their
mobile messaging on COVID-19 prevention.² A Facebook survey suggested this
home and crossed an international border in
campaign was working.³
order to seek protection in Iraq. All refugee
However, when people are inundated with information, they may find it challenging respondents in this survey are Syrian nationals.
to weed out rumours. Close to half (43%) of respondents say they are unable to
distinguish between rumour and fact around the virus. Refugees and returnees find it Returnee: refers to a person who was
more difficult than IDPs. People in Anbar and Erbil find it harder than those in other displaced between 2014 and 2017 but has
governorates. We will be unpacking the reasons for this in our next survey. since returned to their sub-district in Iraq.
Are you able to separate rumours from facts around the Coronavirus? (n=556)
Status
IDP in camp n=135 Note: in this report, error bars are included
21 58 21 representing the margin of error at the 95%
IDP out of camp n=188 confidence level. A 95% confidence interval
19 66 14 is a representation of the spread of the data
Refugee n=67 around the mean. A smaller confidence
31
How has your ability to meet your basic needs changed since the virus started spreading in the world? 55 13 interval
If/when you experience coronavirusindicates less
symptoms, what variance
do you around
think you would do? the
Returnee n=166
Go to health provider mean. If repeated samples were drawn, 95%
57
Worsened
30 74
56 14 of those confidence intervals would include
Who is your main source of information? // What source do you trust the most?
Results in %provider
Call health 26
News media the true population proportion.
Social media No Yes Don’t know
Health providers No change 17 Self−isolation 12
Don' t know
People may feel informed, but not about everything. Around half (49%) of respondents
National government
Nothing 4
still want more information on how to identify symptoms, treatment options, and the
UN/NGOs
Local government
Binary Survey Responses
Improved 9
locations of current cases.
Family/friends
Employer
Other 1
Binary Survey Responses
Do you have enough information on how to protect
Overall, do you believe the measures that have been introduced in your area will reduce the spread of the virus?
Don' t want to answer 0 10 20 30 40 50 60 70 80 0 10 20 30 40 50 60
What do you need more information on inPercent
relation to the Coronavirus?* (n=556) Percent
yourself from the virus? (n=556)
None
n = 556 n = 556
Religious groups Overall, do you believe the measures that have
Dobeen introduced
you have in information
enough your area will
to reduce
protect the spread
yourself of the
from the virus?
virus?
What do you need more information on in relation to the coronavirus? Why are these measures difficult for you?
Community leaders
Community groups
Nothing Nothing 49 AreDo
youyou have
able enough information
to separate
Fear
to protect
rumours from
of missing
yourself
facts around thefrom
aidvirus?
the
coronarvirus? 21 36 79
Other
50 40 30 20 10 0 10 20 30 40 50
Percent
Don’t know Don' t know 15 Other
−40
Are you able to separate rumours from facts around the coronarvirus?
−20
26 0 20 40 60 80
n = 556 Percent
What measures are most important? // What measures are most difficult? No YesNo Don't know Yes
−40 −20 0 20 40 60 80
Identifying symptoms
Identifying symptoms 11 Don' t know 13 Binary Survey Responses
Percent
Hygiene practices
No Don't know Yes
Staying indoors
Treatment 8 11
Are you able to separate rumours from facts around
Treatment Lack of enforcement
Overall, do you believe the measures that have been introduced in your area will reduce the spread of the virus?
Social distancing
Wearing mask
Access Access
to information
to information 7 Don' t want
Do you have enough information 9
to yourself from the virus?
to protect
the Coronavirus? (n=556)
Wearing gloves
0 10 20 30 40 50 0 10 20 30 40
Leaving home for critical tasks only Percent Percent
Are you
n= able
556to separate rumours from facts around the coronarvirus?
28 15 57 n = 556
Crisis-affected
Whatpeople
measures are are
Don' t know
relying
most important? onmeasures
// What news, social
are most difficult?media, and health professionals
Who is your main source of information? // What source do you trust the most?
– their most trusted sources overall₄– to get their information on the virus. Females
−40 −20 0 20 40 60
Those at risk staying indoors
Percent
Hygiene practices 49 6 News media 49 40
Other No Don’t know Yes
appear to trust news media far more than other sources, while the trust gap between
No Don't know Yes
Don' t want to answer
news media and health providers is narrower among males. 43 29 19 11
Staying indoors Social media
50 40 30 20 10 0 10 20 30 40 50
Percent
n = 556
Social distancing
Main information source*
Who is your main source of information? // What source do you trust the most?
43 7
Trusted information source* Health providers 12 18
Wearing mask 33 10 Don' t know 5 9
News media
News media 49 40
Wearing gloves 20 5 National government 3 6
Social media
Social media 19 11
60 50 40 30 20 10 0 10 20 30 40 60 50 40 30 20 10 0 10 20 30 40 50
Percent Percent
n = 556 n = 556
Health providers
Health providers 12 18
News media
Don' t know 5 9
National government
National government 3 6
60 50 40 30 20 10 0 10 20 30 40 50
Percent
n = 556 *Percentages do not total 100 because respondents
2 What measures are most important? // What measures are most difficult? could choose multiple options.
UNICEF, “Iraq: COVID-19 situation report no. 2” (28 April–11 May 2020), https://www.unicef.org/
Hygiene practices
iraq/media/1151/file/IRAQ%20Country%20Office%20COVID%20Sitrep%20Report%202.pdf.
49 6
3
Health Cluster Iraq, “Health cluster bulletin no. 4” (April 2020), https://www.humanitarianresponse.
info/sites/www.humanitarianresponse.info/files/documents/files/iraq_hq_bulletin4_april_2020.pdf.
Staying indoors
4
43 29
2
Ibid.
Social distancing 43 7What do you need more information on in relation to the coronavirus? Why are these measures difficult for you?
Nothing 49 Fear of missing aid 36
Don' t know 15 Other 26
Behaviour What measures do you find most
Identifying symptoms 11 Don' t know 13
important to protect yourself from the
Respondents say8
better hygiene, staying indoors, social distancing, and wearing a
Treatment Lack of enforcement 11
virus?* (n=556)
facemask are the most important measures to prevent exposure to the virus, but they
also find complying
7 with these measures difficult. Only 41% say they have no trouble
Access to information
following guidance around COVID-19. 0 10 20 30 40 50
Don' t want to
0
9
10
49% 20
Increased hygiene practices
30 40
Percent Percent
n = 556 n = 556
Most important measures* Most difficult measures*
What measures are most important? // What measures are most difficult?
43%
Who is your main source of information? // What source do you trust the most?
Staying indoors
Hygiene practices
Hygiene practices 49 6 News media 49 40
Staying indoors
Staying indoors 43 29 Social media 43% 19 11 Social distancing
Social distancing
Social distancing 43 7 Health providers 12 18
Wearing mask
Wearing mask 33 10 Don' t know
33% 5 9
Wearing mask
Wearing gloves
Wearing gloves 20 5 National government 3 6
? If/when you experience coronavirus symptoms, what do you think you would you do?
What measures do you find most difficult
60 50 40 30 20 10 0 10 20 30 40 60 50 40 30 20 10 0 10 20 30 40 50
49
Go to health provider Percent
n = 556 55
to take to protect
Percent
yourself from the n = 556
virus?* (n=556)
g in the world? Asked
Call healthwhat
If/when provider makes
you experience compliance
If/when you coronavirus
experience coronavirus challenging,
symptoms, what
symptoms, doyouyou
what do people
think
think
34
youdo?
you would say
wouldthey fear missing out on
you do?
29
gender aid or services or going without work. They also say enforcement
49 is lacking. Among gender
41%
Go to health provider Go to health provider 14 57
Female
female
Self−isolation
respondents, missing9 out on aid is the primary impeding
55
factor, while male
Female
No difficulty
Male Male
34
respondents
Call health provider
Nothing are more concerned about
2
Call health provider
29 losing access
26
to jobs.
5 gender
These concerns
Self−isolation
Other 9
are
1 Self−isolation
14
unsurprising given delays in cash distributions and the suspension
12 Female
30% Staying indoors
of some2 emergency
1
livelihoods activities due to movement ₅ Male
0 20 40 restrictions. Households 60
Nothing Nothing 4
across Iraq5 are experiencing widespread job Percent losses and challenges in meetingn =their
basic1needs.
Other
₆ Other 1
556
What precautionary measures do you find most difficult to do to protect yourself from the virus? (max 3)
10% Wearing mask
1
70 80 0 0 10 20 20 30 40 40 50
41 60 60
Why do you find these measures difficult?*
None
n = 556
Percent Percent (n=556)
Why are these measures difficult for you?
28
n = 556 49
n = 556 7% Social distancing
What precautionary
Staying indoors measures do you find most difficult to do to protect yourself from the virus? (max 3)
Fear of missing aidaid
Fear of missing 36 33
gender gender
41
None
Female Wearing mask
9
49 Female If/when you experience Coronavirus
5
Other**
Male Other
8
26
28
Male
symptoms, what do you think you would
Staying indoors
Don' t know
Don’t know Don' t know
5
13
33
gender do? (n=556)
9
Wearing mask 10 Female
Social distancing
5
3 Male
Lack ofLack
enforcement
of enforcement 11
57%
8 0 20 40
Don' t know
5 Percent Go to health provider
Don’t wantDon'
to t want to 10 9 n = 556
Social distancing
? (max 3)
50 3 What source
0 do you trust
10 the most for20 information on30 how to protect40 yourself from the virus?
26%
Percent
n = 556
0
News media
20
Percent
40 33 n = 556
Call health provider
Who is your main source of information? // What source do you trust the most? 44
WHO and Health Cluster messaging instructs 23
those who suspect they n = 556
are infected
What source
providersdo you trust the most for information on how to protect yourself from the virus?
12%
Health
gender
to immediately self-isolate
News media
and
13 call the government hotline for further support. But
49 40
gender Self-isolation
33
News media close to 60% of respondents 8 tell us they would go to a health facility – contravening
Female Social media Social media 44 19 11 Female
13
Male
Health providers
this advice – even though 10
the primary
23 barrier to health access among returnees Male
andDon'IDPst know
in the 201913
Multi-Cluster
Health providers
8 Needs Assesment (MCNA) was the gender
high cost 12 18
Social media of healthcare.₇ Only one-quarter
8
UN/NGOs 13
Don' t know
11 say they would call a health provider – possibly Female
5 9
6 Male
because they0 do 10 not know10how. Fewer 20 still would self-isolate.
30 40 50
Don' t know National government
8 3 Percent
6
20 30 40
Why do you find
11 these measures difficult?* (n=556)
60 50 40 30 20 10 0 10 20 30 40 50
n = 556 “There is no doctor, no disinfectant in the
UN/NGOs
n = 556
6 Why are these measures difficult for you?
Percent
n = 556
area, there are no masks or gloves.” –
Fear
0
Fearofofmissing
missing aid
aid
10 20
Percent
30 26 40 50
Male returnee in Salah al-Din
44
n = 556
31
Why are these
Other** Other measures difficult for you?
19
gender gender
Fear of missing aid 11
26 Impact of Ramadan
Female Lack
Lack of enforcement
enforcement 44 Female
16
Male Male
31
13
Other
Don’t know
Don' t know
8
19 Data was collected during the month of
gender
Lack of enforcement
11
9 Female
Ramadan, during which movement restrictions
Don’t want
Don' t to
want to 16
6 Male were more relaxed. After observing an
0 13 20 40
Don' t know
8 Percent increase in daily confirmed cases, Gol and
9
n = 556
KRG reintroduced strict lockdown measures
Don' t want to
**Among people 6 who selected “other”, going without work was identified as the primary challenge in complying with measures. on 31 May.₈
This0 will be added as a closed answer option
20 in the next iteration of our survey. 40
Percent
5 n = 556
OCHA, “Iraq: COVID-19 situation report no. 14” (1 June 2020), https://reliefweb.int/sites/reliefweb.
int/files/resources/20200601_COVID19_SitRep_No.14%20%281%29.pdf.
6
Ibid.
7
OCHA and REACH, “Iraq Multi-Cluster Needs Assessment (MCNA) VII” (December 2019), available at: *Percentages do not total 100 because respondents 3
https://www.reachresourcecentre.info/country/iraq/cycle/651/#cycle-651. could choose multiple options.
8
OCHA, “Iraq: COVID-19 situation report no. 14” (1 June 2020).Economic impact
COVID-19 has undoubtedly impacted livelihoods. The majority (74%) of respondents
tell us that their ability to meet their basic needs has worsened. Curfews, lockdowns,
and other measures have reduced economic activity and have particularly impacted
vulnerable groups, including casual and low-income workers.₉ People fear losing “Markets are all open and people are
their jobs.10 Of the 4,000+ calls the IIC handled between March and June 2020, the going without masks or gloves.” – Male
primary COVID-related issue has been loss of employment opportunities.11 IDP in Ninewa
How has your ability to meet your basic needs changed since the virus started
spreading in the world? (n=556)
How has your ability to meet your basic needs changed since the virus started spreading in the world? If/when you experience coronavirus symptoms, what do you think you would do?
Go to health provider 57
Worsened
Worsened 74
Call health provider 26
No change
No change 17 Self−isolation 12
Nothing 4
ImprovedImproved 9
Other 1
0 10 20 30 40 50 60 70 80 0 10 20 30 40 50 60
Percent Percent
n = 556 n = 556
What do you need more information on in relation to the coronavirus? Why are these measures difficult for you?
Price increases for food and household items compound these worries. An ongoing
assessment on market perspectives by the Cash Consortium of Iraq (CCI) reports
Nothing 49 Fear of missing aid 36
price increases and shortages in basic food and hygiene items – including lentils,
Don' t know 15 Other 26
rice, vegetable oil, and disinfectant – across five governorates.12 More than half of
“The curfew affected our livelihood
the households in the same study report having been unable to meet their basic needs
Identifying symptoms 11 Don' t know 13
and restricted access to our daily, basic
within the last week, with 73% saying they have been unable to work.13
Treatment 8 Lack of enforcement 11 needs.” – Female returnee in Anbar
Trust Access to information 7 Don' t want to 9
0 10 20 30 40 50 0 10 20 30 40
According to our respondents (90%), preventative measures are working, even Percent
n = 556
Percent
n = 556
though
Binary theyResponses
Survey are difficult to follow. People in Salah al-Din feel notably more negatively
What measures are most important? // What measures are most difficult? Who is your main source of information? // What source do you trust the most?
on this indicator than those in other locations. The measures introduced there were
Hygiene practices 49 6 News media 49 40
some of the most stringent, so this may be linked to resentment or discontent with the
Staying indoors 43 29 Social media 19 11
obligation to comply, especially during Ramadan.
Social distancing 43 7 Health providers 12 18
Overall, do you believe the measures that have been introduced in your area
Binary Survey Responses
will reduce the spread of the virus? (n=556)
33 10 5 9
Wearing mask Don' t know
Wearing gloves 20 5 National government 3 6
10 60 50 40 30 20
90
10 0 10 20 30 40 60 50 40 30 20 10 0 10 20 30 40 50
Percent Percent
n = 556 n = 556
−20 0 20 40 60 80 100
Percent
No Yes
No Don't know Yes
Location
Anbar n=48
10 90
−20 Dahuk 0 20 40 60 80 n=133 100
Percent
8 92
No Don't know Yes
Erbil n=74
9 91
Ninewa n=168
13 87
Salah al-Din n=69
25 75
Sulaymaniyah n=30
3 97
Results in %
9
WFP, “Iraq market monitor report,” Issue 30 (April 2020), https://docs.wfp.org/api/documents/WFP-
0000115988/download/?_ga=2.68168340.440888833.1591881014-1575341897.1591881014
10
Ibid.
11
IIC, “COVID-19 dashboard,” https://app.powerbi.com/view?r=eyJrIjoiNzRmNDc5NjAtN- *Percentages do not total 100 because respondents
2QyMS00NmNlLWE4MDAtYTg0N2FiODM5YWVjIiwidCI6IjViNGExMjM3LWU1MjUtNDIwOS1iN- could choose multiple options.
WIyLTY5ZTQ0ZWM4MTk5NiIsImMiOjEwfQ%3D%3D.
CCI, “Beneficiary market perspectives – 8th round” (30 March–20 May 2020), https://www.
4
12
humanitarianresponse.info/sites/www.humanitarianresponse.info/files/assessments/19-may_bene-
mark_eighth_round_brief.pdf.
13
Ibid.Methodology
Sampling
We designed the sampling strategy using the most recent figures (9 April 2020) from the IOM This report presents highlights from the findings of
Displacement Tracking Matrix (DTM) returnee and IDP master lists, as well as UNHCR refugee Ground Truth Solutions’ (GTS) telephone surveys with
statistics, which provide the following population figures for Iraq: 1,399,170 IDPs, 4,660,404 323 IDPs, 67 refugees, and 166 returnees across six
returnees, and 247,440 Syrian refugees. governorates in Iraq in April and May 2020.
People in Need (PIN), as defined in the 2020 Humanitarian Response Plan (HRP), were divided Our quantitative citizen survey is conducted in
into four strata across the six governorates: returnees, refugees, IDPs living in camps, and IDPs partnership with the Iraq Information Centre (IIC).
outside of camps. Not all the strata were sampled in all five governorates. Strata amounting to 1% GTS will collect surveys of approximately 530
or less of the total PIN figures were not included. respondents per round for an initial duration of six
The sample frame consisted only of people who recently contacted the IIC and is therefore not months and will target IDPs, refugees, and returnees
representative of the Iraqi population in need in the selected governorates. Budget constraints across the six governorates with the highest numbers
did not allow for the random approaches commonly used in phone surveys, such as random digit of People in Need (PIN): Anbar, Dahuk, Erbil
dialling. Nonetheless, the sample includes different population types across each location. To Ninewa, Salah al-Din, and Sulaymaniyah.
generate a more reliable sample, we used oversampling in regions and among population types
with small numbers of people in the relevant population. GTS is sharing these findings with humanitarian
actors to inform response planning and programme
Survey questions adjustments. Over the coming months, we will
Ground Truth Solutions designed the survey questions in consultation with the WHO Global Risk provide time-series data to track affected people’s
Matrix14 and the Global Humanitarian COVID-19 response plan.15 We identified four metrics perspectives on the COVID-19 response in Iraq in
to guide our questions: information, trust, behaviour, and economic impact. We reviewed other more detail.
actors’ COVID-19-focused tools and surveys in order to avoid duplicating their efforts and to
ensure that our data is useful and actionable. The IIC reviewed the questions and translations to Perception data
ensure the survey is appropriate to country-specific realities.
Ground Truth Solutions gathers feedback from
Participants affected people, using their views, opinions, and
perceptions to assess humanitarian responses.
All participants were IDPs, returnees, or refugees over the age of 18. Of the total number of
Gathering perception data from affected
respondents, 37% were female and 63% were male. Respondents were selected from the IIC
populations should be viewed as complementary
database of recent callers and chosen at random by IIC Information Management (IM) within to other monitoring and performance data.
the parameters set by the sample, aiming for a 50:50 gender split. Operators were instructed Collecting feedback is a vital first step in closing
to obtain consent twice – first to enable IIC to use the stored contact information, and a second the accountability gap, empowering affected
time for participation in the GTS survey. In total, 78 individuals did not give their consent to be populations to be part of the decisions that govern
surveyed, and no interviews were conducted with them. All those who participated in our survey their lives, building relationships with communities,
were given information on the government hotline and received key messages on COVID-19. and understanding local knowledge. Whenever
possible, the process of collecting such feedback
Weighting should be followed up with longer-term dialogue
The overall mean values presented in this report were estimated based on strata means which between affected communities and aid agencies.
Communicating the results of the surveys back to
were weighted based on demographic information outlined in the 2020 HRP. For the multiple
affected people and triangulating perception data
choice questions, the maximum margin of error lies at (+/-) 8.5 percentage points, and between
with other information sources is central to our
(+/-) 3.76 and 5.94 for the binary questions. Margins of error for breakdowns by status, location,
approach in Iraq.
and gender are larger than for the overall weighted means. Data points that did not contain
the respondent’s governorate or status (IDP, refugee, etc.) were not considered for the weighted
analysis.
Table 1: Sampling strategy, April 2020 with actual numbers*
Governorate IDPs in IDPs out of Returnees Refugees Total
camp camp
Anbar 54/-1 54/-1
Dahuk 77 34/-1 29/-1 140/-2
Erbil 46/+1 38/+8 84/+9
Ninewa 58 45 71/+6 174/+6
Salah al-Din 31/+1 41/+11 72/+12
Sulaymaniyah 32/+2 32/+2
Total 135 188/+3 166/+16 67/+7 556/+26
14
WHO, “Survey tool and Guidance: rapid, simple, behavioural insights on COVID-19,” Table 1: *+/- represents number of surveys above or below
Questionnaire – validation and value of variable and items included (2020), http://www.euro.who. original target sample.
int/__data/assets/pdf_file/0007/436705/COVID-19-survey-tool-and-guidance.pdf?ua=1.
15
OCHA, “Global Humanitarian Response Plan COVID-19” (April–December 2020), https://www. 5
unocha.org/sites/unocha/files/Global-Humanitarian-Response-Plan-COVID-19.pdf.Language of the survey
Surveys were conducted in Arabic.
Data collection
Dates
Data collection took place between 26 April and 15 May 2020.
Data collection partner
The Iraq Information Centre (IIC) is a central accountability mechanism for the humanitarian Author
response in Iraq, implemented by UNOPS on behalf of the Humanitarian Country Team (HCT). A Cholpon Ramizova – Senior Programme Analyst
team of 22 operators collected the data, with two IIC supervisors managing the process.
Challenges and limitations Recommended citation
Response rates: Surveys were conducted during the month of Ramadan, during which those Ground Truth Solutions, COVID-19: perceptions of
observing the fast are less inclined to pick up their phones. Issues with network connectivity and people in need in Iraq, June 2020
phones being switched off also contributed to lower response rates.
Gender balance: Women in the affected population commonly suppose that the male head of
For more information about our work in
household’s contact information must be provided in order to qualify for assistance. This presented
Iraq, please contact Cholpon Ramizova
challenges in targeting female respondents when sourcing information from the IIC database.
(cholpon@groundtruthsolutions.org) or Meg
Additionally, a male member of the household often answered the phone. To mitigate some of
Sattler (meg@groundtruthsolutions.org).
these challenges, only female operators were instructed to engage with female respondents.
Where appropriate, female operators asked to speak to a female member of the household if the
call was taken by someone else.
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