Public Health During COVID-19
Vaccines are more widely available and have clear benefits on reducing severe illness and death due to COVID-19. Why then is COVID still a concern for refugees?
While some countries are seeing a decline in COVID-19 cases and deaths, largely due to high vaccination coverage, people in many countries remain unvaccinated and still at risk.
Most of the world's 27.1 million refugees live in low- and lower-middle income countries which are already facing humanitarian, economic and climate change-related crises. These countries often have weaker health systems and the overall COVID-19 vaccination rates tend to be lower. As of June 2022, most refugee-hosting countries were not on track to reach 70 per cent vaccine coverage in their populations.
Refugees have always been among the most exposed to the pandemic and its impacts. They often live in overcrowded or densely populated urban shelters, settlements, or camps. Space, soap and water, the prescribed measures to protect oneself and others from the virus, are not always easily accessible.
Refugees may also already be in a more fragile state of health due to limited-to-severely-limited access to health services, malnutrition, underlying health conditions and inadequate access to water, sanitation and hygiene services (WASH). In their country of origin, they may not have had access to quality health services for many years, if ever. They also often face extreme conditions during their flight which further threatens their health.
How is UNHCR supporting refugees and host communities during the pandemic?
Wherever possible, refugees should be included and integrated into functioning national health systems and services. UNHCR recognizes, however, that many refugee-hosting countries may need support to ensure their capacities are strengthened to meet the needs of refugees as well as host communities.
Increasing access to COVID-19 vaccines
UNHCR is working to ensure refugees have access to COVID-19 vaccines despite challenges on the ground.
Inadequate transport and cold chain systems in remote areas, insufficient awareness, and competing national priorities contribute to reduced vaccine access and uptake among refugees. The data is limited, but where it exists the vaccination rates of refugees generally trend below national averages. Vaccine rollout for refugees depends on the capacity of local health systems and prior planning by ministries of health, WHO and UNICEF.
UNHCR supports ‘last mile’ efforts to ensure vaccines reach refugees where gaps exist. This covers logistics and transportation, providing cold chain supplies, training health workers and supporting community mobilization. UNHCR conducts surveys within refugee communities to estimate vaccine coverage and identify gaps and the reasons for these gaps. UNHCR uses this data to improve knowledge sharing with refugees and advocate with and provide support to governments.
Distributing essential medicines and supplies
In support of governments and partners, UNHCR procures and distributes personal protective equipment (PPE, e.g., N95 masks, surgical masks, gowns), disinfectants, WHO-approved rapid antigen tests, medicines (e.g., two-to-three-month supplies of medication for refugees with stable chronic diseases, including mental health conditions, HIV, and tuberculosis, to reduce the need for in-person follow-up at the facility) and medical equipment (e.g., oxygen concentrators, ventilators).
Strengthening capacity of health workers
UNHCR trains health workers on infection prevention and control, disease surveillance, case management and contact tracing. Through UNHCR, community health workers learn and share key messages on how the virus spreads, how refugees can protect themselves and others and the benefits and the risks of vaccination.
Maintaining access to routine health services
As with all major disease outbreaks, diversion from routine services often results in even more suffering and death. COVID-19 has overwhelmed health systems across the globe. Almost all countries have resorted to canceling or limiting routine services. This can have a devasting impact on primary health care including immunization, sexual and reproductive health, HIV, tuberculosis, mental health and malnutrition.
Since the onset of the pandemic, UNHCR has maintained refugee's access to essential health services despite restrictive measures and their impacts on mobility and livelihoods. UNHCR has consistently worked to ensure that refugees are included in national COVID-19 planning and response policies.
UNHCR Covid-19 vaccine access report 2021
Guidance note on COVID-19 acute respiratory disease for UNHCR operations
UNHCR priority activities in public health, WASH, shelter and settlements
Inter-Agency Standing Committee (Interim Guidance): Scaling-up COVID-19 outbreak readiness and response operations in humanitarian situations
The Sphere Standards and the coronavirus response (external link)
COVID-19 Vaccine Introduction Readiness Assessment Tool (VIRAT) for UNHCR Operations (file will automatically download)
COVID-19 preparedness and response: procurement and supply of medicines, medical supplies, WASH and logistical items
Public health surveillance guidance for COVID-19
Supporting the continuity of health and nutrition services in the context of COVID-19 in refugee settings
Mental health and psychosocial support
Emerging Practices: mental health and psychosocial support in refugee operations during the COVID-19 pandemic
Storybook for children: My hero is you (English - French - Spanish - Arabic)
IASC Basic Psychosocial Skills – A Guide for COVID-19 Responders (external link)
IASC Operational considerations for multisectoral mental health and psychosocial support programmes during the COVID-19 pandemic (29 May 2020) (external link)
IASC Interim Guidance on COVID-19 Outbreak Readiness and Response - Food Distribution - March 2020
Management of Child Wasting in the Context of COVID-19 - 27 March 2020
Infant & Young Child Feeding in the Context of COVID-19 Version 1 - 30 March 2020
GTAM Guidance for Nutrition COVID-19 Version 1 - 13 March 2020
Sexual and reproductive health
Inter-Agency Working Group on Reproductive Health in crises:
- Programmatic guidance for sexual and reproductive health in humanitarian and fragile settings during the COVID-19 pandemic (external link)
- Extra programmatic guidance