Ebola Impact Revealed: An assessment of the differing impact of the outbreak on the women and men in Liberia | Ebola Virus Disease

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This research report examines the differing impacts of the Ebola outbreak in Liberia on women, men, girls and boys. Focusing on the areas of agriculture and livelihoods
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  EBOLA IMPACT REVEALED  An Assessment of the Differing Impact of the Outbreak on Women and Men in Liberia Dala T. Korkoyah, Jr. (MPH)Francis F. Wreh (MA) July 2015  iii In March of 2014 the EVD outbreak hit Liberia, taking with it many lives in its wake. As a move to ensure that further programming is rooted in evidence, this study was conducted to shed light on the gender dimensions of the EVD outbreak. Many thanks to UN Women, Oxfam, Ministry of Gender, Children and Social Protection and the WASH Consortium for seeing it prudent to undertake this assessment. This document epitomizes their quest to support evidence-based practice in policy formulation and effective program design especially during the Ebola recovery phase; and it stands as a testament of their strategic focus on gender equality and women’s empowerment. The assessment would not have been possible without the tireless contributions of a broad team of people. We acknowledge all the men and women who took time off to participate in the assessment. We also thank all the local government officials, community and traditional leaders who cooperated with, and supported the teams across the country. We owe an enormous depth of gratitude to the team of enumerators, supervisors, monitors and transcribers whose unique professional contributions enhanced the quality of data gathered by the assessment. There are few people who went the extra mile to make outstanding technical and logistical contributions; it is only proper that they are mentioned personally. To this end, recognition is given to the Oxfam team: Country Director, Mamudu Salifu, Cathy Stephen, Tess Dico-Young, Samuel Quermorllue and Alieu Swary for technical backstopping on the questionnaire design, PDA programming, training of enumerators and monitoring of field teams. From UN Women, the support and leadership is much appreciated particularly from the Country Representative, Awa Ndiaye Seck, and the Deputy Representative Peterson Magoola, with technical and logistical support from Blerta Aliko, Mahmoud Koroma and Ramon Garway. Francis Wreh, Thomas Davis and Joseph Nyan from LISGIS led efforts on the identification of enumeration areas and data analysis, respectively.It is also important to recognize the Deputy Ministers at Gender, Children and Social protection, Madame Mardea Martin Wiles and Madame Sienna Abdul-Baki for their support throughout the study. Special recognition goes to Dr. Geetor S. Saydee, Reginal W. Fannoh, and Daniel Kingsley for contributing towards the writing of the report.Again, thank you all for making this assessment a reality.  ACKNOWLEDGEMENTS It was not easy for us to live; it is just by the grace of God we continue to be alive. We ate anything and all kinds of food just to live. We even ate the seeds for the next farming season, and used the little money we had to survive until Ebola cools down. We even borrowed money to live, and only God knows how the money will be repaid. Male participant in a focus group discussion in Grand Kru county  viv  Acknowledgements iiiForeword ivTable of Contents v Abbreviations viiiList of Tables and Figures xExecutive Summary xii INTRODUCTION AND BACKGROUND   1 Research Aim 2 Specific Objectives 2Research Areas 2Research Questions 3 RESEARCH METHODOLOGY    4 Design and Sampling 4Data Collection 4Ethical Considerations 4Data Analysis and Quality Assurance 5 KEY FINDINGS   6 Characteristics of Respondents 6 Response rate 6Age, marital status, educational level and religion 6Sources of livelihoods 6 Knowledge, Attitudes and Practices Relating to Ebola 6 Ebola awareness 7Ebola prevention 7 TABLE OF CONTENTSFOREWORD  The Ministry of Gender, Children, and Social Protection including UN Women, Oxfam and the Liberia WASH Consortium with other relevant partners, grounded in the vision of equality enshrined in the Charter of the United Nations, work for the elimination of discrimination against women and girls; the empowerment of women; and the achievement of equality between women and men as partners and change agents of development, human rights, humanitarian action and peace and security.  This gender assessment report provides key information on the comparable impacts of the Ebola Virus Disease (EVD) on women and men in Liberia. In addition to providing evidence on the gender disaggregated effects of EVD, this report reveals the growing discourse on gender in emergency, articulating gender perspectives of knowledge, beliefs and practices regarding Ebola; women’s leadership and participation in the national response, and communities’ coping mechanisms and perception regarding the promotion of early recover.Liberia’s EVD crisis disrupted the development progress achieved since the restoration of peace and democracy in Liberia. As of 10 December 2014, nearly 18,000 people had been infected and more than 6,400 had already died in the region. In Liberia, health facilities were not well equipped to fight the disease, and the crisis eventually outstripped their ability to stem its spread by the lull of the virus in March 2015 about 4806 deaths had recorded in Liberia alone. 1  The disease had far reaching impact on women and girls such as: the closure of borders that affected regional trade, thus, the livelihoods of thousands were affected within the Mano-River Union region. The Association of Women in Cross Border  Trade in Liberia reported a significant decrease in savings as a result of the borders being closed. Rural women in agriculture and small businesses also reported a drop in earnings, and this contributed to increased hardship, especially for women and girls. Teenage pregnancy rates experienced a sharp increase and number of girls expected to return to school were also negatively forecasted.In all of this, the Government of Liberia continues to work with the United Nations, along with relevant UN Country Teams, Member States and partners, in order to ensure full alignment and seffective overall action in support of the recovery process. Ms. Awa Ndiaye Seck Country Representative,UN Women LiberiaMr. Mamudu SalifuCountry Director,Oxfam LiberiaHon.Julia Duncan-Cassell,Minister of Gender, Children, and Social Protection 1  http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/case-counts.html   Table of Contents vii  vi Table of Contents Increased burdens on women and girls 36Perceptions about the work of the courts and police during Ebola 36Alternative justice systems 36 CONCLUSION AND RECOMMENDATIONS   38 Recommendations 39 Scaling up the effectiveness of the national Ebola response 39Promoting income generation and food security 40Increasing access to health services 40Improving access to WASH services 41Curbing GBV and child abuse 41 REFERENCES   42 APPENDICES   44 A. Research Methodology 44 Research design 44Sampling and sampling size 44Data collection 45Ethical considerations 45Data analysis 46Data management and quality assurance 46Challenges 46 B. Characteristics of Respondents 46 Response rate 46Age and marital status 47Level of education 47Living arrangements 47Religion 48Sources of livelihood 48 C. List of Persons Interviewed in Key Informant Interviews 48 Biography of Lead Researchers 50 Sources of Ebola information 9Perceived risk of contracting Ebola 10Perceptions of gender-based vulnerability to Ebola 10Health-seeking intentions 11Community Ebola response activities 12 Livelihoods and Food Security 13 Income-generating activities before Ebola 13 Type of income-generating activities 15Participation in economic activities before and after Ebola 15Incomes of respondents 17Local commerce and trade 18Personal savings practices 19Access to finance 20Effect of Ebola on vulnerable populations 21 Access to Health Services 22 Pre-existing health problems 23Availability of health services during the Ebola crisis 23Alternative sources of healthcare 24Cost of healthcare 25Access to PPE and other medical resources 26 Water, Sanitation and Hygiene 26 Access to water points 27Changes in the condition of water points 28Responsibility for water collection 28Household defecation practices 29Hand-washing behaviour 30Distribution of Ebola prevention materials 31WASH and Ebola response activities 32 Gender-Based Violence and Protection 32 GBV during Ebola 33Perceived trends in cases of GBV 33Perceptions about child marriage 34Stigma and discrimination 34Social protection for orphans and vulnerable children 35
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