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Socio-Economic Impact of the Ebola Virus Disease

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Socio-Economic Impact of the Ebola Virus Disease Sierra Leone 2015 Population and Housing Census Thematic Report on socio-economic impact of the Ebola Virus Disease STATISTICS SIERRA LEONE (SSL) OCTOBER 2017 i Sierra Leone 2015 Population and Housing Census Thematic Report on socio-economic impact of the Ebola Virus Disease ii Sierra Leone 2015 Population and Housing Census Thematic Report on socio-economic impact of the Ebola Virus Disease By Michael Matthew Amara Francis Tommy Abdulai Hassan Kamara iii We wish to thank the Government of Sierra Leone for the financial and oversight support to the project. Special thanks goes to our development partners DFID, Irish Aid, UNFPA and UNDP for providing the funds, technical support and guidance in the implementation of the Census project. DISCLAIMER Statistics Sierra Leone cannot be held responsible for errors, or any consequences arising from the use of information contained in this report. All rights reserved. This document may be freely quoted or reproduced, in part or in full, provided that the source is acknowledged. iv Acknowledgements This report by Statistics Sierra Leone was prepared under the leadership of Mohammed King Koroma, former Statistician General, with the close collaboration of UNFPA, Irish AID, UKAid and UNDP. We acknowledge the immense support of The Statistics Sierra Leone technical support team that consisted of’Francis Tommy (Principal Statistician) and Abdulai Hassan Kamara (Assistant Statistician). Michael Matthew Amara was the principal author of this report, co-authored with Francis Tommy and Abdulai Hassan Kamara. The editorial work of M. S. Fofanah (National Coordinator for lead writers) and Eric Appiah Okrah, (National Programme Analyst, UNFPA, Ghana) is deeply appreciated. In the preparation of this report, valuable contributions, comments and critical remarks were provided by Mr. Kwadwo Danso-Manu (Technical Specialist, Census, UNFPA). Special gratitude goes to UNFPA Country Office staff who painstakingly revised the report to its current state, especially Dr. Mohammed Elhassien (Technical Specialist, RH, UNFPA), Sonia Gilroy (Programme Specialist, ASRH, UNFPA), Dr. James S.K. Akpablie, (RH Technical Advisor, UNFPA) and Mr. Aiah Lebbie Sosokoeneh (Programme Officer, P&D). Many thanks go to the leadership of the Statistician General and the entire management team of Statistics Sierra Leone, without which this report would not have been possible. We wish to thank the Government of Sierra Leone for its financial and oversight support to the Census project. Special thanks also go to our development partners DFID, Irish Aid, UNFPA and UNDP for providing the funds, technical support and guidance. v Contents Acknowledgements | V List of tables | viii List of figures | ix Abbreviations | ix Executive Summary | 01 CHAPTER 1: Introduction | 03 1.1. Background and context | 03 1.2. Impact on weak health systems | 04 1.3. Impact on health-related MDGs | 05 1.4. Definition of concepts | 05 1.4.1. Occupation | 05 1.4.2. Economically active | 05 1.4.3. Household income | 06 1.4.4. Orphans | 06 1.5. Conceptual framework | 06 1.5.1. Economic effects of EVD | 06 1.5.2. Social effects of EVD | 06 1.5.3. Intangible effects of EVD | 07 CHAPTER 2: Methods of analysis | 08 CHAPTER 3: Analysis and discussion of results | 09 3.1. Ebola impact on revenue of those reported to be economically active 12 months | 16 before the 2015 PHC CHAPTER 4: The socio-economic impact of the EVD outbreak | 21 4.1. The economic impact | 21 4.1.1. Households | 21 4.1.2. Health | 21 4.1.3. Education | 21 4.1.4. Occupation | 23 4.1.5. Transportation and tourism | 23 vi Contents 4.2. The social impact | 24 4.2.1. Households | 24 4.2.2. Health | 24 4.2.3. Education | 24 4.2.4. Occupation | 25 CHAPTER 5: Key findings, conclusions and recommendations | 26 5.1. Key findings | 26 5.2. Conclusion | 27 5.3. Recommendations | 27 5.3.1. Policy recommendations | 27 ANNEXES | 29 References | 39 vii List of tables Table 3.1: Population confirmed positive of EVD by district | 09 Table 3.2: Household members confirmed positive of EVD by age-group and sex | 10 Table 3.3: Households with confirmed EVD cases by district | 11 Table 3.4: Status of Ebola patients by region and district | 12 Table 3.5: Ebola deaths by region, district and sex | 13 Table 3.6: Orphans due to EVD by region, district and place of residence | 14 Table 3.7: Count and percentage distribution of persons who were sick and did not seek | 15 medical attention at health facility Table 3.8: Main occupation before and after the Ebola outbreak of economically active | 17 household members (10 yrs+) at national and by place of residence Table 3.9: Main occupation before the Ebola outbreak of economically | 19 active household members (10 yrs+) by region Table 3.10: Main occupation after the Ebola outbreak of economically active | 20 household members (10 yrs+) by region Tables in annexes Table A 1b: Households with confirmed EVD cases by district | 31 Table A 3: Population confirmed positive for contracting Ebola by region/district and sex | 33 Table A 4: EVD patients by region, district and sex | 34 Table A 5: Distribution of children (0–17 years) who confirmed positive for EVD by single age, | 35 place of residence and sex Table A 6: Status of Ebola population by region and district | 36 Table A 7a: Ebola EVD impact on household revenue | 37 Table A 7b: Ebola impact on household revenue | 38 viii List of figures Figure 3.2: Ebola impact on revenue | 16 abbreviations EVD Ebola Virus Disease GDP Gross Domestic Product FHI Free Healthcare Initiative HIV Human Immunodeficiency Virus HDI Human Development Index MDG Millennium Development Goal MoHS Ministry of Health and Sanitation MoFED Ministry of Finance and Economic Development PHC Population Housing Census UNFPA United Nations Population Fund UN United Nations UNICEF United Nations Children’s Fund WHO World Health Organization ix x EXECUTIVE SUMMARY The Ebola Virus Disease (EVD) outbreak in Sierra Leone had the worst death toll since the disease was diagnosed in 1976 in the Democratic Republic of Congo. It also had far-reaching socio-economic consequences. It was unprecedented in terms of its duration, number of infections, fatality, geographical spread, and social and humanitarian damage, accompanied by severe economic consequences. It remarkably reduced the impressive gains made in economic growth over the years. It is against this background that when conducting the 2015 Population and Housing Census (PHC), the socio-economic impacts of EVD were strongly considered as one of the thematic areas to be included, to advocate for policy recommendations. This report provides an analysis of the socio- economic impacts of EVD from the PHC as well as from studies conducted during the post-EVD period in Sierra Leone. The data source for the Ebola socio-economic impacts module is from the 2015 PHC that was conducted nationwide from 5 to 18 December 2015. Five questions were embedded in the census questionnaire. These data are presented in the analysis using the following: (a) simple percentages with one decimal place, (b) pie charts, (c) graphs and (d) line graphs. Additionally, the data were analysed using socio-economic variables such as (a) health (b) education and (c) agriculture. The 2015 PHC report revealed that a national total of 13,575 persons contracted the virus. Port Loko reported the highest number of infected individual cases at 3,594 (26.5 per cent), persons followed by Kailahun with 1,727 (12.8 per cent). 13,575 With regard to the rural/urban divide, there contracted the virus were 7,263 (53.5 per cent) reported rural cases as against 6,312 (46.5 per cent) urban cases. The findings revealed that the largest number of 5,666 children below 18 infected persons were within the ages of 25–29 years had either lost a father or a followed by the ages of 15–19. This shows that youths, who are more active, were more infected mother as a result of EVD. by the virus and there were more deaths among youths within the age bracket of 25–29. The findings also revealed that all districts in Sierra Leone had at least one confirmed case of Ebola. Port Loko district recorded the highest number of households with confirmed Ebola cases at 1,643 55.5% of the economically (23.6 per cent), followed by Kailahun with 1,033 active persons had a decrease in (14.9 per cent). Rural households reported 3,765 their revenues. cases (54.2 per cent) as against 3,186 (45.8 per cent) reported for urban households. The largest number of infected persons were within the ages The 2015 PHC report revealed information on of the status of persons confirmed positive for EVD. 25–29 The findings show a very high death rate. 1 Out of 13,575 reported EVD infected persons, Leone’s economy. But it was not just the disease 11,015 (81.1 per cent) were reported to have but also the strategies put in place to contain died of the virus. The Northern region recorded the disease that were contributing factors. For the highest percentage of deaths, with 5,392 instance, the quarantine measures that were (39.7 per cent) out of the 6,566 reported to introduced to limit its spread strangled economic have contracted EVD. The lowest percentage is activities. Farmers could not properly tend their recorded by the Southern region, with 861 (6.3 fields or buy and sell as normal in markets. per cent) reported deaths out of 1,090 reported Companies saw their businesses disappearing to have contracted EVD. The findings also as costs increased.
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