AREA PROFILE: MARIINKA/ /

UKRAINE, JULY 2020

Localised Response Inclusive Recovery Effective Stabilisation Table of Contents List of Acronyms RATIONALE ...... 3 ASC Administrative Service Centre ATCs Amalgamated Territorial Communities AGORA APPROACH ...... 4 DV Domestic Violence METHODOLOGY ...... FKIs Facility Key Informants 5 FTE Full Time Equivalent OVERVIEW OF TARGET AREA ...... 6 GBV Gender Based Violence GCA Government Controlled Area OVERVIEW OF ASSESSED AREAS ...... 7 HH Household MAIN FINDINGS ...... 8 HoHH Head of Household IDP Internally Displaced Person HOUSEHOLD PROFILE ...... 10 KIs Key Informants NGCA Non-Government Controlled Area SOURCES OF INCOME ...... 13 PLW Pregnant or Lactating Women LEVELS OF INCOME ...... 15 PwD Person with Disability SESU State Emergency Services of HEALTH ...... 18 SOP Standard Operating Procedure SRH Sexual and reproductive Health EDUCATION ...... 25 TTU Target Territorial Unit ADMIN ...... 32 WASH Water, Sanitation and Hygiene JUSTICE ...... 37 SOCIAL ...... 43 FINANCIAL ...... 47 AGORA is a joint initiative of ACTED and IMPACT Initiatives, founded in 2016. AGORA pro- motes efficient, inclusive and integrated local planning, aid response, and service delivery MARKETS & TRANSPORTS ...... 48 in contexts of crisis through applying settlement-based processes and tools. AGORA ena- bles more efficient and tailored aid responses to support the recovery and stabilization of cri- SESU ...... 49 sis-affected communities, contributing to meet their humanitarian needs, whilst promoting the MARKETS ...... 50 re-establishment of local services and supporting local governance actors. AGORA promotes multisectoral, settlement-based aid planning and implementation, structured around partner- UTILITIES ...... 51 ships between local, national and international stakeholders. AGORA’s core activities include community mapping, multisector and area-based assessments, needs prioritisation and plan- TRANSPORTS ...... 53 ning, as well as support to area-based coordination mechanisms and institutional cooperation. ANNEX ON FUNCTIONAL URBAN AREAS ...... 54

2 HEALTH 2 RATIONALE BOX 1. DECENTRALIZATION AND THE HROMADA APPROACH As the conflict in Eastern Ukraine enters its economic growth have mostly happened in Decentralization in Ukraine started with the Concept of Reforming Local Self-Government and sixth year, addressing long term recovery large urban centres since the early 1990s. The 3 needs in the Government Controlled Areas REACH area-based assessment (2017) and Territorial Structure of Power in April 2014. The main objective of the reform is to strengthen (GCA) of and Luhansk re- the Capacity and Vulnerability Assessment local self-governance capacity via merging the obsolete administrative units of local councils mains a priority for regional and national au- (2018), by looking beyond administrative units (villages, townships, and towns) into larger and more capable amalgamated territorial com- thorities, as well as for development actors. as a planning unit, showed how relevant this munities (hromadas). It has resulted in the establishment of Amalgamated Territorial Commu- approach is by demonstrating for example how nities hromadas, (ATCs or hromadas), new units of basic territorial administrative level; and The significant impact of this conflict isin acts as a health service provider be- rayons, new units of the sub-regional level, within the boundaries of each (see Map 1).* part due to the separation of the “contact yond its city or planned Amalgamated Territorial line” of large urban centres in non-govern- Communities (ATCs or hromada) boundaries. The process has significantly gained momentum in the year 2020, as the amalgamation ment-controlled areas from their peripher- must now be completed by the central government on capability basis to enable nation- ies in government-controlled areas. The Overall, the joint effects of conflict, decen- wide unified local elections in October 2020 (as of June 2020, amalgamated communities separation has impacted people’s ability tralization and urbanization makes under- coexist with the councils and rayons where amalgamation was not accomplished). Due to to access basic services, employment standing actual service access dynamics the ongoing conflict in Donetsk and Luhansk oblasts there are no oblast councils and lo- and markets.1 Furthermore, restrictions of in eastern Ukraine critical to ensure that de- cal councils along the “contact line”, where civil-military administrations are functioning in- movement and significant changes in the velopment support effectively targets the com- stead. It remains unclear whether those bodies will be elected in October 2020. In Donetsk dynamics of population flows have also al- munities that are most in need of long-term re- Oblast, out of 15 cities of oblast significance, only 3 managed to voluntarily amalgamate. tered the capacities to deliver these services. covery and sustainable development support. Thus, the majority of communities will pass through the government-led amalgamation.

In parallel, the Ukrainian government has By producing unique, community-level data In comparison to former basic level administrative units, hromadas are empowered with a mandated that decentralization reform will on vulnerabilities and capacity gaps in ser- broader range of governance tools and larger budgetary resources. In addition, they are be implemented across the country in vice provision, this assessment addresses assigned with new responsibilities to make decisions about provision of most public ser- 2020. Although 31 Amalgamated Territorial an important information gap and comes to vices and development at the community level. Land management and utilities, infrastruc- Communities (ATCs or hromadas) have been support recovery actors to provide integrat- ture and local economy, education and healthcare, social and administrative services formed in some areas of Donetsk and Luhansk ed and inclusive services to conflict-affected are the segments of public life where hromada authorities now have executive functions oblasts, this reform remains significantly ham- communities by informing the development of to deliver those services to the population, to which they are now directly accountable. pered by the conflict (see box on the right). evidence-based recovery strategies and plans which build on community-level priorities. The capacity of newly created (or to-be-formed) executive local authorities to maintain quality Furthermore, a recent Organisation for Eco- governance practices and effectively implement the original ambitions of the reform is crucial nomic Cooperation and Development (OECD) 1. REACH, Capacity and Vulnerability Assessments in Torestsk, to the sustainable development of the targeted areas (see Map 1). By providing accurate, 2018. study2 on decentralization in Ukraine high- up to date data on specific vulnerabilities and capacity gaps in service provision at the hro- 2. OECD, “Regional development trends in Ukraine in the af- mada level, this assessment is supporting all stakeholders towards this common objective. lighted the importance of planning using termath of the Donbas conflict”, in Maintaining the Momentum of Decentralisation in Ukraine, 2018, OECD Publishing, Paris. “functional urban areas” especially in the 3. Ukraine Government portal, “Decentralization”. https://www. Ukrainian context where both population and kmu.gov.ua/en/reformi/efektivne-vryaduvannya/reforma-decen- * An interactive webmap has been created with the latest administrative boundaries of the assessed areas. tralizaciyi

3 HEALTH 2 MAP 1: Evolution of hromada creation over time and AGORA Target areas AGORA: A PROJECT AND AN APPROACH This assessment is part of the 5-year project: “EU Support to the East of Ukraine - Recovery, Peacebuilding and Governance” implemented by the United Nations Recovery and Peace- building Programme (UN RPP, see box 2 below). One of the key objectives of this project is to support evidence-based recovery and planning in conflict-affected cities and communi- ties of Donetsk and Luhansk oblasts through area-based approaches, geographic informa- tion systems and information management. To that end, a set of activities are implemented by ACTED/ IMPACT -–engaged in Eastern Ukraine since 2016– to achieve two specific results: 1) Access to quality information for local planning is improved This report, constructed at the target area level (see Map 1), enables the identification of vul- nerable populations, as well as of response and service provision gaps within and across stra- tas and hromadas. This assessment covered 38 stratas in total, which have been regrouped and adjusted to fit the composition of hromadas and target areas – i.e. urban (city of significance) or rural (amalgamation of rural councils). When relevant and as muchaspos- sible, the information products (this report and the associated interactive dashboard and web- map) have been reviewed and designed in close partnership with relevant aid actors, and lo- cal stakeholders (through a dedicated field team in permanent contact with local authorities).

2) Capacities of local authorities for evidence-based planning is strengthened Leveraging assessment findings, ACTED/IMPACT will support local authorities in using gender and age disaggregated data and managing information for evidence-based local level planning based on participatory, inclusive and transparent processes. AGORA will link relevant aid actors and local stakeholders through a series of consultations and workshops in order to facilitate the develop- ment of hromada or target area-based recovery plans. Such plans will highlight priority needs, as well as potential solutions to resolve them, while identifying exogenous actors with resourc- es and expertise, and linkages with local actors to effectively support crisis-affected population.

BOX 2: UNITED NATIONS RECOVERY AND PEACEBUILDING PROGRAMME (UN RPP) The United Nations Recovery and Peacebuilding Programme (UN RPP) is being implemented by four UN agencies: The UN Development Programme (UNDP), the UN Entity for Gender Equal- ity and the Empowerment of Women (UN Women), the UN Population Fund (UNFPA) and the Food and Agriculture Organization of the UN (FAO). Twelve international partners support the pro- gramme: Tthe European Union (EU), the European Investment Bank (EIB) and the governments of Canada, Denmark, Germany, Japan, The Netherlands, Norway, , Sweden, Switzerland and The United Kingdom.

4 The objective of the assessment was to enable the identification of specific sectors that should be prioritized based on current HCMETHODOLOGY service delivery systems and user priorities, as well as household specific vulnerabilities, to facilitate the emergence of informed, transparent and inclusive policies.

INITIAL MAPPING EXERCICE Mapping exercise of settlements (in hromadas) and functional urban areas (in cities) using geospatial data provided by the main mapping services available in Ukraine.

150 FACILITY KEY 29 GBV KEY INFORMANT 120 COMMUNITY 2.725 HOUSEHOLD INFORMANT INTERVIEWS INTERVIEWS KEY INFORMANTS SURVEYS

Facility representatives participated in a semi- In addition to the 150 KIIs, representatives of Representatives from the A quantitative investigation of service demand was conducted structured key informant interviews (KIIs) covering facilities providing Gender Based Violence (GBV) community (elderly people, em- through household (HH) surveys, drawing on a structured core indicators and qualitative measures of changes services have participated in a semi-structured ployed persons, and individuals survey that was principally focused on HH barriers to accessing in service delivery as well as challenges faced by KII about the types of GBV cases, and barriers to working in local services) were services and HH satisfaction with the availability of services, their respective facility in providing comprehensive service provision faced by their facility. randomly selected and then as well as identifying which HHs were most vulnerable to and quality services. surveyed in order to acquire a disruptions of access (both due to conflict or to other conditions). general understanding about To ensure encompassing findings, all service- A census approach has been used through the area’s general infrastructure The survey used a two-stage stratified random sampling providing facilities in the target areas were secondary data review to map out all facilities and available services. approach, allowing for a representative sample of HHs identified through secondary data and direct responsible (and required by law) for provision in urban and rural stratas with a 95% confidence level field observations by IMPACT enumerators. of GBV services within the target geographies. Data collection took place and 5% margin of error (targeted cities belong to urban Facilities were included if they offered services Data collection took place between 24/03/2020 alongside HH surveys. strata). Data collection took place between 28/10/2019 and in any of the below target sectors. KIIs with and 30/04/2020. 4/12/2019 . facility representatives took place between 18 November 2019 and 11 December 2019 URBAN RURAL AREAS AREAS 1 4 18 7 46 37 37 SESU FINANCE SOCIAL POLICE/ JUSTICE EDUCATION HEALTH ADMIN Kurakhove Kurakhove Rural KII KIIs KIIs KIIs KIIs KIIs FKIS Kurakhove Urban Mariinka Rural Mariinka Vuhledar Rural Vuhledar

OUTPUTS: ANALYTICAL REPORT, ONLINE DASHBOARD (POWER BI) & WEBMAP These mixed data collection methods have been used to inform this present report, as well as to feed an online dashboard (using the Power BI platform) to allow for further exploratory analysis using its interactive features. An interactive webmap has also been developed in order to visualize key indicators collected from all targeted facilities. OVERVIEW OF TARGET AREA

MAP 2: Prospective hromadas in the Mariinka target area and strata selection INDICATORS TOTAL

% of HH members above 60 34% % of Pensioners amongst HH members 37% % of IDPs amongst HH members (with and without status) 6% % of HH members having completed higher education 8% % of HH members employed full time 29% % of HH members with an average monthly income less than 4.000 UAH 56% % of HH members working in the area where they reside 75%

Quality of healthcare TOP 1 Greatest concern for HH services

Access to healthcare TOP 2 Greatest concern for HH services

Housing TOP 3 Greatest concern for HH (incl. utilities)

Utility with the highest proportion of dissatisfied users Roads (64%)

Utility with the second highest proportion of dissatisfied users Water (52%)

Top environmental concern for HH Air pollution

% of facilities experiencing pressure on their facilities due to NGCA residents* 20% % of facilities with not enough FTEs to manage the workload 28% % of facilities experiencing frequent shortages of water* 7% % of damaged and unrepaired or partially repaired facilities* 16% % of facilities not having or having only partial SOPs for GBV* 24%

The assessed area involves settlements planned to amalgamate into Mariinka, Vuhledar, and Kurakhove hromadas. According to the latest plans, Kurakhove an Mariinka hromadas will belong to Pokrovsk rayon, while Vuhledar community will join rayon. *As reported by Facility Key Informants from Social + Admin + health + Education sectors OVERVIEW OF ASSESSED STRATAS

Kurakhove Kurakhove Krasnoho- Mariinka Vuhledar Kurakhove Kurakhove Mariinka Mariinka Vuhledar Vuhledar INDICATORS Hromada Rural Urban Hromada rivka Rural Hromada Rural

% of HH members above 60+ 36% 42% 37% 33% 37% 36% 35% 38% 26% 21% 32 % of Pensioners amongst HH members 39% 48% 41% 34% 41% 42% 39% 41% 31% 28% 35% % of IDPs amongst HH members (with and without status) 5% 5% 4% 7% 7% 9% 5% 7% 7% 10% 3% % of HH members having completed higher education 5% 4% 4% 8% 7% 9% 8% 5% 13% 19% 8% % of HH members employed full time 28% 24% 32% 28% 24% 20% 24% 26% 35% 41% 28% % of HH members with an average monthly income less than 4.000 UAH 57% 68% 46% 60% 63% 65% 61% 63% 46% 37% 57% % of HH members working in the area where they reside 76% 48% 74% 89% 72% 80% 75% 61% 78% 92% 57%

Quality of Access to Quality of Quality of Quality of Quality of Access to Quality of Quality of Quality of Housing (incl. Top 1 Greatest concern for HH healthcare healthcare healthcare healthcare healthcare healthcare healthcare healthcare healthcare utilities) healthcare services services services services services services services services services services Access to Quality of Access to Access to Non Quality of Non- Quality of Housing Housing Access to Top 2 Greatest concern for HH healthcare healthcare healthcare healthcare affordability of healthcare affordability of healthcare (incl. (incl. healthcare services services services services basic goods services basic goods services utilities) utilities) services Housing Non- Housing Non- Non- Access to Access to Housing (incl. Housing (incl. Housing (incl. Top 3 Greatest concern for HH Transportation affordability of affordability of affordability of healthcare (incl. utilities) (incl. utilities) healthcare utilities) utilities) basic goods utilities) basic goods basic goods services services Roads Roads Roads Utility with the highest proportion of dissatisfied users Roads (65%) Roads (61%) Roads (51%) Water (90%) Roads (75%) Roads (52%) Water (79%) Roads (90%) (57%) (72%) (67%) Water Water Water Heating Utility with the second highest proportion of dissatisfied users Leisure (39%) Water (59%) Water (44%) Roads (88%) Water (70%) Leisure (33%) Water (39%) (45%) (57%) (60%) (78%) Water Water Water Illegal Top environmental concern for HH Air pollution Air pollution Air pollution Air pollution Water pollution Water pollution Illegal landfills pollution pollution pollution landfills

% of facilities experiencing pressure on their facilities due to NGCA residents* 18% 13% 0% 48% 9% 6% 25% 8% 22% 50% 10% % of facilities with not enough FTEs to manage the workload 29% 38% 38% 46% 14% 0% 13% 20% 31% 36% 31%

% of facilities experiencing frequent shortages of water* 3% 0% 10% 0% 5% 11% 13% 4% 9% 0% 18%

% of damaged and unrepaired or partially repaired facilities* 0% 0% 0% 0% 27% 56% 60% 8% 2% 0% 4% % of facilities not having or having only partial SOPs for GBV* 21% 23% 0% 39% 6% 0% 6% 29% 41% 57% 38%

*As reported by Facility Key Informants from Social + Admin + Health + Education Sectors tion was found to be unemployed. Noticeable the targeted areas has completed higher ed- absence of tertiary level healthcare facility in KEY FINDINGS differences were reported between men and ucation, with an even lower proportion in the all assessed hromadas. Healthcare facilities in women in terms of the unemployment rate (8% Kurakhove Urban, Kurakhove Rural and Mari- Kurakhove were reportedly experiencing pres- POPULATION PROFILE for men vs. 16% for women), structural causes inka Rural areas. However, more than half of sure from NGCA and GCA residents, which Demographic trends: The preliminary analy- of unemployment or socioeconomic vulner- HH members were reported to have complet- might result from the lack of facilities in its sur- sis of the household profile depicts an ageing abilities, and average income. This suggests ed vocational training (53%). roundings. Finally, findings suggest that, while population, (low proportion of children, youth entrenched sociocultural gender divisions. physical access to healthcare facilities is gen- and pregnant and lactating women (PLW) vs. Physical access: Overall, availability of and erally perceived to be good, barriers remain for a high proportion of population above 60) with GEOGRAPHIC VULNERABILITY physical access to education facilities was PwD, who constitute 9% of the population. a high prevalence of women in older popula- Regarding the geographical spread of vulner- found to be good. However, reports of poor ac- tion groups. Moreover, on average, women abilities, the area of Kurakhove Rural slightly cessibility for Persons with Disabilities (PwD) Quality of health services: This section seem to be more socio-economically vulnera- differs from the other areas, with a relatively were widespread, which could constitute an has demonstrated that quality and access to ble than men. Despite these figures, the pop- higher proportion of older, vulnerable and impediment for this specifically vulnerable healthcare are major priorities and sources ulation appeared to be in a good health, with retired individuals, as well as a more limited population group. of concern for HHs in the target area of this a very low proportion indicating the need for a amount of income-generating opportunities, assessment. Findings have shown that HHs social worker of carer. often reportedly forcing the few individuals Financial access: Financial barriers in ac- were relatively dissatisfied with their current who are actively seeking employment to move cess to education did not appear to exist, access to healthcare services, primarily due Economic vulnerability: Findings indicate a to other, more dynamic areas. although solicitations of punctual voluntary to financial reasons (namely the cost of medi- higher proportion of retired people (42%), who contributions from parents (either financial or cines and treatments); but also because of the thus depend on pensions for a living, than ac- Displacement trends: The locations targeted in-kind) seem to be relatively common at the reportedly poor quality of equipment. In that tive individuals (35%) who contribute to pen- for this assessment did appear to be a rela- community level. regard, facilities’ conditions and infrastruc- sions funds, which appears to be symptomatic tively important hosting area for Internally Dis- tures were commonly reported to be “average” of the lack of financial sustainability that is placed People (IDPs), as IDPs represented Quality of Education services: Overall, HHs or “unsatisfactory” by both FKIs and IMPACT at the heart of the Ukrainian pension system 6% of the overall population in the assessed and facility representatives seemed to concur enumerators. Provision of services associated crisis. The relatively low average monthly in- areas, with a slightly higher proportion in Vu- on the fact that the lack of capacity (in terms of to mental health were also found to be limited. come (56% of HH members earned less than hledar area (10% of the local population). availability and skills of teaching staff) consti- However, the availability and quality of facili- 4.000 UAH per month), which is directly cor- tutes a major impediment to quality education ties’ supplies and equipment was relatively related with the low pensions, might imply a Priority Needs: In line with the population pro- in targeted areas. Additional barriers included satisfactory. limited stimulation of the local economy, fur- file (i.e. ageing and relatively poor), the three poor quality of educational equipment (particu- ther dragged by the seemingly low appetite primary concerns of HHs in the areas covered larly IT); and limited availability of psychoso- Financial access to health services: Al- of youth and working-age adults in starting by the assessment were found to relate to 1) cial support services. though the vast majority of services provided up new businesses (87% of working age HH the quality of healthcare services 2) access to are reportedly free, the cost of meeting health members never considered it as a possibility). healthcare services and 3) housing, including HEALTH needs remains the primary challenge reported Unemployed individuals might be particularly utilities. Physical access to health services: Access by HHs, particularly for HHs with most vulner- vulnerable, since they generally do not benefit to healthcare might be impeded by the rela- able members (estimated to be 51% of the from any social safety net assistance and often EDUCATION tively limited number of secondary healthcare overall population). Health associated costs do not have any form of substantial sources Education profile of the population: Find- system facilities that were only present in constitute one of HHs’ primary expenditures, of income – 12% of the overall adult popula- ings suggest that just 8% of the population in larger urban centers, but also because of the and a relatively high one, when considering

8 HEALTH 2 HHs’ average monthly income. Further quali- high number of social facilities present, there tative analysis is recommended to better un- were no social service centres in Krasnohoriv- LIMITATIONS OF METHODOLOGY: derstand the nature of these ad-hoc costs. ka, Kurakhove Rural and Vuhledar Rural are- Finally, the health reform appeared to be wel- as at the time of the assessment. Not all facility representatives agreed to participate in the KII, which may limit the census ap- comed by HHs as well as professionals; but proach on the facility level. Moreover, since most FKI findings are solely based on individuals’ some concerns have been raised about the CROSS-CUTTING ISSUES reported perceptions of the service providing facilities they work for, all FKI findings presented in lack of preparedness or funds to meet the ex- The analysis of transportation trends indicat- this report should be considered as indicative only. Concerning the HH surveys, for some subsets pectations raised by the reform. ed that Vuhledar Rural and Kurakhove Rural in the report, the confidence interval may be lower and should thus be considered as indicative areas were not “functional urban areas” per only. Due to the sensitive nature of some questions included in the interview and survey tools, it is ADMINISTRATIVE SERVICES AND PUBLIC se, since a large proportion of the respond- likely that some sensitive issues have been under-reported and remain under-represented in this INSTITUTIONS ents living there reportedly regularly needed to report. In addition, findings on HH members are based on reporting by proxy, and therefore are not Overall, HHs were commonly satisfied with the travel to other settlements to access services. reflective of the lived experiences of HH members, but rather on the perception of the respondent available services, but “complexity” and “length Satisfaction towards transportation services reporting on them. of procedures” were the main subjects of dis- appeared to be “average”, with the cost of trav- satisfaction by far, and could thus be consid- elling, quality of service provision and roads NOTE ON REPORTING OF HOUSEHOLD DATA: ered as a potential area of improvement. The being the primary causes of dissatisfaction. possibility of reinforcing e-administration might Household (HH) data was collected on multiple levels. Data collected at the HH level is reported be explored but in a geographically differenti- Provision of quality water also appears to be as % of HHs. Some questions were asked on an individual level directly to the survey respondent; ated manner, and also taking into account the an issue in Mariinka Rural and Kurakhove these are reported on as % of respondents. Other questions were reported by the respondent overall low readiness of users. It should also Rural, with a high proportion of HHs not being on behalf of the head of household (HoHH) or on behalf of each individual member in their house- be noted that, while distance to facilities was connected to a water services at all. In addi- hold, by proxy; such findings are reported as % of HoHHs and % of HH members. Lastly, the not reported as a major issue overall, it did tion, most users were dissatisfied with water subset of HH members reportedly accessing/using a particular service (e.g. education services, seem to be a challenge in Kurakhove Rural services in Vuhledar Urban. Moreover, the social services) is sometimes referred to as % of (service) users for narrative purposes. and Mariinka Rural. vast majority of HHs in Vuhledar Rural and Kurakhove Rural were not connected to the Overall, findings demonstrate a low usage of central heating system. courts, and a relatively low trust in the police and court system. Nonetheless, findings sug- Finally, most facilities across the surveyed ar- gest that citizens generally feel safe in their eas were found to lack adequate infrastructure everyday life and conflict-related reasons for to receive and cater to PwD. insecurity are secondary, while road condi- tions, sidewalks in particular, are the main re- ported reasons for why HHs felt unsafe.

Findings showed that an overall low proportion of the population is using social services, most of whom were reportedly satisfied with these services. While Vuhledar had the relatively

9 HOUSEHOLD 39% of female HH members over 60 years 23% of HHs on average were reported to have more, the proportion of pensioners is relatively old and 27% of male HH members. The survey at least one child, and 11% of HH members were higher among HoHHs particularly (52% overall), PROFILE respondents in particular tended to be relatively of school-age (from 5 to 18). These results are in comparison with the HH members sample. This section provides a description of house- old and close to retirement age, with 57 years old corroborated by the low proportion of pregnant or holds’ main socio-economic characteristics in on average (see Table 1 and Figure 2). lactating women (PLW) (3%), and are in line with TABLE 2: % of reported vulnerabilities the targeted areas. In total, 2.725 respondents the average natural decrease in the population amongst HH members per location were surveyed, of whom 88% reported to be size at the national level (-0.61%).1 FIGURE 2: Counts of respondents Other the Head of Household (HoHH). HoHHs or Chronic Disability Pensioner vulnera- respondents acting on behalf of the HoHHs illness (official) 80 57% of HH members were bilities answered questions on the HH level as well as women on an individual level per HH member, hereby 60 55+45A Female 42% 20% 5% 9% representing 5.874 individuals. The typical of respondents had lactating Male 32% 12% 9% 8% HH was female-headed (62% of HoHHs were 1% 40 women in their household, and 1% female), relatively small (with 2 members per pregnant women Krasnohorivka 42% 18% 7% 10% 20 HH on average), with a high proportion of 1+981A Kurakh. Rural 48% 15% 5% 6% elderly and very limited number of children and Kurakh. Urban 41% 16% 5% 7% youth compared to the elderly. 0 16% of household members 18 40 62 84 Kurakhove 34% 11% 5% 12% Age of HoHH were minors As corroborated by the population pyramid 17+83A Mariinka 39% 21% 6% 8% below, 57% of HH members were women, sim- These findings were relatively homogenous Half of HoHHs (49%) were reportedly married, Mar. Rural 41% 18% 6% 8% across locations, except in Kurakhove Rural, 29% were widowed, 11% divorced and 4% ilarly to the 2018 national average of 53,7% in Vuhledar 28% 18% 11% 8% 2018.1 The average age of HH members was where the findings suggest the population was single. Finally, 33% of HHs were composed of Vuhl. Rural 35% 18% 8% 12% 44, and 53 when excluding minors from the generally older than the nation-wide average, only one person (41% in Mariinka Rural). calculation. Overall, 34% of the HH members and with less children (see Table 1). Overall, Overall 37% 16% 7% 9% VULNERABILITIES were reportedly 61 years old or older; with TABLE 1: HH characteristics These preliminary findings seem to indicate that Overall, 51% of HH members were reported to women are generally more socio-economically % of HH % of HH Average FIGURE 1: Population pyramid, % of total members with at have at least one vulnerability, with 56% of female vulnerable than men, but there were also indica- age of HH over 61 least 1 tions of a higher resilience among them, such as HH members (5.874 persons in total)* member and 45% of male HH members. As indicated in y.old child

3+12+14+10+9+5+4 1+6+10+9+9+6+3 Table 2, more than a third of HH members (37%) the higher average life expectancy. Almost twice 3% 81+ 1% Krasnohorivka 49 36% 16% were reported to be pensioners (individuals re- as much female HH members were reported to 13% 66-80 6% Kurakh. Rural 52 42% 15% ceiving all kind of pensions) which has to be read be chronically ill (20%) than male HH members (12%). However, the proportion of people living 16% 51-65 11% Kurakh. Urban 48 37% 19% in line with the average age of the population and the average nation-wide retirement age.2 The with an official disability status was found to be 10% 36-50 9% Kurakhove 45 33% 26% proportion of pensioners among HH members higher amongst men (9%) compared to women 8% 19-35 7% Mariinka 49 35% 20% appears to be particularly high in Kurakhove Ru- (5%). 5% 6-18 6% Mar. Rural 48 38% 22% ral, where almost 1 person out of 2 was found to 3% 0-5 3% Vuhledar 40 21% 36% be a pensioner, which is reflected in the generally Overall, two percent (2%) of HH members older population living there (Table 1). Further- were reportedly disabled but did not have any Female Male Vuhl. Rural 45 32% 26% Overall 46 34% 23% * The overall sum of all percentages equal 101% due to arithmetical rounding. 10 1. Statistical yearbook of Ukraine, 2018, state statistics service of Ukraine 2. 59.5 years old for women and 60 years old for men officially recognized disability status. Amongst As illustrated in Figure 3, the primary reported using a full-time caregiver, and only 1% of HH age vs. 46 years old). IDPs also seemed to all disabled HH members with an official status cause for not receiving benefits was the com- members were reportedly in need of these ser- be more highly educated than non-displaced (7%), the most frequently reported disabil- plex administrative procedure that had to be vices without being officially entitled to receive people, as 15% of IDP HH members have ity groups were group III (52%), followed by undertaken to claim them (as per 35% of them. This relative independence from social reportedly completed higher education, in group II (35%) and group I (8%), and lastly dis- HH members). The second most commonly services might not stand on itself. It might, for comparison to 7% of non-displaced HH mem- abled since childhood for 5% of HH members.* reported reason was that the benefits were instance, coincide with strong supportive net- bers. With regard to their economic inclusion, Finally, considering the Veteran of war/ATO/ “cancelled or not assigned yet” (30%), followed works of people taking care of each other and IDP HH members were reportedly less likely JFO status to be a vulnerability, no HH mem- by lack of access to the facility itself (16%). This a prevalence of social barriers, such as a lack to be retired (37% vs. 43% overall) but more bers reportedly had this vulnerability. Overall, latter reason especially appeared as a chal- of trust in state services. Additional data and likely to be unemployed (19% vs. 12% overall). this preliminary analysis of HHs’ demographic lenge for HH members in Krasnohorivka and in-depth analysis is required to further explore and socioeconomic vulnerability profiles sug- Kurakhove Urban, where 33% and 38% of the how such social dynamics impact social ser- Finally, findings suggest that IDP HH mem- gests a high dependency on social protection disabled HH members, respectively, report- vice uptake. Such a perspective might be rele- bers were more likely to have a disability schemes. edly faced challenges to physically access the vant to consider as intra-household caretaking than non-displaced population (13% vs. 6%); service. It is also worth noting that 16% of HH reduces time that could otherwise be allocat- while also being more likely to not receive BENEFITS members were reportely not receiving bene- ed for income generating activities, impacting any benefits (8% of displaced HH members fits because claiming them was not financially HHs’ availability for employment, particularly were reportedly entitled to benefits while not 4% of HH members did not appealing compared to current income (16%), for women, who might be more likely to as- receiving them, vs. 4% of non-displaced HH receive the benefits they were enti- and a same proportion because the efforts sume caregiving roles. members). 6+94A tled to (8% could not answer) were not worth the compensation. Finally, 8% Almost all HHs reported receiving the benefits of HHs reported corruption as a perceived bar- INTERNALLY DISPLACED PERSONS FIGURE 4: % of IDP HH members amongst they were entitled to. rier to access benefits. On average, 6% of HH members were report- HH members per assessed area FIGURE 3: Most commonly reported rea- edly displaced, but with notable differences Overall 5% 1% sons for not receiving benefits, by % of between areas, since the proportion of HH HH members who were reportedly entitled members that were reported to be displaced Vuhledar to receive benefits but were not receiving 4+96A 5+95A varied from 3% in Vuhledar Rural to 10% in 10% Vuhledar. The greater attraction for Vuhledar them (4%) of HH members 5% of HH members Kurakhove 6% 1% 34 4% might be partially explained by its younger reportedly needed a reportedly needed a Hard procedure 35% (Tables 1 & 2) and more dynamic labour Marinka Rural 6% 1% + 31+16+16+15+9+8 social worker carer Cancelled or not assigned 30% market (Table 4). With regard to the specific Marinka 4% 1% In contrast to the relatively high proportion of demographic characteristics of IDPs, the IDP Cannot access the facility 16% Krasnohorivka 4% 5% vulnerabilities highlighted above, only 4% of population seems to be gender-balanced. IDP Lack of money 16% HH members reportedly needed the services HHs more commonly reported having children Kurak. Rural 4% 1% Not worth the efforts 16% of social worker; with 2% of HH members re- than non-displaced HHs (36% of IDP HHs had Kurak. Urban 3% 1% Lack of documents 9% portedly needing it without being entitled. Like- at least one child, in comparison with 23% Vuhl. Rural 3% Corruption 8% wise, only 3% of HH members were reported of non-displaced HHs). Furthermore, IDP HH members were generally younger than * Group I: Completely disabled, incapable of doing any work, and requiring constant attendance Group II: Disabled, incapable of IDP with official status doing any work, but not requiring constant attendance Group III: Incapable of usual work (Convention on the Rights of Persons with non-displaced HHs (40 years old on aver- IDP without status Disabilities & Social Security Programs throughout the world: Asia and the Pacific, ISSA, 2006)

11 HEALTHPROFILE 2 Respondents commonly perceived them- larly high, as the vast majority of HH members This latter proportion varied significantly 99% of HH members (overall) selves as not having major health issues, with were reportedly not drinking alcohol at all (57%) between areas; 52% of respondents in Kura- were not considering themselves 18% of respondents reporting being in either or only drinking for special occasions (38%). khove Rural reported having a smartphone, as part of an ethnic or religious “very bad” or “bad” health, as illustrated in However, findings suggest that men are slightly compared to 77% in Vuhledar. Moreover, 68% minority (and 97% of IDP HH mem- Figure 6. Given the relatively high proportion more inclined towards drinking on special occa- of respondents in Vuhledar reported having a 98+2A bers). of aged people, people suffering from chronic sions, and 10 times more likely to drink during smartphone and being comfortable using it, KEY HEALTH CHARACTERISTICS illness(es), and PwD, and the difficulties such the weekends. Quite similarly, the overall propor- compared to only 22% in in Kurakhove Rural. impediments create in everyday life, the pro- tion of male HH members who were reportedly The population in the targeted areas was rel- portion of HH members who reportedly used smoking on a daily basis was higher than the Likewise, computer literacy skills were une- atively aged (46 y/o on average), with 16% of and needed the services of a social worker or proportion of female HH members, as shown in venly spread across assessed areas, with chronically ill individuals and 7% living with a caregiver was remarkably low, as mentioned Figure 8. There were no significant differences lower levels of skills in Kurakhove Rural and disabilities. Out of the 12% of “other” answers earlier. When asked about how they would like found in the frequency of tobacco and alcohol Mariinka Rural (where respectively 23% and for reported difficulties faced by people living to change their lifestyle in order to improve their use between the assessed areas. 27% of respondents reported being fully com- with disabilities illustrated in Figure 5, the most health, respondents were commonly inclined puter literate, in contrast to 68% in Vuhledar), FIGURE 8: % of HH members (older than reported issues were related to oncology. towards changing their eating habits, with 30% of which could be due to the fact that these areas 14) by reported consumption of cigarettes, respondents reporting wanting to eat more fruit are also the areas with the relatively oldest FIGURE 5: Reported types of difficulties by gender

and vegetables, and 29% following a healthier 9 population. faced by 7% of HH members with disabilities 11% +40+0 62 diet (by reducing the consumption of fried and Every day 43% 62% Walking or climbing stairs +88+ + 23+11+11+2+1 greasy food). Reducing smoking was a desire for Do not use 87% 56+ Self care (washing or dressing) 23% 12% of respondents, and losing weight for 5% of 52% 0+ TABLE 3: Computer literacy and % of 3+ respondents who can use basic computer Remembering or concentrating 11% respondents. Finally, only 8% reported that they 2% 3 Other/ refuse to say 4% services Seeing even when wearing glasses 11% would like to exercise at least 3 times a week. Female Male Hearing even if using a hearing aid 2% As indicated in Figure 7 below, the reported Not Yes, can do Can do comfortable consumption of alcohol did not seem to particu- ACCESS TO COMMUNICATION AND all basic some Speaking or understanding own language 1% with a actions actions FIGURE 7: % of HH members (older than 14) COMPUTER LITERACY computer by reported alcohol consumption, by gender

FIGURE 6: % of respondents per reported 0 The vast majority of respondents reported Krasnohorivka 33% 32% 35% health status 0% +0+ Every day 1% 0+0+ having a mobile phone, and 64% of respond- Kurakh. Rural 23% 30% 47% 50% ents reported possessing a smartphone. 3-5 times a week 0% 1 Kurakh. Urban 34% 24% 42% 2% +0+ 31% 1 Kurakhove 35% 28% 37% 2 16% Once a week 0% + 0+ 3% + Mariinka 33% 27% 40% 1

2% 2% Only during the weekends 1% +10 Mar. Rural 27% 28% 45%

8% +0 Very bad Bad +32 96% of respondents 40% of respondents Vuhledar 68% 7% 25% Neither good On special occasions (on 43 32% + Good Very good nor bad reported being comforta- reported being comfortable holidays) 51% +0 Vuhl. Rural 41% 13% 46%

+66 ble using a mobile phone using a smartphone on their Methodological note: the black line represents the 67% +43 on their own. did own, while 24% were not Overall 38% 23% 39% Do not drink alcohol +0 2% weighted average of respondents’ choices. 35% not have a mobile phone comfortable. 36% did Female Male not have a smartphone.

PROFILE 12 SOURCES OF the annex to this report page 54 showing the MAP 3: Employment catchment areas (see also Map 15 of Functional Urban Areas page 54) respective Functional urban areas of Kurakh- ive and Vuhledar. Several sub-centers were Access to work across settlements INCOME also discernible, such as Mariinka, Krasno- (as reported by CKIs and HHs) This section provides an overview and analy- horivka and Hirnyk within the assessed area, sis of the main employment statuses reported and Volnovakha, or Pokrovsk out- for adult HH members (18 and older, total- side the target area. ling 4.941 HH members). When relevant, the comparison with the International Labour Organi- On the other hand, the map also illustrates zation (ILO) categorization (18-70) is made.3 quite well that most peripheral areas (espe- cially Vuhledar Rural and Mariinka Rural) were devoid of economic opportunities, forcing 29% of adult HH members workers to move to their nearer more cen- are employed. (38% ILO) 38+62A tral areas. In the same vein, the sectors with the lowest proportions of HH members being Overall, just over a third of adult HH members employed in the area where they live are the (35%) were found to be directly participating to mining, agriculture and state services sectors. the local economy (employed full-time, part-time and self-employed combined; officially as well Finally, it is interesting to note that female as unofficially), while 42% of HH members (39% employed HH members were seemingly more ILO subset) were reportedly retired (see Table 4). likely to work in their own settlement (85% of female employed HH members reportedly did LOCALIZATION OF EMPLOYMENT AND so) than employed male HH members (67%). FUNCTIONAL URBAN AREAS FIGURE 9: % of employed HH members The majority of employed HH members were who live and work in the same settlement, employed in the area where they live (75%). per area The comparison between areas clearly 75 Overall 75% demonstrates that HH members in rural areas + 0

were more likely to work in another settlement +93+89+80+75+74+61+57+48 than HH members in urban areas, and most Vuhledar 92% especially for HH members in Kurakhove Kurakhove 89% Rural, where only 48% of HH members were Krasnohorivka 80% reportedly working in another settlement. Map Mariinka 75% 3 visualises these differences in terms of job Kurakh. Urban catchment and economic vitality; with Vuhle- 74% dar and Kurakhove areas attracting the most Mariinka Rural 61% workers from all surrounding areas. These Vuhl. Rural 57% two economic poles are also clearly visible in Kurakh. Rural 48% 3. Key Indicators of the Labour Market, Ninth edition; Geneva, International Labour Office, 2016

13 HEALTHPROFILE 2 TABLE 4: % of HH members per employment status, by gender and area As indicated in Table 5 above, the primary informal employment and total or partial unde- source of employment for HH members was clared work can be hard to capture in stand- Full-time Part-time the service sector (incl. trade, logistics, se- ardized surveys, whereas such types of em- Retired In education Unemployed Self-employed employed employed curity) in most areas, except for Kurakhove ployment are likely relatively common in the Rural where agriculture is the primary source Ukrainian context.4 Female 47% 26% 10% 16% 3% 2% instead, and Vuhledar, where mining is the pri- Male 37% 33% 16% 8% 6% 2% mary source. As highlighted in Table 4, findings suggest that women in the assessed areas are more likely Krasnohorivka 44% 20% 12% 13% 8% 5% Overall, the mining industry was the second most to be unemployed than men (16% vs. 8%, Kurakh. Rural 52% 24% 8% 14% 4% 2% commonly reported source of employment, but respectively, and 21% vs. 10% with ILO cat- Kurakh. Urban 45% 32% 11% 9% 4% 2% with significant differences between areas, rang- egorization). In addition, 56% of unemployed Kurakhove 42% 28% 13% 15% 3% 2% ing from 1% of employed HH members in Kras- male HH members have reportedly been nohorivka to 30% in Kurakhove Urban and 42% searching for a job in the 30 days prior data Mariinka 44% 24% 11% 14% 6% 2% in Vuhledar. The agriculture sector was relatively collection, compared to 23% of female unem- Mar. Rural 46% 26% 12% 12% 6% 1% important only in the three rural areas (Kurak- ployed HH members. Vuhledar 33% 41% 17% 9% 3% 2% hove Rural, Mariinka Rural and Vuhledar Rural, Vuhl. Rural 39% 28% 16% 15% 3% 1% where respectively 29%, 22% and 20% of em- ployed HH members were reportedly employed Overall 42% 29% 13% 12% 4% 2% in this sector), and far less elsewhere. Likewise, TABLE 5: % of employed HH members per work sector and assessed area the industry sector seemed relatively important in Kurakhove, while it was not commonly reported

Municipal State in any other assessed area. Finally, in Krasno- Service Mines Industry Agriculture Construction Education Healthcare sector services 52+48A 20+80A horivka, a relatively high proportion of HH mem- bers were reportedly employed in the healthcare 56% of unem- 23% of unem- ployed male HH ployed female HH Female 47% 8% 5% 6% 1% 12% 6% 9% 3% sector (11%, in comparison to 5% overall). Over- all, less than 1 % of all employed HH members members have been members have been Male 27% 27% 11% 11% 15% 1% 4% 1% 1% looking for a job in looking for a job in the were reportedly workingin the military sector. the last three months last three months Krasnohorivka 47% 1% 3% 6% 17% 6% 4% 11% 3% Kurakh. Rural 25% 2% 12% 29% 8% 7% 11% 5% 0% UNEMPLOYED HOUSEHOLD MEMBERS Figure 10 shows that the primary causes of unemployment vary considerably between Kurakh. Urban 35% 30% 8% 3% 5% 6% 2% 6% 1% Overall, 12% of HH members were reported- the two groups. In fact, the primary cause of Kurakhove 37% 2% 28% 5% 8% 8% 4% 3% 2% ly unemployed. This needs to be considered women unemployment (55%) was associated Mariinka 46% 6% 2% 6% 18% 8% 9% 3% 2% in parallel with the relatively high proportion to household duties (“homecarer”), which was Mar. Rural 34% 13% 5% 22% 6% 9% 8% 3% 1% of NEET (Not in Education, Employment, or considered as a cause for only 10% of men. Training) among working-age school drop- On the other hand, 43% of male HH members Vuhledar 34% 42% 3% 0% 3% 4% 4% 4% 4% outs and graduates (almost 30%). Similarly, were reportedly unemployed due to physical Vuhl. Rural 28% 23% 6% 20% 5% 7% 3% 5% 0% Overall 37% 18% 8% 10% 8% 7% 5% 5% 2% 4. “Inclusive Labour markets for job creation in Ukraine”, ILO website, 2017

PROFILE 14 inability to take a job, in comparison to only was significantly higher in Vuhledar (73%) This proportion remains relatively low even also means a relatively low average monthly 13% of unemployed female HH members. than anywhere else (44% on average). within the ILO working age population, with income per HH member. As shown in Figure 85% of them reportedly never having consid- 12 below, the majority of HH members report- Overall, factors that were exogenous to the RETIRED HOUSEHOLD MEMBERS ered starting a business, 10% having thought edly earned less than the recently increased household itself (lack of vacancies, company about it but not actually having started one, and national official minimum wage (5.000 UAH).5 closed, end of contract) accounted for only 5% who reportedly have started a business in 42% of HH members are FIGURE 12: % of HH members (older than 39% of reasons for unemployment. Neverthe- retired (39% ILO) the past. Amongst the subset of people con- 14) by income bracket (over the last three less, 82% of HH members indicated that they 40+60A sidering starting up a business, lack of start-up months) would accept a new employment opportunity if financial capital was identified as the primary offered, irrespective of their gender. The relatively high proportion of retired pop- barrier preventing individuals from starting up 0 6% ulation has to be read in line with its relatively a business (82%), followed by risks associated < 4000 56% FIGURE 10: % of unemployed HH members old age (Figure 1 and Table 1) and the official to starting up businesses (25%), lack of skills to 4001-8000 26% by most commonly reported causes of retirement age in Ukraine (59.5 for women and implement their idea (19%) inability due to family 8001-12000 7% unemployment, per gender 60 for men). Overall, the highest proportions of reasons (8%), and (perceived) corruption (6%). + 12000 3% 56 10 Homecarer 55% + retired HH members were found in Kurakhove Don’t know 2% 0 10% + Rural (52% HH members), in line with the older FIGURE 11: % of working age HH members +10

13% +43 6INCOME ANALYSIS +5626732A Physically unable population on average (42% of the population (older than 14) who reportedly have thought 42% +0 +21 being over 60 years old, compared to 34% on about starting up a business The following section proposes a disaggre- No vacancies available 21% +21+ 20% 0 average). Accordingly, these proportions were gated analysis of income levels by gender, +4 even higher for HoHHs (with 56% of HoHHs No +7 87% Company closed / downsized 5% geographic areas, vulnerability profiles, and 7% +0 being retired on average, and 65% in Mariinka Yes, but haven’t started displacement status, to better identify overlap-

+3 8%

Dismissed due to own will 3% +12 Rural). Yes, have started ping and coinciding HH-level vulnerabilities. 11% +0 4% +0 Don’t know/ refuse to answer 0% +2 1% Due to end of contract 2% ENTREPRENEURS AND SELF-EMPLOYED 87+841z The higher proportion of vulnerabilities HOUSEHOLD MEMBERS amongst female HH members that was iden- Female Male tified in the previous section of this report Although self-employment constitutes the LEVELS OF (higher proportion of pensioners, chronically In terms of geographical differences, some most profitable income generation source * ill, and unemployment as well as overall interesting differences emerged from the (Figure 15), only 2% of the overall assessed INCOME higher age) is reflected in their relatively lower comparative analysis. First, the closure or population appears to be self-employed (Table reported income. As illustrated in Figure 13, downsizing of companies was more com- 4), an image that is traceable in ILO findings As previously mentioned, findings suggest that the data suggests that women are likely to monly reported by HHs in Krasnohorivka and as well (3% of the population). This tendency only 35% of the adult population is directly earn less than men, with 69% of female HH Mariinka (respectively 43% and 40% vs. 18% is directly reflected in the fact that starting a participating to the local economy through members reportedly having an income lower overall), suggesting a less performing local business or becoming entrepreneurs did not income generating activities, while 42% is than 4.000 UAH per month, compared to 37% economy than elsewhere. Besides, the pro- appear as an appealing income generating retired. This translates into a high economic of men. Likewise, 54% of male HH members portion of HH members who were reportedly option for HH members, as 87% were reported dependency upon pensions. An analysis of had a reported monthly income of more than unemployed because they were “homecarer” to never have considered this option. HH members’ levels of income shows that it 4.000 UAH, compared to only 22% for women. * Income was defined here as all types of financial sources, salary, pension, benefits, trade, relatives’ help) 5. “President Zelensky signs law to raise minimum wage in Ukraine”, Ukrinform, August 2020

15 HEALTHPROFILE 2 The disaggregation by geographical area est (32% in Kurakhove Urban and 41% for generating more than 8.000 UAH per month. nerability types further confirms that socially reveals two distinct sub-groups. The first sub- Vuhledar Urban; in comparison to only 20% Employed HH members constitute the second vulnerable HH members, such as pensioners, group is poorer than the overall average, and in Krasnohorivka for instance), but also where better off group, the majority of whom were chronically ill people, disabled people, and is mostly concentrated in Kurakhove Rural, the proportion of unemployed HH members reportedly earning more than 4.000 UAH per veterans, are also the most economically vul- Krasnohorivka, Mariinka Rural, Mariinka and was the lowest (9% for both). On the other month (69%). nerable. In fact, 72% of socially vulnerable HH Kurakhove areas, where more than 60% of hand, Krasnohorivka and Mariinka Rural are members belonging to these groups report- HH members reportedly received a monthly the areas with the oldest population on aver- 27% of unemployed HH edly received an income lower than 4.000 income lower than 4.000 UAH (red lines in age (see Table 1). Figure 15 highlights that members reportedly did not UAH per month, compared to 49% of (report- Figure 14). The other sub-group consists of retired HH members are in fact the poorest 27+73A receive any form of income. edly) non-vulnerable HH members. This has the population of Vuhledar and Kurakhove population group (73% have an income lower to be read in line with the fact that pensioners Urban, where respectively only 37% and 46% than 4.000 UAH per month) alongside unem- This finding suggests a gap in safety net sys- constitute the bulk of this group of socially vul- of HH members reportedly received a monthly ployed individuals (86%). Self-employed HH tems. This also suggests that the unemployed nerable HH members; with pensions benefits income lower than 4.000 UAH. Coincidentally, members, on the other hand, were found to population likely constitutes the most econom- that can be as little as 1.300 UAH per month, these are the areas where the proportion of be financially better-off, with 25% of the sur- ically vulnerable group in the assessed areas. and with 79% of pensions amounting less than HH members working full time were the high- veyed HH member entrepreneurs reportedly The disaggregation of income levels by vul- 3.000 UAH per month in 2018.6

FIGURE 13: HH members’ (older than 14) FIGURE 14: HH members’ (older than 14) FIGURE 15: HH members’ (older than 14) FIGURE 16: HH members’ (older than 14) income distribution disaggregated by income distribution disaggregated by area income distribution disaggregated by income distribution disaggregated by vul- gender employment status nerabilities 70% 80% 80% 70% 73% 70% 60% 69% 70% 60% 60% 70% 50% 60% 50% 50% 59% 50% 37% 50% 40% 38% 40% 40% 33% 40% 30% 27% 33% 30% 30% 37% 30%

20% 20% 14% 20% % of surveyed population 20%

% of surveyed population % of surveyed 11% 6% 20% 10% 7% 20% 10% % of surveyed population 10% 10%

% of surveyed population 10% 6% 4% 2% 5% 2% 0% 0% 0% 0% 0% 2% 0 Up to 4000 4001-8000 8001-12000 More than 0 Up to 4001- 8001- More tha n 0 Up to 4000 4001-8000 8001-12000 Mor e th an 0 Up to 4000 4001-8000 8001-12000 More than UAH UAH UAH 12001 UAH 4000 UAH 8000 UAH 12000 UAH 12001 UAH UAH UAH UAH 12001 UAH UAH UAH UAH 12001 UAH Female Male Overall Krasnohorivka Retired Full-time employed No vulnerability Kurak. Rural Mariinka Unemployed Self-Employed Kurakhove Kurak. Urban With at least one vulnerability Mariinka Rural Vuhledar Vuhl. Rural 6. Key issues in pension system reform in Ukraine, USAID, 2018

16 Interestingly, only 2% of vulnerable HH mem- bers reportedly had no income; compared to KEY FINDINGS 11% of HH members without any vulnerabil- Overall, the preliminary analysis of the household profile depicts an ageing population, (low ities, indicating that most HH members with proportion of children, youth and PLW vs. high proportion of population above 60) with a at least one vulnerability are almost all either high prevalence of women in older population groups. Moreover, women on average tend employed or benefiting from financial/ safety to be more socio-economically vulnerable than men. Despite these figures, the population net assistance or pensions. Finally, and unlike appeared to be in a good health, with a very low proportion indicating the need of a social in the Sievierodonetsk target area where worker of caregiver. IDPs were generally richer than the non-dis- placed people, IDPs in the Mariinka area Findings indicate a higher proportion of retired people (42%), who thus depend on pension were reported to have more or less the same for living, than active individuals (35%) who contribute to pensions funds, which appears income as the non-displaced population. This to be symptomatic of the lack of financial sustainability that is at the heart of the Ukrainian might be partially explained by the fact that pension system crisis.7 The relatively low average monthly income (56% of HH members the lower proportion of retired IDPs (37% vs. earn less than 4.000 UAH per month), which might be further reflected in the low pensions, 43% for overall population) is counterweighted suggests a limited stimulation of the local economy, further dragged by the seemingly low by the higher proportion of unemployed IDPs appetite of youth and working-age adults in starting up new businesses (87% of working age (19% vs. 12%) and higher proportion of IDPs HH members never considered it as a possibility). currently in enrolled in education programmes (20% vs. 13% overall). Findings suggest that the 12% of unemployed individuals constitute a particularly vulnerable FIGURE 17: HH members’ (older than 14) group, since they often do not benefit from any type of social/safety net assistance and do income distribution disaggregated by dis- not appear to have any substantial sources of income. Noticeable differences were reported placement status between men and women, particularly, in terms of the unemployment rate (8% for adult 60% 55% male HH members vs. 16% for adult female HH members), structural causes of unem- 60% 60% 55%55% ployment, socioeconomic vulnerabilities, and average incomes. This suggests entrenched 50% 55% sociocultural gender divisions. 50% 55%55% 40% In terms of geographic differences, the population in the areas of Kurakhove Rural was 40% 40% older, more vulnerable, and with more retired people, but also with more limited employment 30% 26% opportunities. Finally, the presence of IDPs was relatively important (6% of the overall pop- 30% 26%26% ulation), though slightly higher in Vuhledar area (10%). 20% 26% 20% 26%26% % of surveyed population % of surveyed population % of surveyed population 6% 9% 10%6% 9%9% 10% 6% 1% 1% 6% 7%7% 3%1% 3% 0%0% 7% 3% 0% 00 UpUp to to 4000 4000 4001-80004001-80008001-120008001-12000More thanMore than 0 Up to 4000 4001-8000 8001-12000 More than UAHUAH UAHUAH UAH UAH 12001 UAH12001 UAH UAH UAH UAH 12001 UAH 7. USAID, Key issues in pension system reform in Ukraine, 2018, http://www.fst-ua.info/wp-content/uploads/2019/02/Key- Issues-in-Pension-System-Reform-in-Ukraine_Aug2018_EN.pdf NotNotNot displaceddisplaced All All Alldisplaced displaced displaced status status status

17 HEALTHPROFILE 2 MAP 4: Available healthcare facilities TABLE 7: Number and types of available healthcare facilities, per area

This section describes the level of access, Primary Secondary Tertiary Ambulance care care care & first aid availability and quality of health services in the targeted locations. Findings are derived from Krasnohorivka 1 1 37 interviews with FKIs, all 2.725 HH surveys Kurakh. Rural 7 and 120 CKIs. Kurakh. Urban 2 1 Kurakhove 2 2 It should be noted that “quality of healthcare Mariinka 1 services” and “access to healthcare ser- vices” were the two most commonly reported Mar. Rural 6 main concerns across all assessed sectors Vuhledar 1 1 1 (reported by respectively 53% and 39% of Vuhl. Rural 10 1 respondents). Overall 30 4 0 3 AVAILABILITY OF HEALTHCARE FACILI- TIES AND SERVICE PROVISION More than 33% of facilities provide the service TABLE 6: Number of available healthcare g Less than or equal to 33% of facilities provide the service services per area, reported by FKIs  No facility provide the service Primary care system Emergency & first aid patients Visiting Family doctor Referral capacity Pediatrics Outpatient services Inpatient capacity Ambulance Basic Lab. services Pharmacy Post-surgery rehabilitation Dental care Primary injury care Basic imaging service Psychiatry Blood bank service & surgery Trauma Intensive care unit Maternity ward

Krasnohorivka       

Kurakh. Rural g g g g g  g g g  g  

Kurakh. Urban g  g          

Kurakhove g g g g g g g g g 

Mariinka           

Mar. Rural g        

Vuhledar g g g g g g  g g g g g g g g g  

Vuhl. Rural g g g g g        While primary care focuses on general care for overall patient education and wellness, secondary care and tertiary care treat more 17 severe conditions that require specialized knowledge and more intensive health monitoring. Once a patient is hospitalized and needs a higher level of specialty care within the hospital, he may be referred to tertiary care. Results of the mapping indicates that primary Map 5 on HH and CKI-reported access to MAP 5: Household and CKI access to secondary healthcare facilities across settlements care facilities were present in all strata with healthcare facilities clearly illustrates that a relatively exhaustive geographical cover- most health service users were traveling to age. On the other hand, only the larger urban the central areas of Kurakhove to access sec- areas of Vuhledar, Kurakhove and Krasno- ondary healthcare services; and to a far lesser horivka hosted secondary care facilities; and extent to Vuhledar, Krasnohorivka and Mari- no tertiary care services were present in the inka. Incidentally, a relatively large proportion targeted areas. of HHs were also reportedly accessing sec- ondary healthcare outside the target areas, in As a result, almost all services that are asso- Selydove and Volnovakha. ciated with secondary care were unavailable in many of the targeted areas, obliging people These geospatial interpretations are reflected seeking these types of health services to travel in the proportions highlighted in Table 8: while to other settlements (Table 5, Table 8 below almost all HHs reported accessing secondary and Map 5). healthcare services within their settlement in Kurakhove, Kurakhove Urban, Krasnohorivka TABLE 8: % of HHs accessing healthcare and Vuhledar, almost none indicated doing so services in their own settlement in all other areas.

Primary Secondary Tertiary Map 5 and Table 8 jointly indicate that people healthcare healthcare healthcare in the areas of Kurakhove Rural, Kurakhove services services services Urban, Mariinka, Mariinka Urban and, Vuhle- dar Rural have to leave their settlement to Krasnohorivka 99% 68% 7% access such services, likely leading to conges- Kurakh. Rural 41% 1% 1% tion of the few available healthcare services. Kurakh. Urban 93% 6% 1% Accordingly, 75% of healthcare FKIs in Kura- Kurakhove 99% 77% 13% khove considered the number of patients in Mariinka 98% 33% 1% their facilities as “too many”, in stark contrast Mariinka Rural 74% 4% 0% to the other assessed locations, where no Vuhledar 100% 74% 1% FKIs reported this pressure, suggesting a lim- Vuhl. Rural 77% 1% 0% ited capacity of health services to cope with the demand. By the same token, 50% of FKIs Overall 88% 38% 4% in Kurakhove reported having not enough full-time equivalents (FTEs) to manage the workload, in contrast with only 22% of FKIs on average.

18 HEALTHHEALTH 2 HOUSEHOLD ACCESS AND USAGE OVERALL USER SATISFACTION According to these HHs, the high price of med- In these rural areas, HHs also more commonly icine (81%) and high treatment costs (56%) reported “cost of travel to facility”. These Only 2% of HHs reporting having needed to As illustrated in Figure 19, the majority of HHs were the primary reasons of dissatisfaction, findings are in line with the relative absence go to a healthcare facility but not having been were dissatisfied with state healthcare ser- while financial support for medical expendi- of available facilities in these areas, leaving able to in the three months prior to the assess- vices that were available to them (67%). tures was also the most frequently reported HHs no option but to travel longer distances ment, while more than half of HHs (57%) have FIGURE 19: Users’ satisfaction towards primary recommendation (65% of HHs). The to access healthcare in other settlements. reportedly visited a healthcare facility in the state healthcare services poor quality of equipment was also an impor- Finally, it is interesting to note that “long wait- three months prior to data collection. 41% tant source of dissatisfaction, since it was ing lines” were relatively frequently reported as 6% reported by 38% of dissatisfied HHs, and the a reason for dissatisfaction in Kurakhove (as of HHs have reportedly 21% second most reported area of improvement per 28% of dissatisfied service users, in com- 57% 26% visited a healthcare facility in the (60%). Lack of professionalism and staff atti- parison to 17% on average), which corroborates three months prior to data collection 8% tudes were also reported as main sources of the FKIs’ perception on the number of patients 57+43A dissatisfaction for 36% and 9% of dissatisfied received in their facility. Neutral FIGURE 18: Most accessed health services Comp. dissatisfied Dissatisfied HHs, respectively, and were also clearly pin- / don’t know HOUSEHOLD HEALTH EXPENDITURES by households Satisfied Comp. satisfied pointed as important areas of improvement 85+36+14+11+5 – improving quality of staff was reported by General practitioners 85% According to the subset of HHs that reported of HH users needed to 46% of HHs overall, improving staff’s atti- 21% being dissatisfied with healthcare services provide extra payments Specialists 36% tude by 20%. The causes of dissatisfaction they had received, the cost of healthcare and Inpatient care 14% were rather consistent across areas, apart 21+79A the quality of healthcare services were both Just over a fifth of HHs reported having needed Pediatricians 11% from those pertaining to distance, which was the primary causes of dissatisfaction as well to provide extra payments in order to get a 5% a commonly reported cause of dissatisfaction. Dentists as the first recommendations for improvement. necessary state medical service during the 3 Primarily in the rural areas: Kurakhove Rural months prior to data collection. The discrepancy As illustrated in Figure 18 just above, the most (69% of dissatisfied HHs), Vuhledar Rural between this finding and the fact that just a few FIGURE 20: Top reported reasons for dis- accessed services were general practitioners (55%) and Mariinka Rural (39%), compared to facilities were reported to charge their patients satisfaction among dissatisfied users just 28% of dissatisfied HHs overall. (85%) and specialists (36%). 81+55+38+36+29+21+17+14+11+10 (Figure 22), might be explained by the preva- High price of medicines 81% FIGURE 21: Most commonly suggested lent, although decreasing, culture to thank for Among those HHs who had reportedly not vis- High treatment costs 56% areas of improvement for healthcare ser- services by giving gifts or rewarding physicians.1 ited a healthcare facility while needing to (2%), Lack of modern equipment 38% vices by service users the most commonly reported reasons were 65+59+46+20+20+8+5 FIGURE 22: Most commonly reported facil- Lack of professionalism 36% Support with medical expenditures 65% the high costs of treatment (60% of HHs), the ity pricing policies according to healthcare Distance to facility 28% Improve quality of medical equipment 60% impossibility to physically travel to/access a FKIs 81+16+3 facility (41%); and finally the difficulty to under- Lack of medical staff 22% Improve quality of health staff 46% Everything is for free 81% stand the new procedures (21%). Long waiting lines 16% Improve transport to facilities 20% Only some medication/ supplies charged 16% Cost of travel 14% Improve attitude of staff to patients 20% Everything is paid 3% Lack of medicines 11% Improve availability of information 8% Relatedly, “informal payments” was reported Complexity of referral system 11% None 5% as a reason for dissatisfaction by 7% of dissat- * Note: As mentioned in the methodology section, the term “users” refer here and throughout the report to the subset of HHs who 1. “How the healthcare system has changed”, web article, Ministry of Health of Ukraine, April 2019 reported having used the services in the three months prior to to this assessment

HEALTH 19 isfied service users (not shown in Figure 20). TABLE 9: Average HH expenditures on healthcare FKIs reported that they would rec- IMPACT OF CONFLICT ON FACILITIES Such additional expenses might be particularly health during the 3 months prior to data ommend their facility to other patients to get taxing on low income HHs, as the financial collection, by vulnerability type treatment. Facilities appeared to be equipped Overall, findings suggest that the impact of conflict on healthcare facilities has been burden of health is likely to be relatively higher Spendings on with acceptable heating, as 62% of FKIs Type of vulnerability moderate. According to healthcare FKIs, for them compared to middle-to high income health evaluated the temperature in the facility as HHs. For instance, health expenditures corre- “somewhat comfortable” or “at the right level”, during the period 2014-2019, only facilities in Disability - unofficial 4.500 UAH spond to 1/6th of the income of the poorest compared to 38% considering it “not very com- Krasnohorivka, Mariinka, Mariinka Rural and population groups (with 1.975 UAH on aver- Disability - official 3.097 UAH fortable” or “not comfortable at all”. Electricity Vuhledar Rural were damaged as a result of age spent over the last three months for all Chronic illness 2.884 UAH shortages were reported being “rare” by 24% shelling (see Figure 26). However, all facilities HHs) (Figure 23). At least one vulnerability 2.208 UAH of FKIs, and “frequent” by 8%, which can con- in Krasnohorivka and Mariinka were reported stitute a potential safety issue if health facilities to have been damaged and not fully renovated FIGURE 23: Average HH expenditures on Pensioners 2.030 UAH are not sufficiently equipped with generators. subsequently. health during the 3 months prior to data No vulnerability 1.525 UAH Regarding WASH, water shortages appeared collection, by income bracket Low income family 1.127 UAH FIGURE 26: % of facilities with damages to be relatively rare, since only 8% of FKIs from the conflict from 2014 to 2019 4000 3830 Pension age without pension 929 UAH reported frequent shortages. In addition, only Overall 11% 84% 3500 41% of healthcare FKIs reported that their FACILITY CONDITION facilities had access to drinking water. Finally, 3000 2657 Overall, healthcare facilities seem to be in 62% of healthcare FKIs reported that their Krasnohorivka 100% 2500 2113 rather satisfactory condition, with relatively few facility was equipped with sufficient toilets for Kurak Rural 100% shortages of utilities (except for electricity) and their staff and users, and 73% reported having Kurak. Urban 100% 2000 1750 sufficient equipment and supplies to function access to basic handwashing stations. Kurakhove 100% 1500 effectively. In fact, facilities were reported to be FIGURE 25: Facilities shortage of basic Marinka 100% 1000 in “satisfactory condition” by most healthcare utilities, as reported by FKIs Marinka Rural 17% 17% 67% Spendings (UAH) Spendings FKIs, while IMPACT enumerators reported Vuhledar 100% 500 finding facilities in “poor condition” (Figure 24). Water shortage 57% 13%8% 22% Vuhl. Rural 0 Nevertheless, it should be noted that 92% of 91% 4000- 8000- <4000 >12000 Was damaged and recovered partially 8000 12000 FIGURE 24: Estimation of facility condition Experiencing pressure due to NGCA residents Income bracket (UAH) Electricity shortage 68% 24% 8% Was damaged and fully recovered by FKIs and IMPACT enumerators Do notWas know not damaged Methodological note: the beige line represents the over- 19+ Excellent 19% 14 Not experiencing pressure due to NGCA residents

all average of HH’ spendings on health (1.975UAH) 0 14% + Gas shortage 19% 81% No facilities had reportedly ceased delivering +19

Further, as indicated in Table 9, there seems Good 19% +24 services due to the security situation during 0 to be a link between relative vulnerability of a 24% + +35 the 12 months prior to data collection. In terms 27+ HH and the HH’s health expenditures. Overall, Satisfactory 35% + Heating shortage 51% 8% 41% 27% 0 of preparedness, 24% of healthcare FKIs these findings highlight the potential limita- +27 reported that their facility had a bombshelter, 27% +35 No Yes, rarely tions of the “Affordable Medicines Program” Poor 35% with 67% of them considering that its safety launched in 2017, which was precisely meant FKIs IMPACT enumerators Yes, often Not applicable level was satisfactory. to ensure free (or almost free) medication for certain chronically ill patients.2 2. “Health Care System Reform”, Web article, Ukrainian Governmental portal - official website - 2018

20 HEALTHHEALTH 2 FIGURE 27: % of FKIs reporting experi- per 41% of FKIs for both), followed by general In terms of other essential equipment, 35% FIGURE 28: % of FKIs reporting having encing additional pressure from NGCA practitioners and paediatrics (both reported by of healthcare FKIs reported that their facilities adequate supplies and equipments to treat residents 27% of FKIs), and basic imaging and labora- were equipped with a landline or a cellular tele- patients with following conditions: tory services (both 14%). phone available to call 24/7, and 51% reported Overall 27% 68% having a landline or cellular telephone but not FACILITY EQUIPMENT AND SUPPLIES HIV/ AIDs 82% 6%12% being available 24/7. Only 14% FKIs reported Krasnohorivka 100% In terms of available services, findings sug- that their facility was not equipped with tele- Tuberculosis 80% 9%11% Kurak Rural 20% 80% gest that the availability of reproductive health phones at all. Finally, the majority of FKIs Kurak. Urban 100% services is limited: only 35% of health service (62%) reported having transportation services Kurakhove 100% FKIs reported being able to provide services, available to people if needed. Mental health 45% 10% 35% 10% Marinka 100% either partially or fully, and only 32% reported Yes Marinka Rural 100% having sufficiently qualified personnel to do so. Yes Partially No Don’tDon't know/ know/ refuse toto answer Partially Vuhledar 67% 33% According to healthcare FKIs, a lack of funding 6% of primary healthcare answer/ hard to say No Vuhl. Rural 100% was the main reported reason why their facility FKIs reported their facility to have lacked any basic medication in could not provide adequate services. Finally, and as illustrated in Figure 28, most ExperiencingExperiencing pressure pressure due due to to NGCANGCA residents 6+94A the past thee months. facilities were reportedly sufficiently equipped DoNot not experiencing know pressure due to NGCA residents In terms of IT equipment, 59% of primary to treat tuberculosis and AIDS patients, but Do not know With regard to basic medications, findings Not experiencing pressure due to NGCA residents healthcare FKIs reported that their facilities were still lacking supplies to treat and sup- indicate that only 6% of primary healthcare had a “sufficient number” of computers for port patients with mental health issues. In As illustrated in Figure 27, close to a third of FKIs reported lacking basic medications in work purposes, while 41% reported not having that regard, only 59% of FKIs reported that FKIs (27%) reported experiencing pressure the 3 months prior to this assessment, and computers at all. On the other hand, 50% of their facility has sufficient equipment. This is on their facility from NGCA residents, par- none for secondary healthcare facilities. The secondary healthcare FKIs reported having suf- particularly concerning when considering the ticularly in Kurakhove, Mariinka and Mariinka least available basic medications as reported ficient computers, while the other half reported potential impact of residing in close proximity Rural (100% of FKIs). Findings for facilities by only one facility in Kurakhove Rural were having computers but not having enough of them. to the “contact line” on individuals’ psycho- in Mariinka might be partly explained by their hypertensive drugs, magnesium, painkillers social wellbeing, as highlighted in a recent proximity to the “contact line”; and those in and antipyretic drugs. Kurakhove area by the more general attrac- protection assessment report conducted by of primary healthcare REACH.3 tiveness of the facilities present there (see 41% Only 6% of the primary healthcare FKIs FKIs reported having no comput- Map 5). Incidentally, secondary healthcare reported having faced a lack of any medical ers at all for their operations. Regarding waste management, 73% of health- FKIs reported experiencing more pressure on 41+59A supplies in the 3 months prior to the assess- care FKIs reported that their facilities collected their facilities due to NGCA residents (50% of ment, and only 1 of the 4 secondary healthcare and sorted their medical waste for recycling or FKIs) than primary healthcare FKIs (13% of The majority of the healthcare FKIs (54%) FKIs did so, in Kurakhove. FKIs who reported further disposal, 62% opted to treat their med- FKIs), reflecting their attraction at the sub-re- reported all their computers were adequately facing shortages mentioned the following ical waste (for instance via incineration), while gional level. updated, while 4% reported that approximately specific items to be lacking: bandages, beds, 43% reported storing and transporting waste “half” of the computers at their facility was ethanol, gloves, cotton, IV systems, and in a secure place. Overall, the most commonly requested ser- updated, and 13% reported that “most” of their syringes – selecting almost all the options that vices from NGCA residents were those related computers were not adequately updated. were given to them in the survey. 3. Protection Assessment of Isolated Settlements in Gov- to primary care and emergency/first aid (as ernment-Controlled Areas Along the “contact line”, REACH, February 2019

HEALTH 21 ACCESSIBILITY FOR PERSONS LIVING HUMAN RESOURCES More specifically, 84% of primary healthcare As illustrated in Figure 30, FTE positions that WITH DISABILITIES (PWD) FKIs reported that all their full-time equivalent were reportedly the least often occupied were Only 8% of facilities were reported by IMPACT FIGURE 29: % of FKIs reporting gender dis- (FTEs) were filled at the time of assessment; those for doctors and nurses. This challenge enumerators to be “accessible” for PwD, and tribution of workforce in staff (top graph) in contrast to none of secondary healthcare seems to also be faced by other rural com- 43% as “partially accessible”. This might be and managerial staff (bottom graph) FKIs. Correspondingly, 78% of healthcare munities across the country, to the extent that particularly concerning for healthcare facilities, FKIs reported that their facility had enough some rural communities are reported to be which can be assumed to be more commonly FTEs to manage the workload, with 72% of pri- offering free accommodation for their doctors.4 frequented by PwD. 8% 86% 3% mary healthcare FKIs reporting so and none of Accordingly, 22% of FKIs reported nurses secondary healthcare FKIs. Interestingly, 50% have been the most ‘overloaded’ medical TABLE 10: % of Health FKIs reporting their of FKIs in Kurakhove reported having enough staff during the year prior to data collection, facilities to be lacking the following inclu- FTEs to manage the workload, confirming and 19% of FKIs reported this to have been sive amenities 13% 70% 3%11% the overall impression of services’ saturation the case for physicians (and “none of them” Type of missing amenities % of FKIs there. being overloaded by 32% of FKIs). However, findings suggest the workload is manageable No males Mostly females Guiding strip to the entrance 92% The main reasons that were brought forward for most facilities, as only 8% of FKIs (all of Slighlty more female Almost even by FKIs to explain this gap in human resources them from Kurakhove) estimated the number Information signboards in braille 92% Slightly more male Mostly male Restroom signed with an were “low salaries” (as per 36% of the FKIs of users in their facility as “too many”. 86% appropriate pictogram Findings from FKIs suggest that the gender who reported that not all of their FTEs were breakdown of the workforce in health facilities occupied), but most principally by the “lack The relatively low proportion of stress and Sound beacon at the entrance 86% is markedly skewed towards female workers, of qualified candidates” (as per 73% of the emotional load, as reported by FKIs, might Doorplates with contrast colours 70% with 86% FKIs estimating their staff body to be same FKIs), which was itself explained by the be partially explained by this relatively low Information signboards with large 57% “mostly of female”, while 70% of FKIs reported “low availability of candidates” in the area (as proportion of human resources (HR) related font and contrasting color a similar gender distribution for managerial reported by 86% of the FKIs who reported a shortages. Handrails on stairs outside 57% staff. Furthermore, according to the majority of lack of candidates). This reported lack of qual- Ramp outside of the building 46% healthcare FKIs (78%), the staff at their facili- ified candidates might be reflected in the more 49% of FKIs reported that Handrails on stairs inside 43% ties was mostly middle-aged (between 36 and general population decline resulting from low stress and emotional load were fertility rates, ageing population and migration Ramp inside of the building 43% 55 years old). common among the staff members outflows to urban centres. 49+51A Elevator 41% In addition, approximately one-third of FKIs FIGURE 30 : Most commonly reported least Finally, 76% of healthcare FKIs estimated that Lift 32% (32%) reported to have IDPs among their staff occupied FTEs by the 30% of healthcare none of their staff members required additional This was further reflected in the reports of health- member, with all FKIs of Krasnohorivka and FKIs having reported that not all FTEs were training in order to improve service provision; care FKIs, as a large number of amenities were Mariinka; and 67% of FKIs of Vuhledar area; filled at the time of asssessment although 46% of healthcare users considered with 4 IDP members on average per facility 64+64+18 the improvement of the quality of staff as a reportedly lacking, obstructing access of PwD as Senior medical staff (doctors) 64% illustrated in Table 10. Nevertheless, a sizeable (with reported presence of IDP staff members). priority (see Figure 21). On another, related Junior medical staff (nurses) 64% proportion of FKIs (41%) reported having PwD note, a relatively high proportion of FKIs (76%) Technical staff 18% would recommend their facility to other doctors among their staff members. Out of an average 70% of FKIs reported that all of 16 staff members per health facility, the aver- their FTEs were filled at the time Administrative staff 0% as a place to work, while 15% of FKIs would age reported number of PwD per facility was 3. 70+30A of assessment Management staff 0% reportedly do so if the salaries were higher.

22 HEALTHHEALTH 2 BOX 3: HEALTHCARE REFORM this information was television (as per 56% of ance mechanisms and operating feedback them). From the facility perspective, 89% of 59% of FKIs reported their mechanisms for users (reported by 84% of facilities were fully equipped to In late 2017, a series of laws were passed FKIs reported that their staff had been suffi- FKIs both). Users were mostly reported to comply with the new requirements to build a new patient-oriented healthcare ciently informed about the reform. 63+37A access these mechanisms “periodically” and 5 service. For instance, citizens are now This might be partly explained by the fact “often” (by 48% and 26% of FKIs respectively), supposed to be assigned one physician of FKIs appear to be a bit more optimistic than that 59% of FKIs considered that they are and most commonly for personal queries 6 their choice. healthcare users concerning the reform, as sufficiently equipped to harness the change (42%) and recommendations (23%). Furthermore, the “Money follows patient” 24% either “agreed” or “strongly agreed “that the reform would require, while 3% of them principle means the government will allo- the reform would positively impact users’ reported being “partially equipped” and 38% GENDER-BASED AND DOMESTIC cate money for the specific needs of a access to healthcare services (and 27% “not equipped”. In that regard, 62% of FKIs VIOLENCE RESPONSE patient instead of financing hospitals, doc- strongly disagreed or disagreed). reported that their institutions were using the Overall, 27% of healthcare FKIs reported that tors, and inpatient beds.2 FIGURE 32: FKIs’ opinion on the impact of “eHealth system”, a series of new instruments their facility had effectively registered possible/ reform on users access to healthcare to organize all medical records (medical e-his- actual cases of domestic and/or gender-based The vast majority of HHs (83%) reported being tory, e-referral, e-prescription for Affordable violence (DV/GBV) among their staff or bene- aware of the new healthcare reform, half of 49% Medicine).7 ficiaries, and subsequently informed the police whom (49%) reported expecting that it would 5% or the adequate social affair services. Facili- negatively impact access to healthcare. 19% GOVERNANCE ties registered 3 GBV/domestic violence (DV) 22% 5% DV/GBV cases on average during the year FIGURE 31: HH members’ opinion on the 32% of FKIs reported their prior to this assessment. impact of reform on their access to health- Comp. disagreed Disagreed Neutral facilities to make their annual care Agreed Comp. agreed / don’t know report publicly available 25% 32+68A 62% of FKIs reported A bit more than a third of the healthcare FKIs that their facilities had effective 49% A relatively low proportion of FKIs (32%) (35%) also agreed or completely agreed that standard operating procedures 26% reported that their facility’s annual report was (SOPs) to react to cases of DV/ the healthcare reform will make the sector publicly available, particularly in comparison GBV. 16% have partial SOPs 8 62+38A more effective (while 27% “completely disa- with the Sievierodonetsk target area (78%). Negatively Don’t know Positively greed” or “disagreed”). The main reasons given by FKIs for not pub- Amongst the 35% of FKIs who reported not It should be noted here that more than half of licizing their annual reports were a “lack of having or partially having SOPs in place, HHs (60%) did not seem to be interested in practice” and “confidentiality” as per 57% and 54% indicated lacking a registration journal. of FKIs agreed or com- getting more information on the reform. On 73% 19% of FKIs respectively. Additionally, it should Another commonly reported barrier to SOPs pletely agreed that the healthcare be noted that almost all FKIs (89%) reported was limited staff awareness around the legal the other hand, 37%, would welcome “gen- reform was not “timely’ eral information” about the reform, while 5% 73+27A collecting data and using it for decision-mak- framework governing GBV survivors’ rights, ing. Similarly, findings indicate that almost all mentioned being interested in “specific guide- However, and despite these rather positive lacking a referral system and an issued order facilities reportedly had internal quality assur- lines on how to use the services online”, and perceptions, there is a relatively high propor- on a GBV case (as per 46% of FKIs each). 5% would reportedly be interested in “specific tion of healthcare FKIs who either “strongly 4. Unchangeable? How medical reforms work and where they slow down, Web article, Vox Ukraine, Dec. 2019 guidelines about registration”. Amongst HHs agree” (27%) or “agree” (46%) that the 5. Key Steps to Transforming Ukrainian Healthcare, Web article, Ministry of health of Ukraine, undated who reported being interested in getting more healthcare reform was not timely (in terms of 6. How the healthcare system has changed, Web article, Ministry of health of Ukraine, April 2019 information, the preferred way of acquiring 7. Health Care System Reform, Web article, Governmental Portal official website, 2018 readiness of users and providers). 8. AGORA Area profile of Sievierodonetsk Agglomeration, IMPACT, July 2020

HEALTH 23 KEY FINDINGS This section has demonstrated that quality and access to healthcare are major priorities and sources of concern for HHs in the target area of this assessment. Findings have shown that HHs were relatively dissatisfied with their current access to healthcare services, primarily due to financial reasons (namely the cost of medicines and treatments); but also because of the reportedly poor quality of equipment. In that regard, facilities’ conditions and infrastructures were reported to be “average” or “unsatisfactory” by both FKIs and IMPACT enumerators. Provision of services associated to mental health was also very limited. However, the availa- bility and quality of facilities’ supplies and equipment was relatively satisfactory.

Access to healthcare might be impeded by the relatively limited number of secondary health- care facilities that were only present in larger urban centers, and the absence of tertiary healthcare facilities in all assessed hromadas. Healthcare facilities in Kurakhove were reportedly experiencing pressure from NGCA and GCA residents, likely due to the lack of facilities in its surroundings, indicating the regional importance of Kurakhove when it comes to healthcare provision, particularly to NGCA residents.

Finally, the Health Reform appeared to be moderately welcomed by HHs as well as profes- sionals, and some concerns have been raised about the lack of preparedness or funds to meet the expectations raised by the reform.

24 Key indicators on community FIGURE G: FKIs’ estimation of the change FIGURE J: FKIs’ estimation of the change in the number of people in the community in the number of deaths in the community well-being according to Health FKIs with alcohol disorder compared to the pre- from non communicable diseases (cardi- vious year. ovascular diseases, cancer, diabetes and FIGURE A: FKIs’ estimation of the frequen- FIGURE D: FKIs’ estimation of the propor- chronic respiratory diseases) compared to cy of suicides and attempts in the commu- tion of children who are completely unvac- 49% the previous year. nity in the year prior to this assessment. cinated in the year prior to this assessment. 3+3+18+18 3+3+33+58+ 20% 39% Often 3% Almost 1/3 3% 17% 31% Very frequently 11% 3% Almost 1/4 3% 3% 19% 8% Don`t know 18% Less than 1/4 33% Decreased Don`t No Increased Significantly 3% Very rarely 18%

+ 59 None of them 58% 3 know change increased Decreased Don`t No Increased Significantly Never 59% Don`t know 3% 11+20+49+17+3 0+8+19+32+39+3know change increased FIGURE B: FKIs’ estimation of the inci- FIGURE E: FKIs’ estimated reasons as to FIGURE H: FKIs’ estimation of the change FIGURE K: FKIs’ estimation of the change dence of maternal mortality in the commu- why parents keep their children unvacci- in the number of their patients with sub- in the number of deaths in the community

nity in the year prior to the assessment. nated. 0+40+5+10+25+10+10+35 stance use compared to the previous year. from communicable diseases compared to 3+90+7 Compromised immune system the previous year. 70% Very rarely 3% 0% Lack of education among parents/guardians Never 90% 40% Vaccination is not available 36% Don`t know 7% 5% 32% Quality of vaccination 10% 19% 19% Religious/ethnic beliefs 25% 13% 7% Socioeconomic factors 10% 4% Decreased Don`t No Increased Do not know 10% know change Significantly Decreased Don`t No Other 35% 19+36+32+13 decreased4+7+19+70know change FIGURE C: FKIs’ estimation of the frequen- FIGURE F: FKIs’ estimation of the change FIGURE I: FKIs’ estimation of the change FIGURE L: FKIs’ estimation of the change cy of preventable deaths under 5 years of in the number of their patient with alcohol in the number of people in the community in the number of HIV positive patients in age in the year prior to this assessment. disorder compared to the previous year. with substance use compared to the previ- the community compared to the previous

3+85+12 ous year. year. Very rarely 3% 51% 55% Never 85% 37% 26% Don`t know 12% 22% 28% 17% 17% 11% 13% 13% 3% 6%

Decreased Don`t No Increased Significantly Decreased Don`t No Increased Decreased Don`t No Increased 11+17+51+17+3know change increased 22+37+28+13know change 6+26+55+13know change

25 HEALTHHEALTH 2 EDUCATION on the contrary, the average number of stu- MAP 6: Available education facilities in the target area dents per education facility was among the This section presents available education ser- lowest of the target areas. It should be also vices in the area of Mariinka, their principal noted that, in most areas, FKIs commonly characteristics and gaps in their capacity. It reported that the number of students was “too also highlights households’ (HHs’) satisfaction low”. This perceived scarcity of students might and their main barriers to accessing these ser- be partially explained by the fact that, overall, vices. In order to obtain this general picture, only 12% of HH members were reported to be 46 FKIs were surveyed, a subset of the overall of school age (5-18 years old). assessment sample composed of the 721 HH members who were reported to access educa- Overall, a bit less than half of all assessed tional facilities, as well as 186 CKIs. education facilities (21 out of 46) reportedly comprised the first three stages of school edu- AVAILABLE FACILITIES cation in the same facility. However, centres for As shown in Table 11, the lowest number of vocational education were poorly represented educational facilities were located in Mariinka (6 out of 44 assessed facilities) and could be and Vuhledar. At the same time, Vuhledar attended only in four large urban centres. had the highest average number of students enrolled in education facilities providing all ACCESS TO EDUCATION FACILITIES stages of school education, while in Mariinka, TABLE 11: Available facilities per area and FIGURE 33: % of HH members reportedly average number of students spending less than 30 min to get to their Avg. No FKIs’ educational facility Facilities 77 of stud. perception Overall 77% + 94+84+81+76+75 Krasnohorivka 6 180 Too few Vuhledar 94% Vuhledar Rural 84% Kurakhove Rural 5 102 Too few Mariinka Rural 81% Kurakhove Urban 5 228 Too few Kurakhove Urban 76% About right/ Kurakhove 75% Kurakhove 7 358 +75+63+54 Too few Krasnohorivka 75% Mariinka 3 137 Too few Kurakhove Rural 63% About right/ Mariinka 54% Mariinka Rural 7 134 Too few Distance to educational services does not Vuhledar 4 468 About right appear to be of particular concern for its users, as only 6% of HHs reportedly consid- Vuhledar Rural 9 112 Too few ered distance as a source of dissatisfaction in Total/ Avg. 46 206 general. However, HHs from Kurakhove Rural and Mariinka reported spending more time in 26 MAP 7: Network map of education access transportation than others (Figure 33), which FIGURE 34: Most commonly reported high- is, in the case of Kurakhove Rural, corrobo- est education level attained by all male rated by the lower proportions of HH members (beige) and female (red) HH members

reporting accessing their education facilities in 58+12+7+7+7+3+5+0 their own settlement (Table 12). As for voca- Vocational 50% / 58% tional centres, none of HH members reported Complete Secondary 15% / 12% accessing these services in Kurakhove Rural, Complete Higher 9% / 7% Mariinka, Mariinka Rural and Vuhledar Rural. Basic Secondary 8% / 7% The movement trends reported by CKIs are Primary Education 7% / 7% visualised on Map 7. Basic Higher 6% / 3% Preschool 3% / 5% TABLE 12: % of school-going HH members 3+6+7+8+9+15+50 Postgraduate 0% / 0%

accessing education in same settlement, 0+ by area 8% 86% 3%

Users of Users of FIGURE 35: Most frequently reported facility vocational schools centres currently used by school-going HH members 33+30+16+11+8+2 Krasnohorivka 94% 79% Middle (level 2) 33% 13% 70% 3%11% Kurakhove Rural 67% 0% Primary Education 30% Kurakhove Urban 83% 22% Secondary 16% No males Mostly females Kurakhove 86% 55% Vocational 11% Slighlty more female Almost even Mariinka 92% 0% Tertiary 8% Slightly more male Mostly male Mariinka Rural 87% 0% Preschool 2% Vuhledar 89% 67% STUDENT PROFILES Vuhledar Rural 78% 0% Overall 85% 39% Data made available on the gender break- down of students, graduates, IDP students OVERALL LEVEL OF EDUCATION and student dropouts do not demonstrate a particular gender discrepancy, which is also More than half of HH members were reported in line with national level statistics.1 Education to have completed vocational training (53%). FKIs reported 7 dropout students on average On the other hand, just 8% of HH members per facility per year, which represents only 3% were reported to have completed higher edu- of all students. The main reasons that were cation. This figure was the highest in the area brought forward to explain this number were of Vuhledar (19%). “family issues” (according to 73% of FKIs

1. World bank data, Ratio of female to male lower secondary completion rate, World bank, 2018

27 HEDUCATIONEALTH 2 reporting dropouts) and because of a “change Many of the education facilities were not SERVICES PROVIDED BY FACILITIES TABLE 14: Available educational services in community” (42%). The vast majority of FKIs accessible for PwD (as observed by 70% of Findings indicate that the majority of education (98%) reported that their facility was hosting IMPACT enumerators) or only partially acces- facilities provide a relatively large array of ser- IDPs amongst their students (with 23 IDP stu- sible (22% of enumerators). This indicates that vices, suggesting their relative importance in dents on average per facility) and 46% of FKIs very few facilities have the required amenities the everyday life of the community. According Mariinka Vuhledar KI Overall reported having IDPs among, their staff mem- needed, which may push students living with to education FKIs, mine risk education was Kurakhove Mariinka Rural Krasnohorivka Vuhledar Rural Vuhledar Kurakhove Rural bers (with 3 IDPs on average per facility). This disabilities towards alternative educational provided by all the facilities, while the most Kurakhove urban Mine risk education 100% proportion varied quite substantially between services, or in some cases, results in them not commonly used service by HHs was medical Career orientation 87% assessed areas, with Vuhledar and Kurak- attending education services altogether. support (as reported by 61% of HH mem- hove facilities hosting proportionally twice as Extracurricular 80% bers). Extracurricular activities (22% of HHs), Education at home 72% many IDP students as facilities located in other IMPACT enumerators also estimated the afterschool care (29%), psychological support Education for PwD 70% areas. These findings match closely with the overall physical condition of the facility as (40%) and social/ pedagogical services (19%) School supplies 70% overall proportion of IDP HH members reported in “satisfactory” (63% of enumerators), which were also reportedly used by many HHs in the Medical support 65% the household profile section (Figure 4 page 11). coincides with findings reported by FKIs (57%). Social support 63% area. Although 29% of FKIs in Mariinka Rural Psych. support 57% FIGURE 36: Estimated % of IDPs amongst reported that their facility provided bus ser- Bus services TABLE 13: % of education FKs reporting 30% students reported by FKIs, by areas vices, a low proportion of HHs reported using it Certificate training 13% their facilities to be lacking the following 27+14+12+11+11+8+6+6 (9%). The main reasons reported by education Mariinka 27% inclusive amenities: FKIs for not providing additional services were Squares: more than 50% of facilities Kurakhove 14% “lack of finance” (reported by 79% of FKIs) and % of “lack of staff” (24%). Kurakhove Rural 12% Type of missing amenities facilities of facilities had a Mariinka Rural 11% 63% Restroom pictogram 87% Most of the assessed education facilities were functioning library with new Vuhledar 11% books. Sound beacon 85% reported to provide courses on human rights 63+37A Krasnohorivka 8% and global citizenship in their curriculum Information signboard in braille 80% Kurakhove Urban 6% (according to 91% of education FKIs). More- of facilities provide Guiding strip 80% 91% Vuhledar Rural 6% over, 67% of vocational training centre FKIs books for free, and 2% partially. Stairs inside 80% reported that their facility provided courses on 91+9A ACCESSIBILITY FOR PWD Ramp inside 72% business and entrepreneurship, expressing Elevator 70% their stronger inclination towards the needs of 80% of facilities provide The vast majority of education FKIs reported free lunch, and 4% partially. Information signboard with the labour market (versus 13% of overall FKIs providing education services to PwD (89%), 67% from all facilities). 80+20A contrasted colors and large font although seemingly in relatively small num- Doorplates with contrast colours 63% families and children of IDP families (65% for bers (with 5 students with disabilities per Findings indicate that most education facil- both), other groups that reportedly received Stairs outside 63% facility on average). Similarly, 65% of FKIs ities provide additional support to vulnerable free lunch at education facilities were children reported the presence of PwD amongst their Ramp outside 52% families, for example through the provision of deprived of parental care (reported by 38% of staff members, with 2 PwD staff members on Lift 50% free lunch. More than a half of education FKIs FKIs), children of military personnel (57%), average per facility. reported providing free lunch to low-income and families with a lot of children (43%).

EDUCATION 28 PRICING POLICY AND HOUSEHOLD Overall, 36% of HH members were reported FIGURE 39: Users’ satisfaction towards From the users’ perspective, even though the EXPENSES to spend up to 500 UAH on school books and state education services quality of staff was their primary concerns, it other educational supplies for themselves, for 44% was not widely considered as sufficiently poor 93% of FKIs reported providing 34% this amount was reportedly between 501 to justify a change of school facility. In fact, free education for their students (and and 1.000 UAH, and for 14% between 1.001 3% only 8% of HHs reported that they were plan- 83% of vocational centres) and 2.000 UAH for the last academic year ning to change facility for the abovementioned 93+7A 14% 37% prior to this assessment. reasons. The most commonly reported paid-for services 2% by students, according to education FKIs, were FIGURE 38: Informal payment modalities of HH member do not school funds (67% of FKIs), followed by tuition Comp. dissatisfied Dissatisfied 86% used by % of HH members reportedly Neutral plan to change their education fees “except for vulnerable categories” (33%). Satisfied Comp. satisfied / don’t know paying for their education facility (6% do not know) On the other hand, a bit less than a quarter 90+46+49+58 86+8+6A of facilities reportedly provided stipends to Class funds 90% Among dissatisfied HH members, the qual- The following sections will further explore the their students (24% of FKIs), which were most Facility funds 46% ity of teaching staff was reportedly the most three main reasons of dissatisfaction, from a notably based on merit (13% of FKIs), and on Targeted payments 49% common source of dissatisfaction, as two-third user (HH) and facility (FKI) perspective. needs (11%). (67%) of them were reported to indicate this Gifts for teachers 58% LACK OF QUALIFIED TEACHING STAFF reason. This was followed by the insufficient These FKI findings are not completely in line use of computers, the outdated curricula and with the HH findings, since a bit less than half of HH members were outdated soviet-style facilities, limited avail- 78% of FKIs reported that 77% all their FTEs were filled at the (47%) of education using HHs reported not reportedly receiving free books ability of equipment (e.g. for sport classes) time of assessment paying for education, while a considerable pro- from their facility, 19% reported (18% of HHs for both), as well as the perceiv- 78+22A portion reported paying either indirectly (45%) some books, 2% none (2% did ably bad conditions of facilities (13%). or directly (7%) (see Figure 37). 77+192+2A not know) Overall, 17% of FKIs considered that their facility did not have enough FTEs to manage Expenses for uniforms and athletic clothing FIGURE 40: Top reported reasons for dis- As illustrated in Figure 38, HHs that reportedly were more likely to be a burden on house- the workload. According to the education FKIs satisfaction among dissatisfied service who reported lacking FTEs, teachers were paid for education most commonly reported holds’ budgets, as 20% of HH member had users doing so through class funds (90%), directly reportedly spent between 2.001 and 3.000 67+18+18+13+12+11+9+7+6 the main FTEs currently lacking in education to the facility (46%) or through targeted funds UAH on school (athletic) uniforms, and 29% Quality of teaching staff 67% facilities, as 70% of FKIs reported that their HR (49%). of HH members more than 3.000 UAH for the Insufficient IT, outdated curricula 18% gap mainly concerned teacher positions. This finding is relatively concerning, as a lack of same time period. Outdated equipment 18% FIGURE 37: % of HH members paying for teaching staff might indicate a general inability Facility is in bad condition 13% education, and associated payment modal- OVERALL USER SATISFACTION to provide adequate education and attention ities Price 12% to students. 47+45+7+1 The majority of HH members were reportedly Quantity of teaching staff 11% Don’t pay anything 47% either “completely satisfied” (37%) or “rather FIGURE 41: Main types of FTEs reported Quality of management staff 9% being not occupied (as per FKIs)

Not officially, but contributions 45% satisfied” (44%) with education services, with 70+30 Corruption 7% We pay fully 7% lower-than-average levels of satisfaction in Teachers 70% Distance 6% Additional subjects 1% Kurakhove Urban, Vuhledar Rural and Vuhle- Administrative staff 30% dar areas.

29 HEDUCATIONEALTH 2 Among FKIs reporting not having enough (16%) were reported to have a private tutor, Regarding quality of infrastructures and equip- Overall, findings illustrated in Figure 44 indi- FTEs, the main reasons that were brought the most commonly reported reasons for hiring ment, only 7% of education FKIs reported their cate that most education facilities did not ex- forward to explain this gap were the lack of such a private tutor were primarily to acquire facilities having enough space and supplies perience frequent shortages of basic utilities qualified candidates (80% of FKIs), followed additional courses not provided by the school for education purposes, while 93% reported such as water, electricity, heating and/or gas. by the low expected salary (10%). The lack of (48%), followed by the need to get better the opposite. However, there were some FKIs in Kurakhove qualified candidates itself was reportedly due marks (28%), for extra help in general (24%) Urban (40%) and Krasnohorivka (33%) who to several reasons, the main one being the and preparation for exams in particular (13%). As a consequence, facilities were reportedly did report that water shortages happened “limited perceived availability of candidates” as unable to function properly due to the lack of frequently. Regarding sanitation, 87% of FKIs per 75% of FKIs that reported lacking qualified INSUFFICIENT EQUIPMENT supplies (Figure 42). reported that their facilities have a sufficient candidates, as well as the “current situation in The insufficient use of computers, technology, number of gender-segregated toilets, while the settlement” (13%) and a quarter of FKIs outdated curricula and outdated equipment FACILITY CONDITION AND IMPACT OF 9% of FKIs reported an insufficient number linked this labour shortage directly to the con- was the second most commonly reported rea- CONFLICT instead. Staff and students reportedly have flict. access to basic handwashing in most educa- sons of dissatisfaction amongst users. This As shown in Figure 43, 57% of FKIs con- finds a direct echo in the 67% of FKIs reporting tional facilities: 98% of FKIs reported their fa- This appears to be a structural challenge sidered that their facility’s condition was cilities enabled basic handwashing. However, having computers “in insufficient numbers”, “satisfactory”. associated to the lack of incentives and ori- and 53% of FKIs reporting most computers access to drinking water was only reported by entation for the educated workforce towards were “obsolete”. Finally, 43% of all education 72% of FKIs to be available at their facilities. FIGURE 43: FKIs estimation on the overall this career path. From the facility perspective, FKIs reportedly considered that the internet Finally, 59% of FKIs rated the overall temper- condition of the facility all FKIs reported that teachers were teach- connection was “too slow” and thus insufficient ature in classrooms at the “comfortable level” ing more than one subject either in the same 2+33+57+9 or “right” (30%), while a few reported consider- for educational purposes. Excellent 2% (74%) or different fields, e.g. history and biol- ing the temperature to be either “not comforta- ogy, (35%). The most significant proportions of Good 33% ble” (9%) or “not comfortable at all” (2%). FKIs reporting teachers to be engaged in the 93% of FKIs reported Satisfactory 57% different fields were in Mariinka (100%), Kura- having not enough space and Poor 9% Levels of infrastructural damage as a result of khove Urban and Rural (60% each). The main 93+7A supplies. shelling varies significantly from one location reasons that were brought forward to explain to another, with Krasnohorivka being the most why teachers were teaching in different fields FIGURE 42: Type of supplies that FKIs FIGURE 44: Facilities shortage of basic utilities, as reported by FKIs were “staffing” (as per 43% of FKIs reporting reported lacking for their facilities

that this was the case), followed by financial 93+79+70+42+40+14+9 reasons (35%), and then “lack of specialists” Laboratory equipments 93% Water shortage 54% 20% 13% 13% (24%). All these figures indicate a clear lack Other equip.(projector etc) 79% Electricity shortage 65% 26% 9% of available qualified staff and a structural Furniture 70% issue of regional importance, and seems to Books 42% Gas shortage 20% 80% be largely unrelated to the ripple effects of the Stationary 40% conflict. Heating shortage 41% 57% Office space 14% Other In the same vein, and even though a rela- 9% No Yes, rarely Yes, often Not applicable tively high proportion of studying HH members

EDUCATION 30 FIGURE 45: % of FKIs reporting damages impacted both in terms of reported damage 41% of FKIs reporting safety concerns), while FIGURE 47: % of FKIs reporting gender dis- on facilitiesOverall as15% a result11% of shellings72% (2014- and lack of repairs (Figure 45). Some FKIs the low quality of roads (61% of HH members tribution of workforce in staff (top graph) 2019) from Mariinka (67%) reported their facilities and 41% of FKIs) and low safety standards and managerial staff (bottom graph) had been damaged and were partially reno- while crossing the roads were also commonly Krasnohorivka 17% 50% 33% vated since, while facilities in Kurakhove Rural highlighted by 48% FKIs; due, for instance, to 93% 3% Kurakh. Rural 100% and Vuhledar had seemingly been exempted fast traffic and lack of appropriate crosswalks. Kurakh. Urban 40% 60% from damages due to shelling. The most commonly reported conflict-related Kurakhove 100% safety concerns for HH members in Mariinka Regarding the impact of NGCA residents on fa- and Krasnohorivka was shelling, as indicated 20% 74% 4% Marinka 67% 33% cilities’ functioning, proportionally more FKIs by 94% and 89% of HHs respectively. Most Marinka Rural 14% 14% 71% in Kurakhove Rural reported experiencing FKIs in Krasnohorivka (83%), in turn, reported No males Mostly females Vuhledar 100% pressure on services due to NGCA residents facing shooting on their way to the facility, as Slighlty more female Almost even Vuhl. Rural 11% 89% than in other areas, but overall this remains well as 67% of FKIs in Mariinka. Slightly more male Mostly male a minor concern (see Figure 46). Mine risk Was damaged and not recovered education was perceived to be the most com- Finally, military presence was reported to be Moreover, finding suggest that the staff at edu- Was damaged and recovered partially monly requested service by NGCA residents a matter of concern only in the Mariinka Rural cation facilities is mostly middle aged or older, Was damaged and fully recovered (41% of FKIs), followed by school supplies and area, where 50% of HHs accessing educa- with 91% of FKIs reporting most of their staff Was not damaged extracurricular activities (31% each). tional facilities and 33% of FKIs reported this being middle aged (between 36 and 55 years concern, and Krasnohorivka with 18% of HHs old) and 7% of FKIs reporting most of their FIGURE 46: % of FKIs reporting experienc- SAFETY and 33% of FKIs reported the same. Addition- staff being “elderly” (older than 55). ing additional pressure from NGCA residents Overall 11% 13% 76% Almost all HH members (97%) reportedly con- ally, Krasnohorivka and Mariinka locations Overall 11% 13% 76% sidered the education facility they attended to had the highest rate of mines being reported According to 80% of FKIs, stress and emo- be “safe” within the premises, with the most to be safety concern, as reported by 67% of tional load were common problems among Krasnohorivka 17% 83% commonly reported safety concern being the FKIs and 22% of HHs in Mariinka, while 11% their staff members. This relatively high pro- Krasnohorivka 17% 83% portion should be put in perspective with the Kurakh. Rural 40% 60% “condition of the facility”, which was reported of HHs and 33% FKIs reported this concern in Kurakh. Rural 40% 60% for 69% of HH members who reportedly con- Krasnohorivka. current shortage of FTEs that has been out- Kurakh. Urban 20% 80% lined above. However, majority of FKIs (80%) Kurakh. Urban 20% 80% sidered the facility unsafe. Physical access to Kurakhove 14% 29% 57% the education facility was reportedly consid- would reportedly recommend the facility to Kurakhove 14% 29% 57% HUMAN RESOURCES other teachers as a place to work at, and 98% Mariinka 33% 67% ered “safe” by 82% of HH members. However, Mariinka 33% 67% two-fifths of HH members in Mariinka and As illustrated in Figure 47, the gender break- as a place to study in. Mariinka Rural 14% 86% Mariinka Rural 14% 86% almost a third (30%) in Krasnohorivka did not down of the workforce in educational facilities Vuhledar 25% 75% feel safe on the way to the educational facility. is markedly skewed towards female workers, It is also noteworthy that a third of FKIs (33%) Vuhledar 25% 75% Vuhl. Rural 11% 89% which is in line with national level statistics, reported that all teachers at their facilities had Vuhl. Rural 11% 89% The main safety concerns that were reported where the education sector is the only overall passed their teachers’ training in the year prior to data collection, while another 30% of FKIs Experiencing pressure due to NGCA residents by both HH members and FKIs were associ- sector where women managers prevail com- Experiencing pressure due to NGCA residents ated with the prevalence of stray dogs or other pared to male managers (77% of managers reported that less than a quarter of their teach- Do not know 2 ing staff had passed training. Do not know animals (reported by 40% of HH members and being women). Not experiencing pressure due to NGCA residents Not experiencing pressure due to NGCA residents 2. Women and men in leadership position, UNDP, 2018.

31 HEALTHEDUCATION 2 GOVERNANCE AND FEEDBACK MECHA- ADOPTION AND READINESS TO THE GENDER-BASED AND DOMESTIC having SOPs in place were the lack of capacity NISMS “NEW UKRAINIAN SCHOOL” REFORM VIOLENCE RESPONSE to introduce an issued “Order” on a GBV case Regarding DV and GBV, 9% of FKIs reported (43%) and lack of contacts on GBV service The newly established State Service for In combination with SSEQ, the “New providers (29%). Education Quality (SSEQ) is charged with Ukrainian School” (NUS) is a UAH 7 bil- that their facility had effectively registered pos- developing a quality assurance system for lion key reform launched in 2018 to improve sible/actual cases of DV or GBV among their secondary education, including audits of edu- the education system as a whole, in an staff or students, and subsequently informed 85% of facilities have effective cation institutions, supervision and monitoring attempt to “better equip schools and pupils the police or the adequate social affair ser- standard operating procedures to compliance, and monitoring quality. However, to the challenges of the 21st century.” 4 vices. Facilities reportedly registered 1 GBV/ react to cases of domestic violence this institution and its functions are new,and DV case on average per year. 85+15A or GBV. 13% have partial SOPs capacity remain weak.3 98% of FKIs reported being Amongst the 15% of FKIs who reported not 100% of facilities dissemi- aware of the NUS concept having or only partially having GBV/DV SOPs nate information on GBV/ DV issues. 98% of FKIs reported that 98+2A in place, 57% indicated lacking a registration 100+0A their facility had publicly available journal, while other reported reasons for not annual reports 20% of FKIs reported that 98+2A all their teachers have passed the Overall, most education facilities were reported NUS training to have functioning self-governance bodies, 21+79A KEY FINDINGS which were mostly involved at planning stages Close to one-fifth (23%) of FKIs who were (as per 74% of FKIs) and in advisory roles aware of the NUS concept reported that their Overall, both education users (HHs) and facility representatives (FKIs) concurred on the fact (48%). Only 4% reported that their facility did facility had sufficient skills to implement the that the lack of capacity (both in terms of availability of teaching staff and skillset) constitutes not have self-governance bodies. In the same NUS approach. However, only 56% of FKIs a major impediment to quality education in targeted areas. vein, 67% of FKIs reported their facilities col- who were aware of NUS agreed that their lected quantitative data at least annually and facility was sufficiently equipped and ready to Additional barriers include poor quality of educational equipment (particularly IT); and lim- used it in decision-making. All FKIs reported implement the NUS approach in practice at the ited availability of psychosocial support services. Poor accessibility for PwD was found to be that their facility had quality assurance mecha- time of data collection (as shown in Figure 48). widespread and could also constitute an impediment for this specifically vulnerable population nisms in place, as well as having an operating group. feedback mechanism for users. This feed- FIGURE 48: % of FKIs reporting that the back mechanism appears to be quite useful facility is sufficiently equipped to implement There did not appear to be specific financial barriers restraining access to education, although for students as they were resorting to it either NUS approach in practice solicitation of punctual voluntary contributions from parents (financial or in-kind) seem to be ”occasionally” or ”very frequently” according relatively common at the community level. 6% 33% to 26% and 72% of FKIs, respectively. The 21% most common forms of feedback reportedly were personal queries (96% of FKIs) and rec- 3. Review of the education sector in Ukraine, World bank, 2019. 23% 4. “Investment volume in the New Ukrainian School makes up UAH 7 billion, New Educational Space needs to be further ommendations (4%). On the other hand, only 18% developed, claims Prime Minister” , web article, Ukrainian decentralization portal 26% of FKIs reported that their facilities had undergone an external evaluation in the 12 Comp. disagree Rather disagree Neither/ don’t know months prior to data collection. Agree Comp. agree

EDUCATION 32

ADMINISTRATIVE In addition, due to the lack of sufficient pension MAP 8: Available administrative facilities per area funds, there is the tendency of HHs and CKIs to SERVICES seek administrative services in other settlements. Pokrovskyi According to FKIs, administrative facilities This section describes the level of access, Yasynuvatskyi generally offer a large array of services, with ² raion availability and quality of administrative servic- ASC facilities regrouping most of these servic- Æ ĈÆ ĈÆ es in the targeted locations. Findings were de- Ĉ Hirnyk es in one place. Commonly reported functions Sontsivka Novoselydivka Ĉ veloped as a result of the analysis of 37 FKIs, ĈÆ Zoriane for all facilities included online services and Velykonovosilkivskyi all 2.725 HH surveys and 120 CKIs. raion Kurakhivka Mobile TsNAP (33% of FKIs both), automatic ĈÆ pÆ ĈÆ `Æ ĈÆ Dachne Æ Krasnohorivka queue and E-document management systems Ĉ ĈÆ AVAILABLE ADMINISTRATIVE FACILITIES Kurakhove AND SERVICES (33% of FKIs both). Maksymilianivka đÆ ĈÆ Ĉ 2 At the time of assessment, only Mariinka, Mariinka ACCESS TO ADMINISTRATIVE FACILITIES ĈÆ Mariinskyi Mariinka Vuhledar, and Kurakhove had more than Uspenivka raion EECP one type of administrative facilities available. Map 8 illustrates, first, that the high quantity ĈÆ ĈÆ As shown in Table 15 below, Administrative and diversity of facilities in Kurakhove appear Yelyzavetivka Æ ii ĈÆ Katerynivka Ĉ Service Centres (ASCs) (also called TsNAP to provide administrative services to individu- Ĉ i Ĉ Bohoiavlenka or Centres for Administrative Provision) were als residing in other surrounding settlements Novomykhailivka Novoukrainka only available in the two central areas of Mari- as well. In the case of settlements surrounding inka and Vuhledar. Consequently, most HHs Mariinka, a relatively sizeable proportion of ĈÆđÆo ĈÆ from Kurakhove Rural and Kurakhove Urban HHs and CKIs indicated going to Kurakhove 2 đÆpÆ`Æ Stepne Vuhledar reported leaving their settlement to access instead of Mariinka itself. This might be due to ĈÆ ĈÆ NGCA their local administrative centres (81% each, the fact that this area is still experiencing reg- Pavlivka Mykilske

compared to 38% overall). ular conflict related violence; but also because Volnovaskyi Novotroitske Æ EECP of a lack of relevant administrative facilities Ĉ raion TABLE 15: Number of available facilities by Yehorivka area there. This migh in turn explain the relatively Type of Administrative facilities high proportion of HH members from Mariin- ĈÆ ĈÆ Ĉ Local Council (28) Local Marriage Passport Pension pÆ Æ Center for marriage registration (3) ASC ka Rural reportedly experiencing distance as Petrivske Council center centre fund o Passport center/Migration center (1) a main cause of dissatisfaction (56% of HH `Æ Pension Fund (2) Krasnohorivka 1 ĈÆ members, vs. 34% on average). Stepne đÆ TSNAP (multifunction center) (3) Kurakh. Rural 4 FTE positions: ĈÆ All FTEs filled Kurakh. Urban 2 In the same vein, 83% of HH members in Kurakhove Rural also reported distance as Ĉ Not all FTEs filled Kurakhove 2 2 1 (apply to all symbols and colors) a reason for their dissatisfaction. Vulhedar, 2 Number of facilities Mariinka 3 1 despite its relatively high number of facilities (symbol without the number represents one facility) Ĉ Facilities experiencing pressure due to Mariinka Rural 6 (including 2 ASCs), did not seem to exert a NGCA residents (apply to all symbols) strong attraction over its surrounding areas. Km EECP (Entry-Exit Checkpoint) Vuhledar 2 1 1 1 2 0 5 10 As shown in Map 9, most HHs and CKIs liv- Vuhl. Rural 7 ing around Vuhledar indicated going to Volno- Overall 27 3 1 2 3 vakha instead of Vuhledar itself. 33 USAGE AND USER SATISFACTION tion are further reflected in the most commonly MAP 9: Network map: access to administrative facilities across settlements reported priorities for improvement, namely: were “simplifying” and “speeding up” the procedure (Fig- 32% of HHs reported having used at least one administrative ure 52). Cost for service was then mentioned as services in the 3 months prior to an important, although secondary, reason of dis- 32+68A this assessment satisfaction as well as priority of improvement. Dis- tance to facility and improvement of the transport As shown in Figure 49, the provision of subsi- system were also pointed as reasons for dissatis- dies was the primary reason for HHs to access faction and improvement priorities. administrative facilities, followed by resolving pension issues and processing of utility bills. On the other hand, lack of information was not considered as the main reason for dissat- FIGURE 49: Most commonly used adminis- isfaction nor as a priority improvement by the trative services, by % of HHs 68 majority of HHs. None 68% +10+8+6+4 FIGURE 51: Most commonly reported rea- Provision of subsidies 10% sons for dissatisfaction according among Resolve pension issues 8% dissatisfied users Utilities (bills,contracts, etc..) 6% 52+52+34+16+15+13+12 Procedure is time consuming 52% Acquire a passport 4% Excessive bureaucracy 52% Overall, 70% of HHs reportedly accessing Distance to the facility 34% administrative services were “rather” or “com- Cost for service 16% pletely satisfied” with their administrative facil- ities. Quality of staff 15% Other costs (notary, printing) 13% FIGURE 50: HH’s satisfaction towards Lack of information 12% administrative services FIGURE 52: Most commonly reported prior- 7% 52% ity areas of improvement according to HHs 19% using administrative services 18% 61+43+19+19+14+12+8 4% Simplify the procedure 61% Speed up the procedure 43% Comp. dissatisfied Dissatisfied Neutral / don’t know Reduce the price 19% Satisfied Comp. satisfied None 19% Time-consuming procedures and excessive Improve transport to facilities 14% bureaucracy appeared to be the most com- Improve availability of information 12% monly reported reasons for dissatisfaction among 8% users (Figure 51). These reasons for dissatisfac- Improve online service provision

ADMIN. 34 Accordingly, most facilities were also report- Finally, Figure 55 shows that facilities gener- IMPACT OF CONFLICT ON FACILITIES 9% of respondents reported ed to be in “satisfactory” condition according ally did not experience frequent shortages of No FKIs from facilities in Kurakhove Rural, having used the internet to access to IMPACT enumerators (53%), while 22% basic utilities, such as gas, heating or water, administrative services Kurakhove Urban, Vuhledar and Kurakhove of enumerators considered that the facilities’ although some FKIs reported occasional short- 9+91A reported that their facilities had been damaged conditions were “poor”. The level of satisfac- ages of such sorts. However, 50% of FKIs in In terms of users’ readiness to online services, as a result of shelling during the period 2014- tion of FKIs regarding the material and tech- Kurakhove Urban reported frequent electricity a relatively small proportion of respondents 2019. However, all FKIs in Krasnohorivka and nical supply in their facility was similarly com- shortages, which is considerably higher than reported having used the internet to access 75% in Mariinka reported that their facilities monly reported to be “average”, as indicated the 17% of FKIs reporting shortages at their administrative services, the highest proportion had been damaged and fully recovered, and in the Figure 54. facilities overall. being in Vuhledar with 13% of respondents. 25% of FKIs in Mariinka reported their facilities These findings coincide well with the over- to be damaged and only partially recovered. FIGURE 54: FKIs satisfaction with material Heating shortages also seemed to vary sig- all low level of computer literacy that have It is also noteworthy that no KIs reported their and technical supply of facilities nificantly between areas, with Kurakhove fa- been reported earlier (38% of HHs reported facilities had to stop service delivery due to the cilities appearing to be the most commonly being fully comfortable with their computers, 19% security situation during the 12 months prior affected (20% of administrative FKIs reported see also Table 3 on page 12 of this report). 42% to this assessment. In terms of preparedness, having heating shortages, compared to 3% on Amongst these 9% of HHs of reported having 19% of FKIs reported that their facilities have 33% average). used internet to access their administrative a bomb shelter, of whom 71% reported consid- 6% services, 92% reported to be either “complete- ering that the shelter’s safety level was “satis- In addition, 14% of FKIs in Vuhledar Rural were ly” or “rather” comfortable doing so. Comp. dissatisfied Dissatisfied Neutral factory”. Satisfied Comp. satisfied / don’t know reportedly facing frequent water shortages in the three months prior to this assessment, FACILITY CONDITION AND EQUIPMENT As illustrated in Figure 56, 28% of FKIs indi- The most commonly reported supplies that while no other administrative service FKIs in were lacking according to dissatisfied admin- cated that NGCA residents were causing pres- As shown in Figure 53, 47% of FKIs consid- any of the other assessed areas reported that istrative FKIs were computers and furniture sure on their facility. However, there seem to ered that their facility’s condition was “satisfac- their facility experienced water shortages. (76% each), followed by stationary (41%) and be considerable differences between areas in tory”. office space (18%). More generally, 75% of FIGURE 53: Overall condition of the facility FKIs reported “having enough” computers for FIGURE 55: % of FKIs reporting their facilities encountering the following shortages according to FKIs (red) and IMPACT Enu- work purposes. Half of the FKIs (50%) report- merators (beige) ed that most computers in their facility were 3+ Electricity shortage 50% 33% 17%

3+ “obsolete”, while only 25% of computers were Excellent 3% 3% 0 considered to be up to date.

+31 Gas shortage 8% 92% Good 31% +22+ 22% 0+19 In terms of Water, Sanitation and Hygiene Heating shortage 36% 3% 61% Poor 19% +22+0+ (WASH), the majority of FKIs reported that 22% 47 their facilities have a sufficient number of toi- Water shortage 56% 19% 3% 22% Satisfactory 47% +53 53% lets (58% of FKIs) and basic hand washing facilities (72%); but less than a third (31%) reported that their facilities have access to No Yes, rarely Yes, often Not applicable drinking water.

35 ADMIN. HEALTH 2 terms of facilities experiencing this pressure, ACCESSIBILITY FOR PERSONS WITH HUMAN RESOURCES Lack of qualified candidates (43%) and low as it was reported by 60% and 57% of FKIs DISABILITIES salaries (14%) were reported to explain these Similar to other assessed facility types, the in Kurakhove and Vuhledar, respectively, and Only 8% of facilities were reported by IMPACT HR gaps. Consequently, almost half of admin- gender breakdown of workforce in adminis- none in 4 of the 7 assessed areas. enumerators to be “accessible” for PwD, while istrative FKIs (44%) considered that their facil- trative facilities is markedly skewed towards 33% were considered to be only “partially ac- ity had not enough FTEs to manage with their FIGURE 56: % of FKIs reporting experiencing female workers. cessible”. In fact, as highlighted in Table 16 be- workload. This may partially explain why 21% additional pressure from NGCA residents low, very few administrative facilities have their of FKIs considered that the number of users FIGURE 58: % of FKIs reporting gender dis- was too high, while 78% of FKIs reported it to Overall 28% 3% 69% amenities adequately adapted to facilitate the tribution of workforce in staff (top graph) access of PwD. Nevertheless, half of admin- be “about right”. High numbers of users might and managerial staff (bottom graph) cause a strain on the staff members and nega- Kurak. Rural 100% istrative FKIs (50%) reported their facilities to tively impacting staff well-being, as the indica- Kurak. Urban 100% have PwD among their staff members, with 2 6% 92% 3% tor below suggests: Krasnohorivka 100% persons on average per facility. Marinka 25% 75% TABLE 16: % of admin. FKIs reporting their Marinka Rural 17% 83% of FKIs reported that facilities to be lacking the following inclu- 81% Vuhl. Rural 29% 71% 6% 61% 11% 17% stress and emotional load were sive amenities Vuhledar 57% 43% 80+20A common among the staff members Kurakhove 60% 40% No males Mostly females In addition, a considerable proportion of FKIs Type of missing amenities % of FKIs Experiencing pressure due to NGCA residents Slighlty more female Almost even indicated the need to have more capacity Do not know Restroom with appropriate Slightly more male Mostly male building/trainings for the facility staff on decen- 86% Not experiencing pressure due to NGCA residents pictogram tralized service provision. Half of FKIs (50%) In terms of age breakdown, most FKIs (86%) considered this proposition as being “extreme- As shown in the Figure 57, the most frequently Information signboards in Braille 78% reported their staff to be “mostly middle aged” ly relevant” and 36% as “very relevant”, which requested services by NGCA residents were Guiding strip to entrance 72% (between the age of 36 and 55), and facilities might indicate a capacity gap. This highlights passport-related services, reported by 34% Doorplates with contrast colours 72% had 17 staff on average (but 7 in median, a potential area of improvement that would si- of FKIs, followed by providing social protec- Information signboards with large which corroborates the variety of facilities’ siz- multaneously address one of the users’ com- tion (28%); and acts of residence registration/ 69% font and contrasting color es). Moreover, 31% of facilities reportedly had monly reported reasons for dissatisfaction: the de-registration (21%). Sound beacon at the entrance 61% IDPs among their staff members, with 5 IDP quality of staff (Figure 52). Handrails outside of the building 61% members reported on average per facility at FIGURE 57: Most requested administrative INTERNAL AND EXTERNAL GOVERNANCE services by NGCA residents (by % of FKIs) Handrails inside of the building 56% the time of data collection.

34+ In terms of internal governance, most facilities Passport related services 34% Elevator 53%

28+ were reported to have one or several mecha- Social protection services 28% Ramp on stairs outside 53% nisms in place to ensure feedback loops and 21+21 81% of FKIs reported that Services of registration/de-registration 21% Ramp on stairs inside 47% all their FTEs were filled at the improve management practices. First, 89% of time of assessment FKIs reported their facilities collected quantita- Land request issues 21% Lift 44% 81+19A

ADMIN. 36 tive data on various aspects of the facility, fur- INTERACTION WITH USERS GENDER-BASED AND DOMESTIC KEY FINDINGS ther reporting using this data in decision-mak- VIOLENCE RESPONSE Most FKIs reported that their facilities were Overall, HHs were commonly satisfied with the ing. Similarly, 81% of FKIs reportedly had an engaging users in the cycle of service provi- Less than a third of FKIs (28%) reported that available administration services. However, internal quality assurance mechanism in place sion (72%). Amongst those FKIs who did en- their facility has effectively registered and “complexity” and “length of procedures” were at their facility, and most facilities reportedly gage their users, 77% reported doing so in the reported possible/actual cases of GBV/DV commonly reported dissatisfaction factors. published their annual reports (as reported by needs assessment/planning stage monitoring among their staff or users. Facilities registered Overall, facilities were reported to experience 78% of FKIs). The main reason reported by all and evaluation plan, 65% reported engaging 7 GBV/DV cases on average per facility per a relatively important pressure from NGCA FKIs for not publishing annual reports was the with users in the monitoring and evaluation year (but 2 in median), while facilities in Vuhle- residents, and most notably in the areas of lack of existing practice. plan, and 42% in the reporting stages. It is dar registered as many as 43 GBV/DV cases Kurakhove and Vuhledar. noteworthy that all FKIs reported having an op- on average per facility per year. A bit less than half of FKIs reported that their erating feedback mechanism for their users, to Findings also indicated an overall low com- facilities had undergone an external evalua- which most users reportedly apply “frequently” puter literacy amongst the population, and a tion or audit in the 12 months prior to the as- of FKIs reported that (47% of FKIs reported this) or “occasionally” 61% low usage of internet to acces administrative sessment, which is a relatively low proportion their facility had effective SOPs to (34%). The most commonly reported types of services online. in comparison to the other sectors covered in react to cases of domestic violence user feedback received were personal que- this assessment. 61+39A or GBV. 3% have partial SOPs ries (63% of FKIs) and administrative queries (13%). According to FKIs, the most preferred of FKIs reported that the Amongst the 36% of FKIs who reported that 47% user engagement modes were team discus- facility have undergone an external their facilities either did not have any SOPs, evaluation or audit in the 12 months sions (73% of FKIs), through available feed- or only had partial SOPs, in place to respond back mechanisms (65%) or face-to-face (38%) 47+53A prior to the assessment. to GBV/DV cases, 38% reported the main el- ement that their facilities were lacking to ade- Finally, administrative FKIs reported using In terms of external engagement, 89% of FKIs quately react to reported cases was an issued many different channels to disseminate infor- order on a GBV/DV case, while 31% of FKIs reported their facilities to have established col- mation to their users (Figure 59). laboration with other institutions to which users indicated lacking a registration journal. Addi- can be referred. tionally, another reported element was a lack FIGURE 59: Most commonly used commu- of a referral system through which GBV/DV On another note, less than half of FKIs nication channels according to FKIs survivors can receive help and support (23% 92+84+76+64+60+56+44+24 of FKIs). (43%) answered “not applicable” when asked Message Boards 78% whether their facilities included non-govern- In the facility itself 78% mental actors in service provision. Among the On the facility website 53% 57% of FKIs who did include these actors in their processes, 29% considered that they had Social networks 47% made service provision more effective “to a Via partner organizations 39% great extent”, and 33% “to some extent”. Information sheets 33% Home-visits 31% Mass media 25%

37 HEALTHADMIN. 2 JUSTICE & MAP 10: Available courts, centres for legal aid and police station per area SECURITY This section explores the level of access, free legal aid. Central police stations were also ² availability and quality of justice facilities in unequally and sparsely scattered across the the targeted locations. It also provides some target area. Consequently, only HHs in the two insights on the main drivers of insecurity as areas of Kurakhove and Vuhledar reported Pokrovskyi raion Yasynuvatskyi well as on the relations with the police. Find- accessing local courts, if needed, in their cur- raion ings are based on structured interviews with rent settlement (95% and 99% respectively). Ē 7 FKIs, among whom representatives from 4 Hirnyk police stations, 1 centre for legal aid and 2 This strong concentration and centralization Velykonovosilkivskyi Ē legal courts; as well on the analysis of all 2.725 of justice services in the urban area of Kura- raion Berestky / HH surveys and 120 CKIs. khove (and to a far greater extent Vuhledar) Ē is clearly visible in Map 10 and Map 11. This Kurakhove AVAILABLE JUSTICE FACILITIES AND latter map is also informative as it highlights ACCESS TO FACILITIES a relatively important proportion of CKIs and

HHs who reported accessing justice ser- Mariinskyi Mariinka TABLE 17: Number of available facilities vices outside the limits of the “target area” of raion EECP per area this assessment, namely in Pokrovsk, Sely- dove and Volnovakha: this might be partially Centres for explained by the lack of relevant facilities in Courts Police stations free legal aid the target area.

Krasnohorivka TYPE OF SERVICES PROVIDED ęÆ/ Ē Kurakh. Rural 1 Vuhledar Kurakh. Urban 1 In terms of available services within the facili- Kurakhove 1 1 ties, all police stations’ FKIs reported that their Volnovaskyi Novotroitske EECP NGCA Marinka facility had a juvenile police department. raion

Marinka Rural Of all justice FKIs, only the FKIs repre- Vuhledar 1 1 1 senting court facilities reported that their Vuhl. Rural facilities provided interpretation (translation for Overall 1 2 4 non-Ukrainian speaker) services for free. To Type of Justice facilities the question whether their facilities provided ęÆÆ Centers for free legal aid, all FTEs filled (1) Ē Police, not all FTEs filled (4) As illustrated in Table 17 and Map 10, only free legal assistance for indigent defenders, / Courts, not all FTEs filled (2) the targeted areas of Kurakhove and Vuhle- only one legal court FKI and one police station FKIs replied positively. ęÆÆ Facilities experiencing pressure due to dar had courts available at the time of data NGCA residents (apply to all symbols) collection, and only Vuhledar had a center for Km EECP (Entry-Exit Checkpoint) 0 5 10 38

The Centre for free legal aid in Vuhledhar the capacity to refer the demands to other regional centres (namely in Kharkov), but not to provide free legal aid themselves. MAP 11: Access to justice services across settlements MAP 11: Access to justice services across settlements USAGE OF COURTS AND FREE LEGAL FIGURE 61: HHs reported level of trust in AID CENTRES the court in their settlement 42 Cannot answer 42% + 29+28 4% of respondents have had No trust 29% a legal dispute in the 12 months Trust 28% prior to this assessment. 4+96A Similarly to HHs’ perception on police, Figure FIGURE 60: Most commonly reported types 61 shows that HHs’ level of trust in the avail- able court in their settlement was most of disputes, by % respondents.26 Legal disputes in family 26% commonly reported to be “average”. + 13+10+10+9+9 Petty theft 13% Labour disputes 10% HOUSEHOLDS’ RELATIONS WITH THE POLICE Pensions disputes 10% Administrative offenses 9% FIGURE 62: HHs reported level of trust in 9% the police in their settlement

Payments for utilities 42 No trust 42% + 40+18 Amongst the few HHs who reported having Trust 40% had a legal dispute, 59% reported that the Cannot answer 18% court proceedings were “affordable” to them in terms of total costs (fees, lawyers, etc.). All Similarly to what was observed for courts, FKIs reported that their facility was not charg- HHs were rather circumspect about the police ing their users for their services. in their settlement. In that regard, 20% of HHs reported knowing their local police officer, with 17% of HHs reported having a relatively high proportion in the rural areas of needed free legal aid services at Vuhledar (42%). 17+83A least once in their life Figure 63 highlights the difference in per- Interestingly, of HHs who reported being ceptions of police between HHs who had in need of legal aid, more than half (62%) reportedly encountered a police officer in the reported that it was not available to them, while 12 months prior to the assessment (8%) and 26% indicated it was “fully available”, and 11% those who did not (92%); this notable differ- “partially”. However, for HHs who did report ence indicates a negative public perception having used this legal aid (17%), 84% consid- of the police which is not generally based on ered that the institution had done everything experience. within its power to solve their problem.

39 JUSTICE & SECURITY HEALTH 2 FIGURE 63: Most commonly reported per- FIGURE 64: Estimation of facility condition FACILITY EQUIPMENT AND SUPPLIES gency/ response preparedness, all police FKIs ceived modes of police conduct, by % of by FKIs and IMPACT enumerators reported that their facilities were equipped with respondents 13+ a landline or a cellular telephone available to

0 FKIs’ satisfaction regarding the material and 30+ Excellent 13% 0 + Refuse to answer 30% 15+ 0% technical supply of facilities varied considera- call 24/7 and that their facility had enough +29 15% 0 bly, and almost equal numbers of FKIs reported vehicles to enable fast responses to incidents. 29% +0+ +33 Good 0% 0+29 being satisfied and dissatisfied (Figure 66). Referred to hierarchy 33% +21+ 21% 0+30

29% +67+0 Satisfactory 67% 30% +45+0 ACCESSIBILITY FOR PERSONS WITH DIS- Treated fairly +29 45% FIGURE 66: FKIs’ satisfaction with material 29% +0+0 ABILITIES +4 and technical supply of facilities Poor 0% 4% +21+0+

Addressed the problem quickly +0 21% 57% No justice facility was reported by IMPACT enu- +33

9 0% Don’t know/ hard to say 33% merators to be “accessible” for PwD, whereas 9% +6 14% Require payment 6% 2 facilities were considered as “partially acces- FKIs’ estimation IMPACT enumerators’ sible” and 1 facility as “not accessible”. estimation Did not encounter Did encounter 14% 14% a police officer a police officer With regard to Water, Sanitation and Hygiene (WASH), water shortages appeared to be Dissatisfied For instance, amongst those who did interact Comp. dissatisfied Neither TABLE 18: % of justice FKIs reporting their relatively common, since two out seven FKIs Satisfied Comp. satisfied with a police officer, 45% of respondents con- facilities to be lacking the following inclu- reported that their facilities were experienc- sidered having been treated fairly, while only sive amenities ing “frequent shortages”, while one reported In terms of IT equipment, six out seven FKIs 30% reported that they would be treated fairly experiencing “rare shortages” (Figure 65). reported that their facilities had a “sufficient # of FKIs if they were to encounter a police officer. Type of missing amenities Moreover, only one FKI reported that their number” of computers for work purposes, (out of 7) facility had access to drinking water at the while one FKI reported insufficient numbers Finally, it is quite noticeable that 30% of Restroom with appropriate time of data collection. On the other hand, six of computers. Further, two out seven FKIs 5 respondents who did not encountered a police pictogram out seven FKIs reported that their facility was considered their facilities’ computers as “obso- officer refused to answer to these questions, Sound beacon at the entrance 3 equipped with sufficient toilets for their staff lete”, and the same number reported that “a corroborating a certain level of sensitivity Doorplates with contrasted colours 3 and users, and all of them reported having few of them” were obsolete (and “none” was regarding the relations with the police. access to basic handwashing stations. reported by only one FKI). In terms of emer- Information signboards in braille 3 Information signboards with large 3 FACILITY CONDITION FIGURE 65: % of FKIs reporting their facilities encountering the following shortages font and contrasting color Overall and as illustrated in Figure 64, justice Water shortage 57% 14% 29% Stairs outside with handrails 2 facilities generally seem to be in satisfactory Guiding strip to the entrance 1 condition (if not good condition), however, two Electricity shortage 71% 29% Ramp outside of the building 1 of the seven justice FKIs reported perceiving Ramp inside of the building 1 Gas shortage 29% 71% their facility to be in a “poor condition”, which, Elevator 1 considering the relatively small amount of Heating shortage 86% 14% facilities available in general, remains a con- siderable amount. No Yes, rarely Yes, often Not applicable

JUSTICE & SECURITY 40 In fact, as highlighted in Table 18, very few facil- Overall, FKIs commonly reported that their The gender breakdown of workforce in police FKIs reported that stress and ities have their amenities adequately adapted facility was experiencing pressure due to stations is markedly skewed towards male emotional load were common to facilitate the access of PwD (according to NGCA residents, with both interviewed FKIs in workers, since most police station FKIs esti- 6/7 among the staff members FKIs). In addition, six of the seven interviewed Kurakhove indicating experiencing this pres- mated their staff body to be “mostly male”, or justice FKIs reported not having PwD among sure, and two out of the three FKIs in Vuhledar. “with a slightly higher proportion of males”; With regard to staff training, three police sta- tion FKIs reported their staff to be trained to their staff members, while the other FKI FIGURE 68: % of FKIs reporting most com- whereas the gender breakdown seems to be manage cases involving mentally ill persons, reported not knowing whether there were PwD monly requested administrative services markedly skewed towards female workers in while the other police FKI could reportedly not among the staff at their facility. by NGCA residents courts and centres for legal aid. Two of the 50+50++25+2525 seven interviewed FKIs reported their staff to answer this question. Furthermore, all of them IMPACT OF CONFLICT ON FACILITIES Drawing up documents 33% be either “mostly young” (i.e. up to 35 years reported their staff to be trained to manage Preparation of applications 33% cases with children. Only one FKI in Kurakhove reported his/ old), while four others reported their staff to be Dispute resolution 17% her facility to be destroyed during the period mostly “mostly middle aged” (i.e. between 36 GOVERNANCE AND INTERACTION WITH 2014-2019 and reportedly moved to another Legal advice and clarificatioon 17% and 55 years old). Facilities had 52 staff on USERS location; while all the other FKIs reported their Fight against violent crime 17% average. Moreover, 6 out of 7 FKIs reported facilities to have remained undamaged. In the that their facilities have IDPs among their staff In terms of internal governance, most facilities same vein, no facilities reportedly had to stop The most commonly requested services by members, with 13 IDP staff members per facil- were reported to have one or several mecha- service delivery due to the security situation NGCA residents were reported to be related ity on average per facility. nisms in place to ensure user feedback and to drawing up documents of a procedural improve management practices. Firstly, all during the 12 months prior to data collection. FKIs reported that all their FTEs In terms of preparedness, the majority of FKIs nature, and the preparation of applications, court FKIs reported having a performance complaints and other legal documents (except were filled at the time of assess- monitoring system in place for prosecution, as (four out of seven) reported that their facilities 1/7 ment did not have a bomb shelter, while two FKIs for procedural documents). well as for their judges. Second, the majority Only two out of seven FKIs considered that of FKIs (six out seven) reported their facil- reported the availability of a bomb shelter in HUMAN RESOURCES, STAFF TRAINING their facility. their facility did not have enough FTEs to ities generally collect quantitative data on various aspects of the facility and use it in FIGURE 69: % of FKIs reporting gender dis- manage with their workload. A lack of quali- fied candidates was reported by five out of six decision-making, which reportedly most com- FIGURE 67: % of FKIs reporting experi- tribution of workforce in police staff (top FKIs to explain these HR gaps. These findings monly happens on a monthly basis (four out encing additional pressure from NGCA graph) and court and centres for free legal are reflected in the similarly low proportion seven FKIs). residents aid staff (bottom graph) of FKIs who considered that the number of Kurakhove 100% requests from the population was “too high” Similarly, five out seven FKIs reported the 50% 25% 25% (only one out of seven FKIs, while the other presence of an internal quality assurance six FKIs reported the number of requests to be mechanism, and six FKIs reported publish- Vuhledar 67% 33% “about right”). However, these relatively posi- ing their annual reports. In terms of external governance, the majority of FKIs (five out of 100% tive findings in terms of workload and human Experiencing pressure due to NGCA residents resources do not appear to be reflected in seven) reported that their facilities have under- Not experiencing pressure due to NGCA residents No males Mostly females the relatively high overall level of stress and gone an external evaluation or audit in the Do not know Slighlty more female Almost even emotional load that was commonly reported by 12 months prior to the assessment. In addi- Slightly more male Mostly male FKIs; which could be correlated instead with tion, five FKIs reported their facilities having the nature and specificity of the work itself. an operating feedback mechanism for their

41 JUSTICE & SECURITY HEALTH 2 users, amongst which two FKIs estimated that FIGURE 72: % of HH reporting about the prob- the perceived threat of “murder” as one of their FKIs were confident that GBV/ the majority of users apply from “time to time” DV survivors trusted their facilities’ lem of domestic violence being aggravated in greatest safety concern threat might be par- and one reported that users “frequently” make 7/7 capacity to protect them and prose- their area compared with the previous year tially due to these areas’ spatial proximity to use of these feedback systems. According to 77+11+7+2+2 the “contact line”. When it comes to perceived cute perpetrators Hard to say 77% all FKIs, feedback most commonly concerned threats in general, there appeared to be no personal queries. Finally, FKIs reported using Despite the apparent lack of preparedness Did not change 11% significant difference between gender, nor several channels of communications in the that has been highlighted just above, FKIs Refuse to answer 7% between the different assessed areas (except direction of their users (Figure 70). were nonetheless generally confident that Aggravated 2% for the abovementioned indicator of “murder”). GBV/DV survivors trusted their facilities’ Became less grave 2% FIGURE 70: Most commonly reported main capacity to protect them and prosecute per- FIGURE 74: Most frequently reported con- communication channels used by facili- petrators. The number of GBV/DV cases was HOUSEHOLD PERCEIVED THREATS ON flict related threats, by % of respondents ties, by % of FKIs most commonly reported to be “unchanged” in 56+32+20+13+11+6 100+86+71+40+40+ PERSONAL SECURITY None 56% Information at facility 100% comparison to the previous year (as per three FIGURE 73: Most frequently reported Shelling 32% On the facility website 86% out of seven FKIs). non-conflict related threats, by % of respon- Shooting (small arms) 20% Social networks 71% In terms of HH perception on DV issues, it dents Military presence 13% Partner organization 43% 62+17+14+8+7+4+3 is important to emphasize, however, that Absence of bombshelter 11% Mass media 43% None 62% the vast majority of HHs were not aware of Mines 6% services available for survivors of GBV, as House is broken into 17% GENDER-BASED AND DOMESTIC VIO- demonstrated by Figure 71: Petty theft 14% As shown in Figure 74, at the target area level, LENCE RESPONSE Damage to personal property 8% the majority of respondents (56%) reported FIGURE 71: % of HHs reporting being aware not perceiving any conflict-related threats of services available for DV survivors Murder 7% FKIs estimated receiving “frequent” 59+16+12+8+7+4+2+1 Street harassment 4% as being of concern for their HHs. However, cases about DV in the year prior to Hard to say 59% 3/7 Tricked into paying money 3% there were noticeable differences between this assessment None 16% assessed areas as most of the shooting, Moreover, DV cases occurred “occasionally” Healthcare facilities 12% As illustrated in Figure 73, the greatest shelling, and military presence concerns were as per two out of seven FKIs (more specifi- Legal aid 8% threats (non-conflict related) that respondents reported in the Krasnohorivka and Mariinka areas (shooting by respectively 68% and 79% cally, one police station reported “occasional” Refuse to answer 7% reported were related to the conservation of individual property. Threats to the physical of respondents, shelling by 74% and 79%; requests and the other one reported “very Psychosocial support 4% rare” cases). In that regard, five FKIs reported integrity were seemingly only perceived sec- and military presence by, 40% and 41% of HH Shelters or safe space 2% that their staff were properly trained to react ondarily, although a relatively high proportion members). Information support and referral on GBV/DV cases in accordance with the new 1% of respondents reported “murder” when asked law. to list their three main perceived threats, Only a very small proportion of respondents Finally, findings suggest that HHs were not especially in the Krasnohorivka and Mariinka in Krasnohorivka (10% of respondents) and FKI estimated that his/her staff were commonlyvery knowledgeable of the evolution area (as per 12% and 11% respectively, in Mariinka (5%) reportedly did not perceive any not trained to react on GBV/ DV of the issue of domestic violence in their com- contrast 7% of respondents on average); and conflict-related threats in their settlements, 1/7 cases (and one FKI didn’t know) munity, as Figure 72 illustrates: “street harassment” (4% overall). The rela- which is relatively low compared to the overall tively high proportion of respondents reporting average of 56% of respondents.

JUSTICE & SECURITY 42 Overall, 90% of respondents reported feeling populated settings. This relatively high propor- The issue appeared to be even more acute at KEY FINDINGS safe walking alone in their community during tion of respondents reporting the absence of night, as it was reported by 88% of respond- the day, with no apparent difference between sidewalks might also be positively correlated ents in Krasnohorivka and 92% of HHs in Overall, findings demonstrate a general low gender (89% of female respondents and 92% with the similarly high proportion reporting Mariinka. usage of courts, but also a relatively low trust of male respondents). This proportion drops cycling to access services in their settlements in the police and court system. Nonetheless, significantly at night, with more pronounced (41% of respondents, compared to 23% over- Finally, “mined roads” was a reason reported citizens generally appear to feel safe in their differences in terms of gender this time: 49% all). by a very low proportion of respondents in everyday life, and conflict-related concerns of female respondents reported feeling safe Mariinka (3% during the day, 1% at night); and seem to be secondary, while concerns walking alone at night; whereas 59% of male Bad encounters (such as people under influ- none elsewhere (0% for the overall average). related to the physical infrastructure, such as respondents did (52% of respondents overall). ence of alcohol or drugs or hooligans) were the road conditions and notably sidewalks, are second most commonly (aggregated) reported seemingly the main reasons for why HHs in reasons for feeling unsafe at night. Regarding the assessed areas feel unsafe. conflict-related reasons, “shelling” was heavily reported as a reason for feeling unsafe during Furthermore, the findings from this section 65+35A 76+24A the day in the abovementioned areas of Kras- also clearly highlighted a gap in knowledge nohorivka (69% of respondents) and Mariinka and trainings on GBV/DV issues, both from 65% of respond- 76% of respond- (89% of HHs), to a lesser extent in Kurakhove the facilities and the population point of view. ents reported road ents reported road and Mariinka Rural (22% and 17%), and very condition and traffic-re- condition and traffic-re- much less so elsewhere. Finally, it is interesting to note that almost all lated reasons* for feeling lated reasons* for feeling FKIs reported to experience an additional unsafe during the day unsafe during night FIGURE 75: Most commonly reported reasons for feeling unsafe while walking in the com- pressure from NGCA residents. munity, by % of respondents reporting feeling unsafe

As disaggregated results show in Figure 75 During the night During the day 49 89 +59 below, stray animals were the most commonly +92 +0 49% / 59% Feel safe walking 89% / 92% +0 0 reported single reason for feeling unsafe (both 0 +0 +0 +54 during the nights and during the days). On +44 37+0 + +35 0 + 44% / 35% Stray animals 54% / 37% +15 the other hand, road conditions and traffic in +10 +17+ +15+ 0+21 general1 accounted for the main aggregated 0+42 10% / 15% Absence of sidewalks 15% / 17% +20 +35 +0 +0 42% / 35% Drunk or drug-addict people 21% / 20% +10 reasons as to why respondents reported feel- +31 +13+0 +32 0+7 ing unsafe during the day and at night. + 31% / 32% Hooligans 10% / 13% +6 +4+ +7+ 0+6 0+8 7% / 7% Drunk drivers 6% / 4% 7+0 +6+0 The absence of sidewalks was most com- + 8% / 7% Robbery 6% / 6% +9 +3 10 2+0 + + 0+4 monly reported in the Vuhledar Rural area 3% / 2% Absence of crosswalks 9% / 10% + +47 +6 as a reason for feelings of unsafety (as per +55 47% / 55% Absence of street lighting 4% / 6% 63% of respondents, compared to 20% of on average), likely reflective of the differentiated Female Male challenges faced by HHs living in less densely * The aggregation of: Absence of sidewalks, Drunk drivers, Absence of cross-walks, Fast traffic, Absence of street lighting, Unregu- lated intersections/traffic

43 JUSTICE & SECURITY HEALTH 2 Facilities, however, were reported to offer a large array of services.

SOCIAL settlements surrounding Kurakhove indicated MAP 12: Available facilities providing social services per area going to Mariinka or Pokrovsk and Selydove SERVICES instead of Kurakhove itself, most probably due

to the lack of relevant social centres there. As Pokrovskyi This section explores the level of access, ² raion shown in Map 13, most HHs and CKIs living Yasynuvatskyi availability and quality of facilities providing raion around Vuhledar indicated going to Volno- social services in the targeted locations. Find- vakha instead of Vuhledar itself, despite the ċ ings are based on structured interviews with relatively high number of facilities present Hirnyk 18 FKIs, as well on the analysis of all 2.725 there. Velykonovosilkivskyi HH surveys and 120 CKIs. raion WÆg XÆ AVAILABLE SOCIAL SERVICE FACILITIES USAGE AND USER SATISFACTION Kurakhove The relatively low number of facilities has to be g WÆċÆ Mariinka At the time of assessment, there were no social put into perspective with the correspondingly XÆ service centres in Krasnohorivka, Kurakhove very low number of social service users, as Mariinskyi Mariinka Rural and Vuhledar Rural areas (table 19 and only 6% of HHs reported using these services. raion EECP Map 12). Facilities in Kurakhove and Mariinka The most frequently accessed services were appeared to commonly attract people from the facilities to support pensioners and/or IDPs ċ region, as indicated by Map 13. In addition, a and PwD. Novomykhailivka sizeable proportion of HHs and CKIsii living in i ZÆ As shown in figure 76, amongst those HHs qÆZÆ gÆ XÆ TABLE 19: Available facilities per area that reportedly used social services, 83% ċ ZÆ gÆ reported to be either “completely” or “rather” Vuhledar satisfied with these services. The main reason for dissatisfaction was reportedly related to Volnovaskyi Novotroitske time-consuming procedures, as illustrated in raion EECP Mariinka Vuhledar Figure 77 below. Incidentally, “distance” was NGCA Kurakhove

Mariinka Rural a commonly reported reason in Kurakhove Kurakhove Urban rural (67% of dissatisfied HHs), Krasnohorivka Type of Social facilities WÆ Center for family and youth (2) Center for family and (50%) and Kurakhove (50%). 1 1 ZÆ Center for the social rehabilitation of children (3) youth ċÆ XÆ Children's service (3) Center for the social FIGURE 76: HHs’ satisfaction towards 44 Stepne qÆ rehabilitation of 3 social services Employment Center (1) gÆ children g Department of Social Protection of Population (4) 47% ċÆ ċ Territorial center (5) Children’s service 1 1 1 4% FTE positions: ċÆ Employment center 1 9% 36% All FTEs filled ċ Not all FTEs filled Department of 4% (apply to all symbols and colors) Social protection of 1 1 2 ċ Facilities experiencing pressure due to Population Comp. dissatisfied Dissatisfied Neutral NGCA residents (apply to all symbols) / don’t know Km EECP (Entry-Exit Checkpoint) Territorial center 1 1 1 1 Satisfied Comp. satisfied 0 5 10 44 FIGURE 77: Top reported reasons for satisfied with the material and technical sup- MAP 13: Network map: access to social services facilities across settlements dissatisfaction among dissatisfied users plies available to their facility. 55+32+30+13+12+12+8+6+6 Procedure 55% FIGURE 80: FKIs satisfaction with material Distance to the facility 32% and technical supply of facilities Lines 30% 24% Quality of social service staff 13% 41% Corruption 12% 29% Lack of transport 12% 6% Price for transport 8% Comp. dissatisfied Dissatisfied Neutral No toilets for visitors 6% / don’t know Satisfied Comp. satisfied Price for service 6% According to FKIs, the supplies that facilities FACILITY CONDITION AND EQUIPMENT were the most lacking of were computers and furniture (both repoted by 75% of FKIs) and Most facilities were reported to be in “satis- office space (38%). However, only 24% of factory” condition, as illustrated in Figure 79. FKIs specifically reported “not having enough” FIGURE 79: Overall condition of the facility computers for work purposes.In addition, 25% according to FKIs (red) and IMPACT Enu- of FKIs reported that “half” of their computers merators (beige) were obsolete, and another 19% reported that 29+

29% 41+ almost all their computers were obsolete. Good 41% 0 +6

6% +6+ On a different note, all FKIs reported that

Poor 0+65 6% their facilities were equipped with a sufficient

65% +53 Satisfactory 53% number of toilets and basic handwashing facil- ities. In addition, a small proportion of FKIs About half of the social service FKIs (53%) (18%) reported that their facility did not have reported being either satisfied or completely access to drinking water. FIGURE 78: % of FKIs reporting their facilities encountering the following shortages

Water shortage 94% 6%

Electricity shortage 76% 18% 6%

Gas shortage 6% 94%

Heating shortage 59% 12% 18% 12%

No Yes, rarely Yes, often Not applicable

45 SOCIAL SERVICES HEALTH 2 Moreover, only 6% of FKIs were reportedly as it was reported by 67% of FKIs in Kurak- TABLE 20: % of social services FKIs FIGURE 82: Gender distribution of work- facing frequent water and electricity shortages hove and 50% of FKIs in Vuhledar, and no reporting their facilities to be lacking the force in staff (top graph) and managerial in the three months prior to this assessment, FKIs from other areas. following inclusive amenities staff (bottom graph) while 29% of FKIs reported that their facility % of either often or rarely experienced heating FIGURE 81: % of FKIs reporting experiencing Type of missing amenities facilities 12% 88% shortages. additional pressure from NGCA residents Guiding strip to the entrance 94% Overall 35% 12% 53% Restroom signed with an Finally, Figure 78 above shows that facilities 76% generally did not experience frequent short- appropriate pictogram 18% 35% 18% 18% 12% Vuhledar 50% 13% 38% Stairs inside equipped with ages of basic utilities, such as electricity, 71% heating or water, but rather on an occasional Marinka Rural 100% handrails on both sides No males Mostly females basis, as reported by FKIs. Information signboards with Marinka 25% 75% 71% Slighlty more female Almost even information duplicated into braile Kurakhove 67% 33% Slightly more male Mostly male IMPACT OF CONFLICT ON FACILITIES Kurak. Urban 100% Ramp inside of the building 59% Doorplates marked with contrasting lowed by “mostly young” (24% of FKIs). Low Experiencing pressure due to NGCA residents 59% None of the FKIs from Kurakhove and Vuhledar colors and large font salaries (75%) and to a lower extent expected Do not know reported that their facilities had been dam- Information signboards with large Not experiencing pressure due to NGCA residents 59% budget cuts (25%) were reported by FKIs so aged as a result of shelling during the period font and contrasting color as to explain these HR gaps. Amongst FKIs 2014-2019. However, in Kurakhove Urban and Sound beacon at the entrance 59% ACCESSIBILITY FOR PERSONS WITH DIS- that did indicate HR gaps, FKIs most com- Mariinka Rural, all FKIs reported their facilities Stairs outside equipped with monly reported that they were due to low ABILITIES 53% had been damaged and fully recovered, and handrails on both sides salaries (75%) and expected budget cuts 50% of FKIs in Mariinka reported their facilities Only 29% of facilities were reported by Elevator 53% (25%). Accordingly, a bit more than half of to be damaged and only partially recovered. It IMPACT enumerators to be “accessible” for Lift 47% all social service FKIs (53%) considered that is also noteworthy that no facilities reportedly PwD, and 35% as “partially accessible”. In their facility had not enough FTEs to manage Ramp outside of the building 41% had to stop service delivery due to the secu- addition, very few facilities had their amenities their workload. The relatively high proportion rity situation during the 12 months prior to this adequately adapted to facilitate the access of HUMAN RESOURCES of FKIs reporting HR gaps may also partly assessment. In terms of preparedness, 35% of PwD, as indicated in Table 20. explain why 29% of FKIs considered that the FKIs reported that their facilities have a bomb The gender breakdown of the workforce in number of users was “too high” (and 71% shelter, of whom all FKIs reported considering Furthermore, less than half of FKIs (47%) social servics facilities appeared to be mark- “enough”). that the shelter’s safety level was “satisfac- reported that their facilities have PwD among edly skewed towards female workers (figure tory”. their staff members, with 2 persons on aver- 82). According to 59% of FKIs, the majority Unfortunately, this may also impact the overall age per facility. of staff at their facilities was “mostly middle staff well-being, as the indicator below sug- Overall, 35% of FKIs considered that NGCA aged” (between the age of 36 and 55), fol- gests: residents were causing pressure on their facil- ity, with significant differences between areas, 71% of FKIs reported that 88% of FKIs reported that all their FTEs were filled at the stress and emotional load were 70+30A time of assessment 88+12A common among the staff members

SOCIAL SERVICES 46 A significant proportion of FKIs indicated the 84). In addition, less than half of FKIs (41%) INTERACTION WITH USERS GENDER-BASED AND DOMESTIC need to have more capacity building/trainings reported that their facilities had undergone an VIOLENCE RESPONSE for their facility staff on decentralized service external evaluation or audit in the 12 months The majority of FKIs (71%) reported that their provision, since 24% of FKIs considered this prior to the assessment, while 47% reported facilities were engaging users in the evalu- Overall, 29% of FKIs reported that their facil- proposition as being “extremely relevant” and that there had not been an external evaluation ating the service provision. Amongst these ity has effectively registered possible/actual 47% as “rather relevant”. or audit (and 12% reportedly did not know). FKIs, 92% reportedly did so in the needs cases of DV or GBV among their staff or bene- Finally, a vast majority of FKIs (88%) reported assessment/planning and in the monitoring ficiaries, and subsequently informed the police INTERNAL AND EXTERNAL GOVERNANCE that their facilities had established collabora- and evaluation stage. It is notable that 93% or the adequate social affair services. Facili- FIGURE 83: Levels of FKIs’ satisfaction tion with other institutions, particularly related of FKIs reported having an operating feed- ties reportedly registered 9 GBV/DV cases on regarding current coordination of social to user referral back mechanism for their users, which FKIs average per facility per year (but 3 in median, service provision by the state most commonly reported to be used by users reflective of the different sizes of facilities). 12% 24% In terms of internal governance, findings indi- “frequently” (69%), followed by “occasionally” cate that most social service facilities have (19%) and “rarely” (13%). The majority of FKIs 23% 76% of FKIs reported their one or several mechanisms in place to ensure (81%) reported that most people’s feedback 35% facilities had effective SOPs in that feedback is taken into account and that concerned “personal queries”. place to react to cases of DV or 6% management practices can be improved upon. 76+24A GBV. 12% have partial SOPs. Comp. dissatisfied Dissatisfied Neutral In this regard, almost all FKIs (94%) reported According to FKIs, the most popular ways / don’t know Satisfied Comp. satisfied collecting quantitative data on various aspects to engage users were face-to-face (92% of of the facility and using this data in deci- FKIs), through organized team discussions 59% of FKIs reported their In terms of external governance, most FKIs sion-making, of whom 29% reported their (67%), and phone interviews (25%). facilities disseminate information (59%) reported to be “rather satisfied” or “sat- facilities were collecting data on a quarterly 60+40A on GBV/DV issues isfied” with the current coordination of social basis, 24% reported this happens monthly or Finally, social service FKIs reported using service provision by the state (Figure 83). Amongst the 24% of FKIs who reported not annually, and 18% indicated that their facilities many different channels of information for their According to FKIs, the stages of state coordi- having any SOPs or only partially having only collected data “if necessary”. users, as illustrated in Figure 85: nation requiring the most improvement were SOPs in place, 75% reported that the reason its forms and modalities of financing (Figure for not fully having SOPs in place was that In the same vein, the majority of FKIs (82%) FIGURE 85: Most commonly used commu- they needed to increase staff awareness reported the existence of an internal quality FIGURE 84: Stages of state coordination nication channels, by % of FKIs around the legal framework governing GBV assurance mechanism within their facilities, 88+76+76+76+76+65+53+53 requiring the most improvements, by % of survivors’ rights first. Other reported reasons and more than half of FKIs (59%) reported In the facility itself 88% FKIs for not having SOPs were lacking a registra- 59+35+29+29+18+18+12 that their facilities publish their annual reports. Via partner organizations 76% tion journal as well as an issued order on a Financing 59% Those who reported not publishing their annual On the facility website 76% GBV/DV case, as per 50% of these FKIs each. Organisation 35% reports indicated that the main reason for not Message Boards 76% Planning 29% publishing was because they lacked the prac- Social networks 76% None 29% tice to do so (reported by 67% FKIs). Finally, Information sheets 65% almost all FKIs reported using case manage- Reporting 18% Mass media 53% ment practices in their day-to-day operations. Monitoring & Evaluation 18% Home-visits 53% Informing people 12%

47 SOCIAL SERVICES HEALTH 2 TABLE 21: Most commonly reported availa- “Long queues” was the most commonly From the FKIs’ perspective and in terms of OTHER SERVICES ble financial services, by % of respondents reported main source for HHs’ dissatisfac- gender, all FKIs agreed that an almost even tion with financial services in the four central distribution of customers were applying for FINANCE Type of financial service % of HH areas of Kurakhove Urban (68% of dissatisfied loans, and that less than a fourth of customers available respondents HHs), Kurakhove (87%), Mariinka (94%) and were late for repaying their loans, with a higher This section present findings on financial Post office or postman providing Vuhledar (83%). This was seemingly much proportion of males. 70% services, from the users’ as well as from financial services less of a concern for HHs in Krasnohorivka, the facilities’ perspective. In total, four FKIs Payment of utility bills 70% Kurakhove Rural, Mariinka Rural and Vuhle- All FKIs concurred that internet banking was dar Rural (58%, 17%, 18%, 11% respectively), agreed to be interviewed, representing facil- ATM 67% popular amongst their customers, and that ities in each of the four more central areas who instead more commonly reported the dis- their facilities have self-serving machines. Bank office 60% of Kurakhove, Vuhledar, Mariinka Rural and tance to the bank office (90%, 93%, 93% and Additionally, all four FKIs reported users Kurakhove Urban”. The findings presented in Withdraw cash from the cashier 41% 82% respectively) as their primary reason of accessing their facilities face long queues this section are based on 4 FKI interviews and Money transfers 36% dissatisfaction. “occasionally”. all 2.725 HH surveys. Other payments 31% Getting state social benefits 16% As demonstrated in Figure 87, the third main In terms of gender breakdown, all FKIs AVAILABLE FACILITIES AND TYPE OF reason for dissatisfaction with financial ser- Loans to individuals 15% reported that both the ground staff and the SERVICES PROVIDED vices was the distance to ATM, which was managerial staff was “mostly female”. Con- Mobile bank 6% also the most commonly reported concern for cerning the disaggregation by age, the most All FKIs reported that their facility provided the Loans to legal entities 3% HHs reporting being dissatisfied in Kurakhove commonly reported age range for staff at entirety of the list of basic financial services, Rural and Vuhledar Rural (76% and 80%). financial facilities was “mostly middle-aged.” HHs reported being satisfied with the finan- such as money transfers, insurance, mort- Furthermore, all assessed facilities were gage, loan credit services, etc. Moreover, they cial services available in their settlement, with FIGURE 87: Most commonly reported rea- reported to have PwD amongst their staff, unanimously reported that the most commonly 74% reporting being either “rather satisfied” or sons for dissatisfaction according to HHs while none of the facilities reportedly had accessed services were services related to “completely satisfied”. However, HHs in Kras- using administrative services employed IDPs amongst their staff. pensions and social benefits, followed by nohorivka, Kurkhove Rural and Mariinka Rural were reportedly relatively dissatisfied, with 59+49+34+14+13+6 “payment services”, and “savings deposit and Lines 59% Finally, all FKIs reported having feedback 29%, 27% and 27% of HHs reporting being investment”. Distance to bank office 49% mechanisms for their users, while at the same “rather dissatisfied” in these areas respectively. Distance to ATM 34% time, all FKIs also reportedly were unaware As indicated in Table 21, HHs were similarly FIGURE 86: Users’ satisfaction towards Cost of transport 14% about whether their facilities had effective reported to have access to a great variety of SOPs in place to react to cases of GBV/DV in available financial services No cash available 13% financial services: their facility. 43% Cash limit for withdrawals 6% 5%

16% 31% Moreover, high prices for transport and the 5% availability of cash were the fourth most com- monly reported main sources of dissatisfaction Comp. dissatisfied Dissatisfied Neutral as reported by 14% and 13% of HHs, respec- / do not use Satisfied Comp. satisfied tively.

48 FINANCE State Emergency tions. The FKI reported being dissatisfied with Kurakhove to be “satisfactory”. GENDER-BASED AND DOMESTIC the material and technical supply of the facility. VIOLENCE RESPONSE Services of Ukraine In terms of specific types of equipment, there Moreover, the FKI reported that their facility The FKI reported that the staff was “partially” This section covers the State Emergency Ser- reportedly were not enough computers and annually assesses the emergency prepared- trained to react in cases of GBV/DV, according vices of Ukraine (SESU) from the perspective furniture for work purposes. ness and safety of public buildings by conduct- to the new legislation in Ukraine. In this con- of one FKI in the area of Kurakhove. ing simulations, checking building structures, text, potential subjects of interest for training INTERACTION WITH USERS AND LEVELS and reviewing evacuation planning. on GBV/ DV were issues of prevention and re- AVAILABLE SERVICES OF PUBLIC AWARENESS HUMAN RESSOURCES sponse on GBV, which might indicate a lack of consistent and comprehensive knowledge on This facility was reported to cover the majority 68% of respondents of functions normally attributed to such cen- In terms of gender breakdown, FKI reported these topics in the facility. reported feeling confident that that the staff, including the managerial staff, tres, such as conducting rescue operations the state emergency services and emergency medical care, evacuation of was mostly male and generally young (i.e. up 68+32A would be available if needed to 35 years old). The SESU facility in Kura- population, minimization and elimination of risks, etc. Most respondents (68%) reported believing khove was relatively sizable, with 190 staff that the state emergency services would be members (with no volunteers), among whom FACILITY CONDITION AND IMPACT OF available in case of emergency .However, in reportedly are five staff with IDP status and no CONFLICT Vuhledar, a relatively high proportion of HHs PwD. The FKI reported their facility to be in “good” (22% compared to 8% overall) reported disa- condition. However, the facility was reported greeing with the statement that the state emer- GOVERNANCE to experience gas shortages (“often”) and gency services would be available if needed. electricity shortages (“rarely”), while heating The facility was reported to have internal qual- and water shortages were not reportedly oc- The facility reportedly published its annual re- ity assurance mechanisms (e.g. internal M&E) curring. In terms of preparedness, the facility ports to the public and has a feedback mech- and to engage in monthly (geo-)data collection reportedly lacked a bomb shelter. Moreover, anism for its users, most notably in place for to support decision-making. Similarly, the fa- the FKI disclosed that the facility had been personal queries. However, the FKI reported cility reportedly collected data on the timing damaged due to shelling but had been fully that the feedback mechanism was only “very of incidents and using it accordingly. Also, the recovered since. rarely” used. According to the FKI, users could facility had reportedly undergone an external reportedly get in touch with the facility through evaluation in the year prior to this assessment. EQUIPMENT AND SUPPLY the facility’s website, information sheets, get- ting information directly at the facility, via social Lastly, the FKI indicated that the announced The FKI indicated that improving the facility’s networks, and through mass media. decentralization reform will likely improve the materael and technical supplies as well as im- effectiveness of the facility. proving information management and availa- The FKI estimated that the general public ble software would in turn improve their overall awareness of how to respond to emergencies capacity to carry out their distinct mandates of was “good enough”. Generally, the FKI also emergency prevention, emergency response, disclosed perceiving the fire safety conditions and reduction of emergency situations’ conse- of the built environment (e.g. apartments, quences and the capability and staff qualifica- schools, hospitals, administrative buildings) in

49 SESU FIGURE 89: HHs’ satisfaction towards their MAP 14: Network map: food market access MARKETS available NFI market FIGURE 88: HHs’ satisfaction towards their available food market 4% 31% 25% 35% 1% 30% 27% 5% 38%

4% Comp. dissatisfied Dissatisfied Neutral Satisfied Comp. satisfied / do not use Comp. dissatisfied Dissatisfied Neutral Satisfied Comp. satisfied / do not use Findings for non-food item (NFI) markets were remarkably similar to those recorded to food The primary reason for HHs’ dissatisfaction markets, with price of goods being the primary with markets was, by far, the price of goods reason of dissatisfaction (75% of dissatis- available in the markets (83% of dissatisfied fied users), followed by range and variety of users), followed by the quality of goods as per goods (32%) and “quality of goods”, “distance 17% of users. The absence of markets was to NFI markets” and “absence of markets” (all mostly reported as a reason for dissatisfaction 12%). Similarly to food markets, 70% of HHs in the areas of Kurakhove Rural and Mariinka in Kurakhove Rural and 45% in Mariinka Rural Rural (46% and 38% accordingly, compared to reported traveling to another settlement to 9% on average). access their main NFI market, compared to 18% on average. Similarly, “distance to food market” was almost exclusively reported by dissatisfied HHs in FIGURE 90: Frequency with which HHs Kurakhove Rural (27%, compared to 12% on reported ordering goods or services online

average), which has to be read in line with the 60+15+15+8+2 fact that 57% of HHs from there were report- Never 60% edly using a food market that was not located Very rarely 15% in their own settlement (and 38% in Mariinka A few times a year 15% Rural, compared to almost no respondent in Every month 8% the other areas). Every week 2%

Finally, 14% reported the “range and variety of More than half of HHs (60%) reported never goods” as a reason for dissatisfaction in their having ordered goods or services online. settlement.

50 MARKETS & TRANSPORT HEALTH 2 Kurakhove Rural HHs reported unavailability ROADS WATER UTILITIES of sewage services, compared to 53% on average. All dissatisfied HHs in Kurakhove 37% 6% 17% The following graphs in the next two pages 40% (amongst HHs reporting having sewage ser- show the overall HHs’ satisfaction towards 24% 13% basic public utilities. Considerable differences vices) reported “regular breakdown” of these 27% 18% were identified between geographical areas services. 6% 12% for the following utilities and services: Comp. dissatisfied Dissatisfied Neutral Comp. dissatisfied Dissatisfied Neutral Water: The majority of HHs in Mariinka Rural / don’t know / don’t know Satisfied Comp. satisfied Satisfied Comp. satisfied Roads: 99% of HHs considered their roads (63%) and Kurakhove Rural (62%) reported / not connected to be in a “bad condition”. Particularly high not being connected to a water service, com- pared to 16% on average. In Vuhledar Urban, Top three most commonly reported reasons Top three most commonly reported reasons proportion of HHs reporting being “completely for HHs’ dissatisfaction regarding roads: for HHs’ dissatisfaction regarding water: dissatisfied” with roads were found in Kras- 76% of HHs reported being “rather dissatis- nohorivka (52%) and Vuhledar Rural (48%) – fied” with the water services available to them. Bad condition 99% Poor quality of water 88% compared to 27% of HHs overall. Unsafe for pedestrians 8% Too expensive 33% Heating: Almost all HHs in Vuhledar Rural Congested 4% Regular shortage 24% Telephone network: Only 2% of HHs report- (98%) Kurakhove Rural (92%) were reportedly ed being connected to a telephone landline. In not connected to the heating system. Amongst Mariinka Rural, no HHs were reportedly con- the 97% of HHs who were reportedly connect- Methodological note: the black line represents the weighted average of users’ satisfaction. nected at all. ed to the heating system in Vuhledar, 93% of All graphs in the following page follows the same schematic layout: average dissatisfac- HHs reported that this is due to a high price tion + top three reasons of dissatisfaction Internet network: Half of HHs (51%) reported (compared to on average 21%). not being connected to internet, the most com- monly reported reason being that the network TABLE 22: Top three most commonly reported reasons for dissatisfaction with water services, by % of dissatisfied HHs per target area quality is too bad (88% of disconnected HHs). Kurakhove Kurakhove Vuhledarska Mobile network: 23% of HHs in Kurakhove TOTAL Krasnohorivka Rural Urban Kurakhove Mariinka Mariinka Rural Vuhledar Rural Rural reported being “dissatisfied” with their mobile network, compared to 16% on aver- age. The most commonly reported reason for Poor quality Poor quality Poor quality Poor quality Poor quality Poor quality Low water Poor quality Poor quality dissatisfaction in Kurakhove Rural was a “poor water (88%) water (98%) water (92%) water (90%) water (93%) water (100%) pressure (65%) water (86%) water (86%) signal” (72% of dissatisfied HHs) Too expensive Too expensive Regular Regular Too expensive Poor quality Too expensive Regular shortages shortages Heavily chlored shortages Waste management and sewage services: (33%) (50%) (30%) (53%) (31%) (40%) water (55%) (75%) (39%) Almost all HHs in Vuhledar Rural (96%) and 72% in Kurakhove Rural reported that waste Regular Regular Low water Too expensive Too expensive Regular Regular Low water Low water management services were unavailable in shortages shortages shortages shortages pressure (14%) (32%) (28%) pressure (17%) pressure (39%) their area, compared to 27% on average. Sim- (24%) (36%) (11%) (15%) ilarly, 98% of Vuhledarska Rural and 92% of

51 UTILITIES HEALTH 2 INTERNET NETWORK HEATING MOBILE NETWORK RECREATION & LEISURE 66% 41% 46% 53% 17% 19% 5% 4% 38% 15% 23% 16% 16% 14% 7% 13% 6% 1% Neutral Neutral Neutral Comp. dissatisfied Dissatisfied Comp. dissatisfied Dissatisfied Dissatisfied Neutral Comp. dissatisfied Dissatisfied / don’t know / don’t know Comp. dissatisfied / don’t know / don’t know Satisfied Comp. satisfied Satisfied Comp. satisfied / not connected Satisfied Comp. satisfied / not connected Satisfied Comp. satisfied Low quality 88% Too expensive 73% Poor signal 72% Limited choice 93% Regular outages 45% Not adapted to temperature 54% Regular outages 44% Too expensive 14% Too expensive 20% Low transparent tariffs 18% Too expensisve 31% Too far 12%

SEWAGE MANAGEMENT ELECTRICITY GAS PROVISION WASTE MANAGEMENT 25% 34% 1% 73% 56% 24% 29% 26% 11% 45% 33% 6% 2% 1% 18% 10% 3% 2% 1% Neutral Neutral Comp. dissatisfied Dissatisfied Neutral Comp. dissatisfied Dissatisfied Comp. dissatisfied Dissatisfied Comp. dissatisfied Dissatisfied Neutral / don’t know / don’t know / don’t know / don’t know Satisfied Satisfied Comp. satisfied / not available Satisfied Comp. satisfied / not available Comp. satisfied Satisfied Comp. satisfied / not connected Too expensive 50% Too expensive 82% Infrequent collection 61% Inreliable quality 49% Low output 46% Low quality of gas 34% No collection 23% Regular breakdown 44% Regular shortages 45% Low gas pressure 13% Absence of waste sorting options 16% Too expensive 20%

ENVIRONMENTAL CONCERNS

TABLE 23: Top three most commonly reported environmental concerns, by % of HHs

TOTAL Krasnohorivka Kurakhove Rural Kurakhove Urban Kurakhove Mariinka Mariinka Rural Vuhledar Vuhledarska Rural

Water Air pollution Water Spontaneous Water Spontaneous Air pollution (42%) pollution (52%) Air pollution (49%) Air pollution (47%) (78%) pollution (58%) landfills (43%) pollution (11%) landfills (42%)

Water Spontaneous Spontaneous Water pollution Air pollution Water pollution (36%) landfill (35%) landfills (47%) Water pollution (43%) (48%) Air pollution (49%) Air pollution (33%) (10%) pollution (24%)

Spontaneous Air pollution Water pollution Spontaneous Waste production Spontaneous Water Spontaneous landfills (21%) (29%) (28%) landfills (12%) (48%) landfills (10%) pollution (27%) landfills (8%) Air pollution (23%)

UTILITIES 52 TRANPORTS FIGURE 92: Most commonly reported rea- In terms of spending, HHs on average seem sons for dissatisfation, by % of dissatisfied to spend more money on private transports FIGURE 91: HHs satisfaction towards of HHs (360UAH/month) than on public transports transport services 60+56+52+36+22+10 High prices 50% (221UAH/month). Finally, a very low propor- 30% Low quality of roads 44% tion of HHs (9%) reported receiving subsidies 33% for transport. 22% Poor service 42% Irregularity of service 24% 5% 10% Overcrowded transports 17% Ineffective routes Comp. dissatisfied Dissatisfied Neutral 14% / do not use Satisfied Comp. satisfied Figure 93 indicates that the assessed areas, As illustrated in figure 91, almost half of HHs particularly the rural target areas, are not fully (43%) reported being satisfied or completely autonomous and self-sufficient service areas, satisfied with the transportation services avail- since considerably large proportions of HHs able to them. The most commonly reported reported needing to travel to other areas reg- reason for dissatisfaction was high prices, fol- ularly (38% of HHs reported needing to go at lowed by the low quality of roads (figure 92). least once day and 36% on a weekly basis) FIGURE 93: % of HHs by reported frequency of traveling to other settlements during the year prior to data collection, and HHs overall monthly spendings in private transport (red) (all expenses except spendings in public transport), and in public transport (black) Private Public transport transport Kurakhove 2%8% 21% 30% 17% 22% 251UAH /218UAH

Kurakhove Urban 7% 14% 31% 34% 9% 4% 377UAH /208UAH Krasnohorivka 4% 13% 39% 28% 9% 7% 328UAH /220UAH Vuhledar 3% 17% 36% 25% 6% 12% 377UAH /264UAH Marinka 4% 16% 37% 27% 6% 9% 291UAH /219UAH Marinka Rural 7% 26% 32% 22% 4% 8% 247UAH /162UAH Kurakhove Rural 6% 30% 35% 19% 3%7% 527UAH /125UAH Vuhledar Rural 15% 23% 35% 16% 3% 8% 443UAH /280UAH

At least once a day At least once a week At least once a month Several times a year At least once a year Never

53 TRANSPORTS HEALTH 2 MAP 15: Main FUAs of the Mariinka/ Kurakhove target area ANNEX: USING FUNCTIONAL tynivka, which might indicate the absence of a URBAN AREAS AS A UNIT OF strong centre of attraction in between those two.

ANALYSIS AND PLANNING Similarly to the different “service catch- ment” areas that have been emphasized Following the OECD definition1, functional throughout this report (Maps 3,5,7,9,13 and urban areas (FUAs) consist of a densely even Map 14); Vuhledar’s FUA appears to cor- inhabited city and a less densely populated relate quite well with its associated hromada commuting zone whose labour market is Vuhledarska, and on the contrary, Kurakhove’s highly integrated with the city. More specif- FUA extends far beyond its associated hro- ically, all local units with at least 15% of mada administrative boundary Kurakhivska, their employed residents working in a encompassing relatively large urban centres different given city are identified as part such as Maksymilianivka and Krasnohorivka. of the commuting zone of that city and are therefore part of its “functional urban On the other hand, Krasnohorivka and Mari- area”. Loosely based on this definition, for inka, despite their relatively large population this assessment, all settlements where more (respectively 11.500 and 8.771 inhabitants) than 15% of the working HH members were do not appear as attractive for working HH reportedly working in “other settlements” were members as other areas. Service catchment regrouped into targeted FUAs.* Following this, area maps also demonstrated that the pau- it seems that FUAs might be better suited city of infrastructure was a polarizing factor, than administrative areas (city administra- determining the movement of service users tive boundaries) to capture agglomeration towards the Kurakhove agglomeration rather economies as they encompass the full than inside their own hromada. These find- extent of the city’s labor market. ings suggest that the Krasnohorivka/ Mariika hromada do not have the usual services that Map 15 is a visual representation of this are normally (and “functionnaly”) attributed to methodology, applied to the full target a hromada; which might be explained by their area. It appears from a preliminary analysis physical proximity to the “contact line”. that only a few large urban centres are actually attracting working HH members from their sur- roundings; for which “functional urban areas” have therefore been constructed. 1. The EU-OECD Definition of a Functional Urban Area, OECD, Dijkstra, Pelman, Veneri, 2019

The map shows that Vuhledar and Kurakhove * With a methodological limitation: the subset of working are major FUAs and have relatively large com- HH members was generally very small at the settlement muting zones. The two zones overlap in the level, so results indicated in this annex are indicative, area stretching from Uspenivka to Kostian- and serve illustrative purposes only.

ANNEX 54