Submission to the UK Parliament, International Development Committee inquiry: Humanitarian crises monitoring: impact of coronavirus on behalf of the
Gender and Adolescence: Global Evidence (GAGE) Programme
GAGE Programme: Overview
The Gender and Adolescence: Global Evidence (GAGE) is a nine-year (2015-2024) mixed methods longitudinal research and evaluation study funded by the UK aid from the UK government, Department for International Development (DFID), following the lives of 20,000 adolescents in six countries in Africa (Ethiopia and Rwanda), Asia (Bangladesh and Nepal) and the Middle East (Jordan and Lebanon). By combining quantitative and qualitative methods, GAGE is generating evidence on ‘what works’ to enable adolescent girls and boys to emerge from poverty and fast-track social change for young people, their families and communities. It aims to explore what strategies are most effective in transforming girls’ and boys’ lives at specific junctures in adolescence. GAGE results will support policy and programme actors to more effectively reach adolescent girls and boys, by focusing attention on what is needed at sub-national, national and international levels in terms of creating adolescent-responsive systems, services and programming.
While adolescence (10–19 years) is acknowledged to be a critical window of opportunity to accelerate progress against poverty, inequity and discrimination (Patton et al., 2012), it can be particularly fraught for young people displaced through forced migration. Evidence suggests that young people and adolescent girls in particular are especially vulnerable to the multiple deprivations and abuses that occur in conflict-affected settings (UNESCO, 2019; Jones, et. al, 2019).
GAGE research has a strong focus on the most vulnerable adolescents, in line with the Sustainable Development Goals’ (SDGs) commitment to ‘leave no one behind’, and GAGE’s sample includes adolescents who are out of school, refugees, internally displaced (IDPs), have disabilities, are married or divorced, and/or are already parents. GAGE’s conceptual framework takes a holistic approach to understanding what works to support girls’ and boys’ development and particular attention is paid to the ways in which gender norms shape young people’s day-to-day experiences and expose them to different risks and opportunities in six broad domains: education and learning, bodily integrity (including freedom from sexual and gender-based violence, and child marriage), physical and reproductive health and nutrition, psychosocial well-being, voice and agency, and economic empowerment.
The GAGE consortium, managed by the Overseas Development Institute (ODI), includes 35 partner organisations from around the world known for their expertise in research, policy and programming in the fields of adolescence, gender and social inclusion.
The programme is currently undertaking mixed methods (survey and in depth qualitative interview) research by phone and virtual platforms to understand the effects of Covid-19 and related governmental responses in Bangladesh, Ethiopia, Jordan and Lebanon (see Jones et al., 2020 and Malachowska et al., 2020). In Jordan and Lebanon the research includes adolescents living in host communities and refugee camps who were displaced from Syria, as well as stateless Palestinians in Jordan’s Jerash Camp.
GAGE Evidence on COVID-19 in Cox’s Bazar, Bangladesh
As the world responds to the COVID-19 outbreak, the overcrowded conditions of the world’s largest refugee camp in Cox’s Bazar, Bangladesh remain highly exposed to the pandemic. As of 07 May 2020, the World Health Organization (WHO) has confirmed 11,719 COVID-19 cases and 186 related deaths in the country (WHO, 2020) and the Institute of Epidemiology, Disease Control and Research (IEDCR) has confirmed 53 cases in the Cox’s Bazar District (IEDCR, 2020), the area enclosing 32 unregistered Rohingya camps home to nearly 1 million refugees, and impoverished host communities where thousands of vulnerable Bangladeshis reside. Though the scale up of testing capacities has seen documented cases rise, testing remains limited and heavily concentrated in Dhaka thus the magnitude of the virus’ spread is likely to be underreported (Vince, 2020).
GAGE’s previous research in Rohingya camps has found that adolescent girls and boys face multidimensional vulnerabilities including gender- and- age based violence, severed educational prospects for older adolescents specifically, widespread psychosocial distress and worry, and limited health uptake (Guglielmi, et. al, 2020a). In order to inform the Bangladeshi government’s response and that of its humanitarian and development partners in Cox’s Bazar, it is essential to supplement the evidence base with a focus on adolescence, as containment measures will have multi-dimensional effects on young people’s well-being in the short- and medium term. Evidence from past crises (Espey et al., 2010; Harper et al., 2011; 2012; Delamou et al., 2017; Lancet, 2019) shows that in addition to the health effects, we should anticipate a number of other possible impacts, including:
The GAGE Programme has ongoing mixed-methods longitudinal research in Cox’s Bazar, and is uniquely placed to capture COVID-19’s short-run impacts and longer-term concerns with its sample of adolescents aged 10-19.
In Cox’s Bazar, a representative sample of 1,071 Rohingya adolescents living in camps and 1,209 Bangladeshi adolescents living in host communities are currently being telephone surveyed, and a total of 30 adolescents are currently engaged via in-depth qualitative virtual interviews.
Taken together, GAGE’s mixed-methods virtual data collection will aim to understand the knowledge, attitudes and behavioural changes related to COVID-19 of adolescents across the six GAGE capability areas. Measures look at:
GAGE research will aim to contribute to policy and programming firstly by collecting age-and gender-disaggregated data on the impact of COVID-19, to fully grasp the inequitable losses affecting adolescent girls and boys in both the immediate and longer-terms. GAGE will also contribute to policy discourse on expanding social protection packages and shock responses that consider the specific constraints faced by adolescents, including household economic resilience to circumvent reliance on negative coping mechanisms adversely affecting girls and boys (child marriage, permanent school drop-out and disproportionate roles in informal sectors). Finally, GAGE will contribute evidence to programming surrounding virtual educational resourcing and virtual protection, justice and referral mechanisms (including protection from gender-based violence and domestic violence).
Initial findings from real-rime qualitative data collection with Rohingya adolescents underscore that preventative measures enacted to contain COVID-19 in the camps risk adversely impacting adolescent wellbeing. The presence of humanitarian staff has been curbed due to containment measures, posing threats to food distribution, nutritional intake, informal educational provision and livelihood opportunities. GAGE findings indicate that food rations have been decreased and the already limited income-generating opportunities pre-COVID-19, have been indefinitely paused due to lockdown, leaving adolescents and their families with virtually no pocket-cash to top up rationed meals, or other expenses. An 18-year-old married girl explained, ‘We just get rice, they don't give anything else.’, a reality echoed by a 15-year- old boy, ‘We could have three meals per day [before]. But we are worried to have two meals now.’ A 17-year-old girl highlighted that food scarcity is leading to coping mechanisms including evading lockdown, ‘People don't get enough ration for their family. Sometime people sell vegetables secretly in the bazar.’
Adolescent knowledge on COVID-19 appears mixed: while GAGE research found that adolescents largely understand they are meant to remain in their homes and repeatedly wash their hands and bodies with soap and water, there are varying degrees of knowledge about virus symptoms or information on how coronavirus spreads. Some adolescents explained that one’s mouth and nose are meant to stay covered at all times, and handshaking is forbidden to prevent the spread of disease. Others, however, appeared less knowledgeable: ‘We heard that the infected patients will die and the surrounding people will die also. [We can be infected with] Corona from dirt.’ (15-year-old boy). Moreover, GAGE findings reveal that there are increasing worries on seeking health services for other illnesses; ‘Patients aren’t admitted in hospitals now’ described a 17-year old girl.
Lockdown is affecting adolescent boys’ psychosocial wellbeing by severing interaction with their peers, Mosque attendance and leisure time spent playing, as expressed by a 17-year-old boy, ‘We used to go to neighbours’ house. If we can move like before it will feel good.’ Conversely, rigid cultural norms restricting adolescent girls’ mobility once they reach puberty means the lockdown has not altered this aspect of girls’ daily realities; ‘We women work at home just like before. We do household chores, pray and sleep.’ (18-year-old married girl). Police enforcement and, in some cases, brutality – including beatings – for anyone venturing outside the home has instilled fear in the adolescents interviewed.
As GAGE data collection continues through October 2020, results will feature in a variety of outlets with the aim to inform possible programming and policy responses to mitigate long-term impacts of the pandemic on the lives of adolescents. GAGE’s local and international partners will facilitate links with key government, UN and civil society actors at national and district levels.
The GAGE preliminary findings highlight the need for policy and programming to pay specific attention to the risks and opportunities the COVID-19 pandemic brings to the lives of Rohingya adolescents in Cox’s Bazar, Bangladesh, specifically and to consider these age- and gender-specific dimensions in the COVID-19 response in humanitarian settings more broadly. Key priorities include the following:
1. Tailored public awareness efforts: There is a need to invest in widespread awareness-raising campaigns on infection-transmission mechanisms and preventative approaches as well as the timely distribution of safety and hygienic material, with tailored targeting of messages to young people with varying levels of digital and mobile connectivity. Messaging needs to incorporate mitigation strategies against negative perceptions surrounding health uptake for those suffering from non-COVID-19 related illnesses or symptoms.
2. Prioritise formal education, including vocational and skills building programmes, in person where feasible and via TV, radio and online platforms during lockdowns: It is critical that adolescents are able to resume their informal, vocational or skills-based education as soon as conditions permit, and the lifting of restricted telecommunications in the camps and nearby host communities will be an important step in facilitating access to remote learning. We urge the anticipated roll-out of the Myanmar curriculum for grades 6 – 9 in the camps to be prioritized as soon as feasible, as well as the expansion of vocational and skills programming to older-cohort adolescents, including mobile-based teaching for girls who remain restricted in movement.
3. Scale up age- and gender-responsive social protection: In the context of livelihood challenges, it is essential that safety net measures including both cash and food vouchers, are scaled up and delivered in a timely fashion and Food Security partners prioritize the continuation of blanket food assistance to the Rohingya community during the pandemic. Efforts should ensure that married adolescent girls are prioritized as direct beneficiaries, due to their typically low decision-making power, particularly those residing in in-laws’ households.
4. Invest in programming at community level to mitigate against psychosocial distress in the context of the pandemic: Given high levels of stress associated with restricted movement, economic and social challenges as a result of the pandemic, it is important that community-based organizations such as those running girl-friendly safe spaces and adolescent associations, local service providers and religious leaders disseminate information to promote psychosocial resilience. This could include information on support for violence or abuse or avenues for volunteerism.
Guglielmi, S., Jones, N., Muz, J., Baird, S., Mitu, K. and AlaUddin, M. (2020a) ‘Age-and gender-based violence risks facing Rohingya and Bangladeshi adolescents in Cox’s Bazar.’ Policy Brief. London: Gender and Adolescence: Global Evidence.
Guglielmi, S., Jones, N., Muz, J., Baird, S., Mitu, K. and Ala Uddin, M. (2020b) “I don’t have any aspiration because I couldn’t study”: exploring the educational barriers facing adolescents in Cox’s Bazar.’ Policy Brief. London: Gender and Adolescence: Global Evidence.
Guglielmi, S., Jones, N., Muz, J., Baird, S., Mitu, K. and Ala Uddin, M. (2020c) ‘How will my life be?’: Psychosocial well-being among Rohingya and Bangladeshi adolescents in Cox’s Bazar.’ Policy Brief. London: Gender and Adolescence: Global Evidence.
Institute of Epidemiology, Disease Control and Research (IEDCR) (2020). Covid-19 Status Bangladesh. Available: https://www.iedcr.gov.bd/
Jones, N., Gebeyehu, Y., Gezahegne, K, Iyasu, A., Tlahun, K., Workneh, F., and Yadete, W. (2020) ‘Listening to young people’s voices under covid-19. Exploring adolescents’ experiences and priorities in Ethiopia under covid-19.’ Policy brief. London: Gender and Adolescence: Global Evidence.
Jones, N., Devonald, M., and Guglielmi, S. (2019). Leave No Adolescent Behind: the gender- and age- specific vulnerabilities of adolescent refugees and IDPs. Policy Brief. London: Gender and Adolescence: Global Evidence.
Małachowska, A., Al Abbadi, T., Al Amaireh, W., Banioweda, K., Al Heiwidi, S. and Jones, N. (2020) ‘Listening to young people’s voices under covid-19. Exploring the impacts of covid-19 on adolescents in Jordan’s refugee camps and host communities.’ Policy brief. London: Gender and Adolescence: Global Evidence.
Patton, G.C., Coffey, C., Cappa, C., et al. (2012) ‘Health of the world’s adolescents: A synthesis of internationally comparable data’, Lancet 379: 1665–75.
UNESCO (2019). The intersections between education, migration and displacement are not gender-neutral. Global Monitoring Report. Paris: UNESCO
Vince, G. (2020). The world’s largest refugee camp prepares for covid-19. BMJ, 368, m1205. https://doi.org/10.1136/bmj.m1205
WHO (2020). Coronavirus disease 2019 (COVID-19) Situation Report – 108.
.  In Cox’s Bazar, the GAGE study is nested within the Cox’s Bazar Panel Survey (CBPS); a partnership between the Yale Macmillan Center Program on Refugees, Forced Displacement, and Humanitarian Responses (Yale Macmillan PRFDHR), the Gender & Adolescence: Global Evidence (GAGE) programme, and the Poverty and Equity Global Practice (GPVDR) of the World Bank.